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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.

Disability Law Blog

Halleron v. Reliance Standard – Baptist Healthcare Physician’s LTD Claim Sent Back for Full Review After Flawed Denial

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Dr. April Halleron, a Kentucky physician, filed for STD and LTD benefits due to disabling symptoms from POTS. Reliance Standard denied both claims, citing a pre-existing condition exclusion for STD and lack of evidence for LTD. The court found both denials procedurally flawed and arbitrary, especially for failing to consider her treating physician’s opinion. The case was remanded for a full and fair review under ERISA.

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Ortiz Law Firm Helps Client Recover Denied LTD Benefits After Cardiac Arrest and Brain Injury

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Our client’s life changed drastically in June 2022, when he suffered cardiac arrest that led to an anoxic brain injury. As a result of his condition, he could no longer work. He filed a claim for long-term disability (LTD) benefits with Mutual of Omaha, and the insurance company initially approved the claim, paying benefits for …

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Ward v. Reliance Standard – Maryland Engineer Wins Long-Term Disability Lawsuit

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When Reliance Standard terminated Christine Ward's benefits in 2022, citing insufficient evidence, Ward challenged the decision. The court found Reliance failed to properly evaluate her cognitive limitations and lacked substantial evidence to support its decision.

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How Long-Term Disability and Workers’ Compensation Benefits Interact

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If you’re unable to work because of an illness or injury, you may be eligible for more than one type of benefit. Two of the most common are long-term disability (LTD) insurance and workers’ compensation (WC). While it’s possible to get both, it’s important to understand how these benefits work together and how one can …

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Do I Automatically Get Long-Term Disability If I’m Approved For Short-Term Disability?

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Being approved for short-term disability (STD) does not automatically mean you’ll be approved for long-term disability (LTD). While the two benefits are often linked, especially if they’re offered by the same insurance company, there are important differences in how they’re evaluated. Here’s what you need to know: 1. Separate Applications and Reviewers Even if you’re …

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Mercer v. Unum – Tennessee Nurse Practitioner Denied Long-Term Disability for Failure to Prove Continuing Disability

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Mercer filed for long-term disability due to chronic conditions including fibromyalgia and chronic fatigue syndrome. Unum denied her claim, arguing she was not continuously disabled during the plan’s 180-day elimination period. Although Mercer submitted strong support from her doctors and a vocational expert, the court upheld Unum’s denial, finding it reasonable under ERISA’s “arbitrary and capricious” standard.

Read moreMercer v. Unum – Tennessee Nurse Practitioner Denied Long-Term Disability for Failure to Prove Continuing Disability
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Case Study: Engineer with TBI Wins LTD Appeal with MetLife

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Our client, a senior principal electrical engineer, had dedicated his career to solving complex problems in a demanding technical field. However, after he suffered a traumatic brain injury (TBI) and developed post-concussion syndrome, memory loss, and additional complications, including edema, a Factor V Leiden mutation, ADHD, and anxiety and depression, he was unable to continue …

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Do Short-Term Disability Insurance Policies Have Pre-Existing Condition Exclusions?

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When shopping for or reviewing disability insurance, one important clause to understand is the “pre-existing condition exclusion.” This clause can significantly impact your ability to collect benefits if your disability is related to a medical condition you had before your coverage began. But here’s the key distinction: while pre-existing condition exclusions are common in long-term …

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Pensacola International Airport Launches Hidden Disabilities Sunflower Program: A Win for Invisible Disability Awareness

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Starting June 2, 2025, Pensacola International Airport (PNS) is rolling out a new initiative that could make travel significantly more accessible for individuals living with invisible disabilities. The airport has officially joined the global Hidden Disabilities Sunflower Program, a voluntary system that helps travelers who may need additional time, support, or understanding while navigating the …

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Claiming Social Security Disability and Workers’ Compensation Benefits

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If you’ve been seriously injured or developed a long-term medical condition that prevents you from working, you may qualify for both Social Security Disability Insurance (SSDI) and workers’ compensation (WC) benefits. While you may be able to get both at the same time, there are important rules about how these benefits work together and how …

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Sami v. Guardian – Florida Shipping Supervisor Wins ERISA Remand After Guardian Failed to Provide Full and Fair Review

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Hari Sami, a Florida shipping supervisor, sued Guardian after it terminated his long-term disability benefits without giving him an opportunity to respond to critical medical reviews. The court ruled that Guardian violated ERISA by failing to provide those reports in advance of its final denial. As a result, the case was remanded for further review, giving Sami another chance to prove his ongoing disability.

