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Home | Disability Law Blog | Page 15

Disability Law Blog

Senegal v. Reliance Standard – Court Remands Case For Further Review

January 7, 2021 // by Nick Ortiz

Reliance Standard paid Tommy Senegal’s long-term disability (LTD) benefits for over two years before terminating them, concluding his medical records showed he could perform sedentary work despite an administrative law judge’s earlier finding that he was totally disabled. The court remanded the case back to Reliance Standard for reconsideration, citing several gaps in its review …

Read moreSenegal v. Reliance Standard – Court Remands Case For Further Review
Category: Disability Case Summaries
Tags: Reliance Standard

Donlick v. Standard – Claim Denial Was Not Arbitrary And Capricious

January 6, 2021 // by Nick Ortiz

Standard Insurance Company approved Donlick’s long-term disability (LTD) benefits after a motorcycle crash left her with a below-knee amputation, but terminated them after 24 months under the policy’s “any occupation” standard — a decision the court upheld, finding it was based on a thorough medical and vocational record rather than arbitrary reasoning. Case at a …

Read moreDonlick v. Standard – Claim Denial Was Not Arbitrary And Capricious
Category: Disability Case Summaries
Tags: The Standard

Diaz v. Liberty Life – Court Rules LTD Claim Denial Was Supported

January 6, 2021 // by Nick Ortiz

Diaz sought long-term disability (LTD) benefits for chronic neck and back pain, muscular spasms, and adjustment disorder following a work-related car accident, but Liberty Life Assurance Company of Boston denied the claim for lack of sufficient supporting evidence. The court upheld the denial, finding Liberty reasonably discounted Diaz’s functional capacity evaluation and that the record …

Read moreDiaz v. Liberty Life – Court Rules LTD Claim Denial Was Supported
Category: Disability Case Summaries
Tags: Liberty Mutual

Deroo v. Unum – Court Rules Job Suitable For Claimant Doesn’t Exist

January 6, 2021 // by Nick Ortiz

Unum paid Deroo’s long-term disability (LTD) benefits for years before terminating them, concluding she could work as a Nurse Triage or Medical Claims Review Nurse instead. The court sided with Deroo, ruling that no suitable job actually existed that would let her elevate her leg as frequently as her lymphedema required. Case at a Glance …

Read moreDeroo v. Unum – Court Rules Job Suitable For Claimant Doesn’t Exist
Category: Disability Case Summaries
Tags: Unum

Counts v. United Of Omaha – Court Rules United Of Omaha Must Pay Benefits

January 6, 2021 // by Nick Ortiz

United of Omaha denied both Counts’s short-term and long-term disability claims for chronic low back pain and related spinal conditions, concluding the medical documentation didn’t support her restrictions. The court disagreed, ruling that Counts met every element of the policy’s disability definition and was entitled to both short- and long-term benefits, leaving United to calculate …

Read moreCounts v. United Of Omaha – Court Rules United Of Omaha Must Pay Benefits
Category: Disability Case Summaries
Tags: Mutual of Omaha

Conner v. Sedgwick – Court Finds Claim Denial Was Reasonable And Supported

January 6, 2021 // by Nick Ortiz

Sedgwick terminated Conner’s long-term disability (LTD) benefits after a functional capacity evaluation and transferable skills analysis concluded she could work in alternative nursing roles, despite her argument that medication side effects left her unable to work any job. Although the court initially remanded the case for Sedgwick to more thoroughly evaluate her medication-related claims, it …

Read moreConner v. Sedgwick – Court Finds Claim Denial Was Reasonable And Supported
Category: Disability Case Summaries
Tags: Sedgwick

Benson v. Hartford – Court Affirms Hartford LTD Claim Denial

January 6, 2021 // by Nick Ortiz

Hartford denied Benson’s long-term disability (LTD) claim, concluding he wasn’t disabled throughout the full elimination period tied to his knee replacement recovery — despite Benson’s argument that fatigue and pain from polymyalgia rheumatica also disabled him. The court affirmed the denial, finding Hartford’s decision wasn’t “wrong” under the deferential Blankenship framework, since Benson’s own treating …

