Nick Ortiz

Hardy v. Unum – Trial Attorney Wins ERISA Lawsuit Against Unum for Wrongful Termination of Disability Benefits

A Minnesota trial attorney diagnosed with multiple myeloma, sued Unum after the insurer wrongfully terminated his long-term disability benefits. Despite medical records and expert testimony confirming that Hardy’s cancer-related symptoms prevented him from working full-time, Unum relied on file reviews by non-examining physicians to justify the termination. The court found that Hardy remained disabled under the terms of his policy and ordered Unum to reinstate his benefits, pay back benefits, and cover attorney’s fees.

The Appeals Process for Mental Health-Related Long-Term Disability Claims

Navigating the appeals process for mental health-related long-term disability (LTD) claims can be particularly challenging. Unlike physical conditions that can be documented with imaging and lab results, mental health disorders rely on more subjective assessments that insurers often undervalue or dismiss. Insurers may also use various tactics to discredit claims, such as surveillance, relying on …

Seneca v. MetLife – IT Administrator Loses Long-Term Disability Appeal Against MetLife

Jason Seneca, an IT Administrator from Louisiana, filed suit after MetLife terminated his LTD benefits based on a shift to the policy’s stricter “any occupation” definition of disability. Despite support from a treating neurologist, the court upheld MetLife’s decision, finding that medical records in 2019–2020 supported functional ability and that MetLife’s review process was reasonable under ERISA.

Research Scientist Wins Reliance Standard Long-Term Disability Appeal

At the Ortiz Law Firm, we understand how devastating it can be when a disability insurance company unfairly denies your claim for benefits. Recently, we had the privilege of helping a brilliant lead research scientist who was struggling with Lance-Adams Syndrome. This condition caused debilitating tremors, ataxia, and startle-induced myoclonus, resulting in frequent falls and …

How Experience Won a Social Security Disability Hearing

Some hearings require more effort than others, and today’s hearing before an Administrative Law Judge was one of them. It was a case where I really had to work as the claimant’s attorney to help him win the claim, but the effort paid off. The Challenge: A Medical Expert Who “Missed” Key Evidence The hearing …

Sobel v. Sun Life – California Physician Challenges Denial of Long-Term Disability Benefits

A California physician filed an ERISA lawsuit after Sun Life denied his long-term disability claim for chronic fatigue syndrome. Despite multiple medical diagnoses supporting his condition, the insurer cited psychiatric history and lack of conclusive evidence. The court stayed the case and remanded it for further review, ordering a neuropsychiatric evaluation and a comprehensive reassessment of all medical records.

How Long Does A Long-Term Disability Appeal Take?

When filing a long-term disability (LTD) appeal, many people ask: “How long will it take?” Unfortunately, the answer is “it depends.” There are two main phases to the appeal timeline: We’ll break down what happens in each phase—and why the entire process can take several months or more. Phase 1: Preparing the Appeal Under ERISA, …

New York Life’s Independent Medical Reviews and How to Respond

When appealing a long-term disability (LTD) claim denial with New York Life, the employee reviewing your LTD claim may not be a medical professional, but they will likely consult with one. New York Life (NYL) will often ask an independent physician to re-evaluate a claimant’s medical condition and determine if it is consistent with the …

Navigating Lincoln Financial’s Long-Term Disability Appeals Process: Responding to Independent Physician Reviews

When appealing a long-term disability (LTD) claim denial with Lincoln Financial Group, claimants often encounter an independent physician review. Lincoln, like many other insurance companies, uses these independent reviews to re-evaluate a claimant’s medical condition and determine if it is consistent with the reported functional limitations. Here, we’ll explore Lincoln’s physician reviews, including what to …

What The Standard’s Acquisition Of Elevance Health’s Life & Disability Business Means For Disability Claimants

On April 1, 2024, The Standard announced the completion of its acquisition of the Life & Disability business of Elevance Health. Elevance Health is the parent company of Anthem. This move marks a significant expansion of The Standard’s presence in the employee benefits marketplace, particularly in the areas of life and disability insurance. While the …

King v. Reliance Standard – Indiana Court Sides with Claimant in ERISA Disability Benefits Dispute

In King v. Reliance Standard Life Insurance Company, the insurer failed to issue a timely decision or seek an extension within the 45-day deadline for reviewing Megan King’s appeal of her terminated long-term physical disability benefits. Under the Department of Labor’s regulations, this failure allowed King to consider her claim “exhausted” and file suit.

