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Ortiz Law Firm | National Disability Law Firm
Ortiz Law Firm is dedicated to helping people recover the disability benefits they deserve. We handle group Long Term Disability (LTD) claims, individual disability insurance policy claims, ERISA disability claims, and Social Security Disability claims.
When it comes to long-term disability (LTD) insurance, it’s important to understand the difference between total and residual disability. These two concepts can significantly impact your insurance benefits and coverage. In this article, we’ll take a closer look at what each term means and how they affect your insurance policy. What Is Total Disability? Total …
Insurance companies often use “boilerplate” language when denying a long-term disability claim. Boilerplate language refers to a long-term disability denial letter that uses standard, pre-written language or a generic explanation rather than a detailed explanation specific to the individual’s claim. Boilerplate denials are often generic and do not provide specific information to explain why the …
This is a continuation from Long-Term Disability Policy Provisions – Part I. Long-Term Disability Insurance – The “Maximum Benefit Period” Almost all long-term disability policies stop paying benefits when you turn 65 years old, or when you reach the federal retirement age. This is often referred to as the “maximum benefit period.” Your policy should …
Your long-term disability (LTD) insurance policy probably reads like most insurance policies, meaning that it is long, confusing and full of industry-specific terms of art that you will most likely have a hard time understanding unless you are a lawyer or insurance professional. In this article, I will explain some of the most important provisions …
A question we often hear is “Can I file for disability if I have a pending Jones Act Maritime Injury Case?” The short answer is – yes, you can apply for disability benefits while your Jones Act case is ongoing. Offshore workers can apply for disability benefits while a Jones Act claim is pending. Applying …
Social Security Disability Insurance (SSDI) back pay or retroactive benefits are lump sum payments that cover the benefits you were entitled to but did not receive while waiting for your application to be approved. It can be a significant amount of money and is a welcome relief for many struggling to make ends meet while …
If you’re looking into long-term disability (LTD) insurance, you may have come across the term “elimination period.” This is an important concept to understand as it can affect when you will receive benefits if you become disabled. In this article, we will explain what the elimination period in a long-term disability claim is and how …
You should not assume that the insurance carrier will continue to pay benefits indefinitely once your long-term disability claim is approved. Your disability insurance policy may state that benefits are payable until you reach retirement age. However, it does not guarantee that you will automatically continue to be eligible to receive benefits until then. Disability …
Applying for Social Security Disability benefits can feel overwhelming. One of the most important steps in the process is your interview with the Social Security Administration (SSA). What you say during this conversation can significantly impact how your claim is evaluated. Most people focus on what they should say. But just as important is knowing …
Social Security Disability Insurance (SSDI) is a government program that provides financial support to individuals who are unable to work due to a disabling condition. However, applying for and receiving SSDI benefits can be a complicated and challenging process, which is why many individuals turn to Social Security disability advocates for help. The Role of …
If you’re unable to work due to a disabling condition, you may be eligible for long-term disability (LTD) benefits. However, obtaining these benefits is often a complex and challenging process. One of the key factors that can affect your chances of getting approved for long-term disability benefits is the medical evidence that you submit with …
In Paquin v. The Prudential Insurance Company of America, the claimant won reinstatement of his long-term disability (LTD) benefits after the United States District Court for the District of Colorado found that Prudential abused its discretion by terminating a claim it had already paid for nearly 11 years, based on a single contested neuropsychological test. …
Laverne Robinson, a former utility machine operator, sued Aetna Life Insurance Company after her benefits were terminated. Aetna argued Robinson hadn’t been approved for Social Security Disability within the Plan’s 24-month window for continued long-term disability (LTD) benefits — even though the SSA later retroactively awarded her SSDI for that same period. The court ruled …
If you’ve filed a Social Security disability claim and are headed to a hearing before an Administrative Law Judge (ALJ), it’s essential to be prepared. Knowing what to say and what not to say can make a significant difference in the outcome of your case. In this article, we’ll explore some common mistakes claimants make …
You may be here because either your Administrative Law Judge or the Department of Disability Services (DDS) arm of the Social Security Administration (SSA) has scheduled an appointment for you to see one of their doctors, either a medical doctor or psychologist. These are commonly called Consultative Examinations (CE) or Medical Examinations (ME). Refer to …
The claimant received two years of long-term disability benefits before Unum terminated the claim under the policy’s mental health limitation, arguing that his chronic pain didn’t amount to an independent physical disability. The court sided with Unum, ruling that the claimant failed to prove chronic pain alone left him unable to perform any gainful occupation. …
If you’re applying for long-term disability insurance, you may be required to apply for Social Security disability benefits along with your LTD claim. You may even be offered the services of companies like Allsup and Advantage 2000 to assist with your claim. However, as a knowledgeable ERISA long-term disability and Social Security disability attorney, I …
After suffering a stroke at work, Gregg Arenson argued that resulting cognitive impairment left him unable to perform his prior job duties, but Unum denied his long-term disability (LTD) claim, concluding his testing didn’t show a disqualifying impairment. Applying the deferential arbitrary-and-capricious standard of review, the court sided with Unum, finding its reliance on multiple …
Unum stopped paying Susan Moseley’s long-term disability (LTD) benefits under her policy’s mental illness limitation, but the court found that Unum’s failure to order an independent medical examination before terminating her claim was itself an abuse of discretion — regardless of the underlying dispute over her Lyme disease diagnosis. The court remanded the case, ordering …
The Social Security Administration maintains all Social Security disability claim files in an electronic format. The instructions below will walk you through the process of obtaining and opening an encrypted CD from the SSA. How Do I Get a Copy of My Social Security Disability File? A claimant and/or an authorized representative has the right …
Jonni Marselle sued Unum in state court alleging breach of contract after it denied her long-term disability (LTD) claim, but Unum removed the case to federal court since the policy qualified as an ERISA plan. The court denied Marselle’s motion to reverse the denial, finding Unum’s decision was the product of a reasoned, well-documented process …
Caroline Foss argued that workplace-specific stress at Boston College left her unable to do her job, but Standard Insurance Company denied her long-term disability claim, concluding her policy’s “normal occupation” standard asks whether she could perform that type of job for any employer — not just her specific workplace. Applying the deferential arbitrary-and-capricious standard, the …
If your impairment does not meet or equal an impairment listing, the Social Security Administration’s medical-vocational or Grid rules come into play. SSA Grid rules may help disability applicants who are 50 years old or older get approved for Social Security disability benefits if they do not have helpful job skills or the job skills …
Ms. Fowkes does not contend the Plan’s written evidence requirement violates ERISA. Instead, she takes issue with MetLife's procedures to evaluate her LTD claim. In particular, she contends MetLife required her to present “objective evidence” supporting her LTD claim. At the hearing, she argued that MetLife did not consider the cumulative effect of her conditions in determining whether she adequately established disability. MetLife contends subjective reports of pain need not be taken at face value and argued at hearing that no disability is established even when considering Ms. Fowkes’s conditions in combination.