Read moreBenson v. Hartford – Court Affirms Hartford LTD Claim Denial
Category: Disability Case Summaries
Tags: Hartford

How to Improve Your Chances of Getting Long-Term Disability Benefits

January 6, 2021 // by Nick Ortiz

In a perfect world, anyone who suffers from a physical or emotional disability would have the resources to seek treatment and provide for themselves without supplemental income. But since we live in the real world, many people struggle to make ends meet during a period of disability. Long-term disability (LTD) insurance is supposed to provide …

Read moreHow to Improve Your Chances of Getting Long-Term Disability Benefits
Category: Your Chances of Getting Approved for Disability Benefits

Own Occupation vs. Any Occupation In Disability Insurance Claims

January 5, 2021 // by Nick Ortiz

The Definition of Disability One of the most important things to know is how disability is defined in your policy. Whether you have an employer-provided group policy or an individual policy, there are significant differences in the definitions of disability. Understanding these differences is crucial for filing successful long-term disability claims. In this article, we …

Read moreOwn Occupation vs. Any Occupation In Disability Insurance Claims
Category: Long-Term Disability

Independent Medical Exams In Long-Term Disability Claims

January 5, 2021 // by Nick Ortiz

What Is an Independent Medical Examination? An independent medical examination (IME) is an exam performed by a medical professional not currently associated with your case. However, we don’t like using the term “independent” when referring to a medical examination ordered by a disability insurance company.  The word independent is in quotes because we do not …

Read moreIndependent Medical Exams In Long-Term Disability Claims
Category: Medical Eligibility for Long-Term Disability

Why Are Long-Term Disability Denials So Common After Two Years?

December 28, 2020 // by Nick Ortiz

Many people on long-term disability worry about whether they will continue to receive benefits beyond the two-year mark, and for a good reason: Long-term disability denials are common after two years because most disability insurance policies change the definition of disability or will no longer pay benefits for certain conditions after benefits have been payable …

Read moreWhy Are Long-Term Disability Denials So Common After Two Years?
Category: Long-Term Disability Denials and Appeals

Why Most Long-Term Disability Appeals Suck!

October 1, 2020 // by Nick Ortiz

When most people file a long-term disability appeal, it is a really basic, one or two-paragraph appeal letter that says, “Look, long-term disability insurance company. I really think you got this one wrong. I think there is more than enough evidence to support my long-term disability claim. I want you to go back, take another …

Read moreWhy Most Long-Term Disability Appeals Suck!
Category: Long-Term Disability Denials and Appeals

Should I File An Optional Long-Term Disability Appeal?

July 23, 2020 // by Nick Ortiz

If your disability insurance company has denied or terminated your long-term disability claim, you should review your insurance policy to familiarize yourself with your appeal rights and requirements. Specifically, you should determine how many appeals you have the right to or are required to file before you can file a lawsuit against your insurer. Most …

Read moreShould I File An Optional Long-Term Disability Appeal?
Category: Long-Term Disability Denials and Appeals

What The SSA Won’t Tell You About Applying For Social Security Disability

July 21, 2020 // by Nick Ortiz

When you apply for Social Security Disability Insurance benefits (DIB, also called SSDI or RSDI), Social Security does not tell you that you can (or should) hire a Social Security disability attorney to assist you in your claim. You Have The Right To Representation From The Beginning Many claimants know they can hire an attorney …

Read moreWhat The SSA Won’t Tell You About Applying For Social Security Disability
Category: Social Security Disability

A Closed Period Of Benefits In Social Security Disability Claims

July 21, 2020 // by Nick Ortiz

A “closed period” of benefits may be appropriate in Social Security disability claims where the claimant’s impairment has lasted for a continuous period of at least 12 months but improves to the point where the claimant is no longer disabled at the time the claim is ultimately decided (in other words, at the time of …

Read moreA Closed Period Of Benefits In Social Security Disability Claims
Category: Social Security Disability

Understanding The Treating Physician Rule In Social Security Disability Claims

July 21, 2020 // by Nick Ortiz

Previously, the “Treating Physician Rule” provided that substantial weight should be given to the impairment opinions given by a treating doctor in a Social Security Disability Insurance claim. However, starting March 27, 2017, the Social Security Administration (SSA) will no longer prioritize the opinions of your personal doctors. Instead, these opinions will be considered equally …