Long-Term Disability Benefits For Google Employees

Working at Google offers many rewards, but it also comes with high expectations and unique challenges. Google employees are expected to be innovative, adaptable, and consistently deliver top results in a fast-paced environment. Whether you’re a software engineer, a project manager, or part of Google’s extensive support teams, these responsibilities can take a toll over …

$150 Thousand In Potential Future LTD Benefits Recovered For Former Claims Adjuster With Fibromyalgia

We recently had the privilege of representing a former claims adjuster for an insurance company who faced an overwhelming array of health issues. Her life was deeply affected by chronic severe pain and a series of debilitating conditions, including osteoarthritis, fibromyalgia, and complications following breast cancer, among others. Lincoln National Cut Off Long-Term Disability Benefits …

Watson v. Reliance Standard – Illinois Social Worker Wins Long-Term Disability Case

Cheryl Watson, a licensed clinical social worker and research coordinator at the Hektoen Institute, faced an uphill battle to secure long-term disability benefits. After years of enduring fatigue, cognitive difficulties, pain, and other symptoms, Watson stopped working in March 2013. Diagnosed with conditions including fibromyalgia, chronic fatigue syndrome, and degenerative spinal problems, she applied for …

UnitedHealth Group Account Executive Wins Hartford Disability Appeal

At the Ortiz Law Firm, we recently had the honor of helping a dedicated Account Executive for UnitedHealth Group who was wrongfully denied long-term disability benefits by The Hartford. Our client had been unable to work for several years, due to numerous debilitating conditions, including ongoing pain from bilateral hip replacements, osteoarthritis, lumbar spondylosis, advanced …

Ortiz Law Firm Recovers $485,000 In Disability Benefits For HEB Employee

I recently had the privilege of representing a 53-year-old client who previously worked as a production meat packer at HEB, Inc. She faced many serious health challenges that made it impossible for her to continue working. Her medical conditions included kidney failure, chronic pain in multiple joints, neuropathy in both arms and legs, osteoarthritis in …

Olah v. Unum – A Clinical Research Associate’s Battle for Disability Benefits

Lori Olah, a clinical research associate, was initially approved for long-term disability benefits following spinal surgery. However, Unum terminated her benefits less than a year later, citing medical reviews that claimed she could perform sedentary work. Despite Olah’s appeal and supporting evidence from her treating physician, the court upheld Unum’s decision, finding it was not arbitrary or capricious under ERISA standards.

What Happens If A Disability Insurance Company Ignores My Long-Term Disability Appeal?

When a disability insurance company ignores your long-term disability (LTD) appeal, it can be both frustrating and legally problematic. The appeals process is designed to give claimants a fair chance to challenge a denial, and insurance companies are legally obligated to respond to these appeals in a timely manner under most LTD policies and federal …

Ortiz Law Firm Wins Guardian Long-Term Disability Insurance Appeal

When Guardian Life abruptly terminated one of our client’s long-term disability (LTD) benefits, we knew we had a fight on our hands. Her case illustrates the importance of challenging insurers who unfairly deny claims based on benefit limitations for mental and nervous conditions—and why having experienced legal representation can make all the difference. Our Client’s …

Is My Church-Affiliated Disability Insurance Plan Covered By ERISA?

If you have a disability insurance plan through your church or a religiously affiliated organization, you may be wondering if it’s covered by the Employee Retirement Income Security Act (ERISA). Understanding whether ERISA applies to your plan is important because it can affect how claims are handled, your rights under the plan, and your legal …

Ortiz Law Firm Helps Client Recover Long-Term Disability Benefits From Lincoln

At the Ortiz Law Firm, we understand how devastating it can be to face a denial of long-term disability (LTD) benefits when you’re already battling significant health challenges. One of our recent cases is a testament to our unwavering commitment to helping clients secure the benefits they deserve. The Challenge Our client, a former data …