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How Insurers Misinterpret Medical Evidence to Deny Long-Term Disability Claims

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For many professionals, a disabling chronic illness brings more than just physical symptoms. It upends your career, your routines, and your sense of identity. You’ve spent years building your professional life, only to be sidelined by a medical condition that makes full-time work impossible. When you file a claim for long-term disability (LTD) insurance benefits, …

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How to Get a Supportive Medical Statement for Your Disability Claim

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When you’re filing a disability claim for Social Security Disability (SSD) or Long-Term Disability (LTD) a supportive statement from your treating physician can make all the difference. But what happens if your doctor is reluctant to get involved? It’s a common hurdle, and one that can often be overcome with the right approach and the …

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Stroke Survivor Wins Back Long-Term Disability Benefits After Wrongful Denial by New York Life

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A 61-year-old former general manager for Chuck E. Cheese’s life was turned upside down when he suffered a serious stroke. The stroke left him with right-sided weakness (hemiparesis), clumsiness, sensory loss, balance problems, memory issues, near-syncopal episodes, and fatigue. These impairments made it impossible for him to continue working. At first, New York Life acknowledged …

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Should You Accept a Buyout Offer from Unum on Your Long-Term Disability Claim?

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If you’re receiving long-term disability (LTD) benefits from Unum, you may eventually receive a buyout offer, which is a lump sum payment in exchange for giving up future monthly benefits. It may seem like a good deal on the surface, but there’s a lot to consider before you say yes. What Is a Long-Term Disability …

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Case Study: How We Helped a Digital Coach Secure LTD Benefits After a Sedgwick Denial

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At the Ortiz Law Firm, we know that navigating the complexities of disability claims can be overwhelming, especially when insurance companies deny benefits due to a lack of so-called “objective evidence.” A recent case illustrates the challenges our client faced and how we stepped in to help her secure the benefits she rightfully deserved. The …

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Understanding Sun Life’s Independent Physician Reviews

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If your long-term disability (LTD) claim has been denied by Sun Life, one of the most critical parts of the appeals process may involve an “independent” physician review. While this may sound like an objective second opinion, the process is often anything but neutral. In reality, these reviews can be a significant hurdle in securing …

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Can I Collect Long-Term Disability Benefits If I Live Outside the United States?

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In 2016, the Association of Americans Resident Overseas estimated that there were 8.7 million U.S. citizens were living abroad, and the Social Security Administration reported that more than half a million people living outside the United States receive some type of Social Security benefit, including Social Security Disability Insurance benefits. Although disability insurance companies do not typically publish …

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Eggleston v. Unum – Florida Nurse Loses Disability Benefits Appeal Against Unum Despite Years of Chronic Pain

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Yvette Eggleston, a nurse from Florida, lost her long-term disability appeal against Unum after the insurer terminated her benefits based on social media activity and a reassessment of her chronic pain conditions. Despite support from multiple treating doctors and a functional capacity evaluation showing she couldn’t sit or stand for long periods, the court ruled in Unum’s favor. It found the decision was not arbitrary or capricious under ERISA standards.

Read moreEggleston v. Unum – Florida Nurse Loses Disability Benefits Appeal Against Unum Despite Years of Chronic Pain
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Can I Quit My Job While on Long Term Disability?

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Many long-term disability (LTD) recipients remain “employed” with their employer, perhaps listed as an “inactive employee”. But let’s say there has not been a formal separation either by resignation or termination. Can one “quit” the job while receiving long-term disability benefits? Yes, you can quit your job while on LTD benefits, but it’s important to …

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Ortiz Law Firm Helps Systems Engineer Recover Long-Term Disability Benefits from MetLife

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At the Ortiz Law Firm, we recently had the privilege of helping a client who had been unfairly denied his long-term disability (LTD) benefits. Our client became disabled due to a combination of debilitating medical conditions, including long COVID syndrome with shortness of breath and dizziness, chronic fatigue syndrome, chronic migraines, dyspnea on exertion, cervical …

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Your Long-Term Disability Appeal May Be Your Only Chance to Submit New Evidence

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Many people assume that if their long-term disability (LTD) appeal is denied, they can simply take the insurance company to court and present all the evidence they didn’t get to include earlier. Unfortunately, that’s not how it works under the law that governs most group LTD policies: ERISA, which is short for the Employee Retirement …

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Understanding Long-Term Disability Reviews: Why Your LTD Benefits Aren’t Guaranteed Forever

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When an insurance company approves a long-term disability (LTD) claim, many claimants assume that their benefits will continue indefinitely into the future. However, insurers are not required to approve benefits forever. Instead, they conduct periodic reviews to determine whether a claimant still meets the policy’s definition of disability. Understanding how and why these reviews occur …

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Peer Review Reports In Long-Term Disability Claims and Appeals

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If your long-term disability (LTD) claim has been denied, there’s a good chance that a “peer review report” played a role in that decision. Understanding what these reports are and how they’re used can help you make sense of the denial letter you received and decide what to do next. What Is a Peer Review …

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