Read moreUnderstanding The Treating Physician Rule In Social Security Disability Claims
Category: Social Security Disability

The Five-Step Sequential Evaluation Process: How the SSA Determines Disability

July 21, 2020 // by Nick Ortiz

Applying for Social Security Disability benefits can feel overwhelming. The process is complicated, and many people are unsure why their claim was denied or delayed. To make decisions, the Social Security Administration (SSA) uses a five-step evaluation process. This process is outlined in the federal regulations at 20 C.F.R. § 404.1520. Understanding these steps can …

Read moreThe Five-Step Sequential Evaluation Process: How the SSA Determines Disability
Category: Social Security Disability Basics

Submitting New Evidence To The Appeals Council

July 21, 2020 // by Nick Ortiz

The Appeals Council is the final level of administrative appeal following an unfavorable decision from an Administrative Law Judge (ALJ) in Social Security disability claims. Sometimes, evidence may not reach the ALJ before your hearing. Fortunately, you can still submit new evidence to the Appeals Council, provided the following conditions are met: Over time, the …

Read moreSubmitting New Evidence To The Appeals Council
Category: Social Security Disability

Speaking Engagements

July 21, 2020 // by Nick Ortiz

Currently Scheduled Speaking Engagements Nick Ortiz is not currently scheduled for any future speaking engagements. If you would like to contact Mr. Ortiz about giving a presentation to your group or organization, please contact the Ortiz Law Firm at (888) 321-8131. Previous Speaking Engagements “Handling A Social Security Disability Case”, March 28, 2011, for the …

Read moreSpeaking Engagements
Category: News

Speaking Engagement With The National Alliance On Mental Illness (NAMI) Pensacola

July 21, 2020 // by Nick Ortiz

NAMI Pensacola Speaking Engagement I just want to give a big thanks to NAMI Pensacola, our local chapter of the National Alliance on Mental Illness, for allowing me to speak to your group last night. I spoke about the basics of Social Security disability benefits and how mental illnesses may qualify for Social Security Disability Insurance …

Read moreSpeaking Engagement With The National Alliance On Mental Illness (NAMI) Pensacola
Category: News

Social Security Disability Claims With A Criminal Record

July 21, 2020 // by Nick Ortiz

I have seen other attorneys post that a criminal background will not keep a claimant from receiving Social Security disability benefits as long as the claimant does not have an outstanding felony warrant. This is mostly correct. However, there is one additional “felony impairment” rule: a claimant cannot receive Title II Disability Insurance benefits if …

Read moreSocial Security Disability Claims With A Criminal Record
Category: Social Security Disability

Social Security Comic Book About Disability From 1965!

July 20, 2020 // by Nick Ortiz

During the 1950s and1960s, the Social Security Administration published comic books relating to Social Security disability benefits and other Social Security issues in an effort to reach the younger individuals. Apparently, Social Security representatives recognized that comic books were an effective method of communicating with the youth of those days. Here is an excerpt relating …

Read moreSocial Security Comic Book About Disability From 1965!
Category: Social Security Disability

Overview Of Rules And Requirements To Get Social Security Disability

July 20, 2020 // by Nick Ortiz

The rules and requirements to qualify for Social Security disability cases are relatively straightforward. In short, to be eligible for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits, a claimant must satisfy both the medical and non-medical (financial) requirements for benefits. You should apply for benefits as soon as you …

Read moreOverview Of Rules And Requirements To Get Social Security Disability
Category: Social Security Disability Basics

A Response To The National Review’s Attack On Binder And Binder

July 20, 2020 // by Nick Ortiz

Today, the National Review published a partisan attack on the organization Binder & Binder and collaterally on the Social Security Disability system of benefits in an article titled Binder on Binder & Binder. Notice that I called Binder & Binder an organization, not a law firm. This is by choice, as it is not really …

Read moreA Response To The National Review’s Attack On Binder And Binder
Category: Social Security Disability
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