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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.
Douglas Domino, Sr., a commercial truck driver in Louisiana, filed a lawsuit against Guardian Life Insurance Company after being denied long-term disability benefits. The court upheld Guardian's decision, agreeing that Domino was not in active full-time service due to an extended medical leave.
Lincoln Life denied a claimant’s long-term disability (LTD) benefits after nearly a decade of consistent approvals, prompting a federal court to send the case back for a full redo. The court found the insurer failed to account for all relevant medical evidence and questioned why prior approvals suddenly reversed without a meaningful change in her …
I’ve had the privilege of helping many claimants appeal unjust long-term disability claim denials. One such case that stands out involves a claimant who had dedicated years to his role in management at JP Morgan Chase Bank. Unfortunately, he developed severe exertional and non-exertional conditions that severely affected his ability to work, especially given the …
I am pleased to share another recent success story where we helped a deserving client recover her long-term disability benefits after an unjust denial in her long term disability insurance claim. As the owner and founder of the Ortiz Law Firm, I find it immensely rewarding to see justice served and to assist individuals in …
As a long-term disability attorney, I have seen firsthand the difficulties individuals face when insurance companies unfairly deny their long-term disability benefits. I would like to share with you a case in which we successfully recovered MetLife long-term disability benefits for a claimant in Texas. This case not only highlights the complexities of disability claims …
A project manager’s long-term disability (LTD) benefits were capped at 24 months after Unum classified his cognitive impairment as falling under the policy’s mental illness limitation. The court sided with Unum, finding that the evidence — including opinions from Gill’s own treating physicians — did not establish that his cognitive deficits were independent of his …
I recently had the privilege of representing a client whose long-term disability (LTD) benefits were wrongfully terminated after ten years of receiving monthly benefits. Our client, a 62-year-old from Rhode Island, had previously thrived in a highly demanding cybersecurity role as a data security specialist. However, because of severe and progressively worsening health conditions, they …
A social worker’s long-term disability (LTD) claim for chronic fatigue syndrome was denied by Hartford and upheld by both the federal district court and the court of appeals. Independent reviewers concluded her fatigue was more likely tied to pre-existing psychiatric conditions than to a separate physical impairment, and both courts found Hartford’s review process reasonable …
Sandra Mucciacciaro filed suit against Hartford Life and Accident Insurance Company after it denied her long-term disability (LTD) claim. Both parties filed cross-motions for summary judgment, and the case was decided in the U.S. District Court for the District of New Jersey. The disability plan at issue was governed by ERISA. At the center of …
A collections representative with serious cardiac conditions and COPD lost her long-term disability (LTD) lawsuit against Hartford after the court found the insurer’s denial was reasonable and supported by substantial evidence. Despite her argument that the stress of debt collection work would aggravate her heart condition, the court found Hartford had not ignored that evidence …
A facilities technician who received long-term disability (LTD) benefits from Unum for several years following back surgery lost his case after the insurer terminated his claim and the court found the decision was reasonable and supported by substantial evidence. The court rejected his arguments challenging Unum’s medical reviewers, vocational analysis, and alleged conflict of interest. …
A wireline operator who received long-term disability benefits for years after two back surgeries lost his ERISA lawsuit after LINA terminated his claim and the court sided with the insurer’s medical reviewers over his treating physician. The court found that non-treating physicians who relied on objective evidence — including imaging studies and surgical outcomes — …
A legal assistant with chronic back pain won a procedural victory when the First Circuit Court of Appeals found that United of Omaha violated ERISA by using an independent medical report to uphold her long-term disability (LTD) benefit termination without ever giving her a copy of it or a chance to respond. The case was …
A dentist who received long-term disability (LTD) benefits for six years had them terminated when Standard Insurance applied a 24-month cap for “Other Limited Conditions.” The Seventh Circuit reversed the lower court’s ruling, finding Standard violated ERISA’s full and fair review requirement by never giving him a copy of the consulting physician’s report before terminating …
A foreman’s long-term disability (LTD) benefits were capped at 12 months after MetLife applied the plan’s musculoskeletal disorder limitation to his shoulder injury, and found his claims of bipolar disorder and radiculopathy unsupported by sufficient objective medical evidence. The court upheld MetLife’s denial, finding the decision was reasonable, consistently applied, and backed by substantial evidence. …
A claimant with congenital hearing loss lost his long-term disability (LTD) lawsuit after the court found he never provided a physician’s certification of his inability to work — a basic requirement under the policy. Despite clear evidence of significant hearing loss, the absence of that certification was fatal to his claim at every stage, including …
A writer/editor at CBS News who underwent open heart surgery lost his long-term disability (LTD) appeal after Zurich terminated his benefits when his condition showed measurable improvement. Both the district court and the Fourth Circuit found Zurich’s decision reasonable, rejecting his arguments that the insurer failed to account for job-specific stress and should have obtained …
A claimant with spinal conditions won his ERISA lawsuit after MetLife cut off his long-term disability (LTD) benefits at 24 months, claiming he lacked “objective evidence” of myelopathy. The court found MetLife set too high a bar — the policy required only some objective evidence tending to establish the condition, not conclusive proof — and …
Recently, we appealed a claim denial issued by The Standard. The claim had been denied because the insurance carrier had determined that the claimant’s condition was caused or contributed to by a pre-existing condition. This is not an unusual basis for a long-term disability claim denial. However, upon further review, we determined this pre-existing denial …
In Gregory Cannon v. Aetna, a pharmacist challenged Aetna’s denial of short-term disability benefits, arguing the insurer ignored his symptoms, failed to follow internal procedures, and overlooked his Social Security approval. The court sided with Aetna, finding no abuse of discretion and concluding Cannon failed to provide sufficient objective evidence of disability.
A claimant with cardiac impairments lost his long-term disability (LTD) case against Unum at both the district court level and on appeal to the Tenth Circuit. The courts found that while Dardick’s cardiac conditions were not in dispute, the medical record failed to establish that those conditions actually prevented him from performing his sedentary occupation. …
Plaintiff appealed the initial denial of benefits under the Plan, stating that her request for disability was not based solely on her thyroid surgery but rather on symptoms associated with lupus and chronic pain. On September 12, 2011, ALIC again upheld the denial of benefits to the Plaintiff. As allowed under ERISA, the Plaintiff sued to challenge that decision. Both parties moved for judgment on the administrative record.
In this case, the Court found that the Plaintiff's complaints of pain were credible there was no reason to question the Plaintiff's credibility. As such, the Defendants' motion for decision was denied and Plaintiff's motions was granted.
Case at a Glance Claimant Win Case Abrams v. Unum Life Insurance Company of America Court United States District Court for the Western District of Washington Decided December 27, 2022 Claim type Long-Term Disability (ERISA) Insurer Unum Employer Schwabe Law Firm Occupation Trial and Appellate Lawyer Conditions Long COVID, chronic fatigue syndrome (CFS) Disclaimer: This …