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.

Manager

Managers will find it challenging to get a long term disability claim approved. Insurance companies such as Cigna, Hartford, Lincoln, and Unum will search for virtually any reason to deny the claim. By providing strong medical evidence, keeping a low profile, and not rushing back to work too soon, a manager can create a solid case for disability.

New York District Court Upholds Hartford’s Denial of LTD for Assistant Store Manager

The claimant in Archer v. Hartford Life and Accident Insurance Company was an Assistant Store Manager at TJX Marshall’s Department Store. She had group Long Term Disability (LTD) coverage. She also had life insurance benefits. Both of these categories of group benefits were issued and administered by Hartford. Hartford had what we call “discretionary authority”. …

New York District Court Upholds Hartford’s Denial of LTD for Assistant Store ManagerRead More

Court Finds There is a Reasonable Basis for USLIC Denial

Mr. Calkin was a 65-year-old manager of architectural design for AIG from June 10, 2013, through June 24, 2014. Mr. Calkin suffered from impingement syndrome in his left shoulder, brachial plexopathy (a form of neuropathy), bilateral shoulder pain, lower back pain due to degenerative disc disease and stenosis in his lumbar spine, degenerative joint disease …

Court Finds There is a Reasonable Basis for USLIC DenialRead More

Liberty’s Long Term Disability Denial was Supported

In this case, David Diaz (“Diaz”) was the district manager at JM Family Enterprises, Inc. (“JM Family Enterprises”) between September 2010 and October 2015. JM Family Enterprises’ had an employee benefit plan which covered long-term disability benefits. This plan was insured by Liberty Life Assurance Company of Boston (“Liberty”). Under the plan, the term “disabled” …

Liberty’s Long Term Disability Denial was SupportedRead More

Appeals Court Reverses District Court Decision And Denies Claim

The case summarized here involves Damon Zaeske (“Zaeske”), who was a project manager employed by Walmart. He ceased working on April 4, 2014, as a result of chronic back pain. Walmart’s insurance plan was underwritten by Liberty Life Assurance Company of Boston (“Liberty Life”); Zaeske applied for long-term disability (LTD) benefits through this plan. When reviewing Zaeske’s claim for benefits, …

Appeals Court Reverses District Court Decision And Denies ClaimRead More

With De Novo Review Court Should Conduct Bench Trial On The Record

Case Name: Rose Bigham v. Liberty Life Assurance Company of Boston Court: United States District Court for the Western District of Washington at Seattle Type of Claim: Long Term Disability Insurance Company: Liberty Life Assurance Company of Boston a/k/a Liberty Mutual Insurance Company (hereinafter “Liberty Life”) Claimant’s Employer: Amazon, LLC Claimant’s Occupation / Job Position: Security Technical Program Manager Disabilities: chronic intractable …

With De Novo Review Court Should Conduct Bench Trial On The RecordRead More

Court Reinstates Plant Manager’s Long Term Disability Benefits

In this case, Fredrick Smith (“Smith”) was employed as a plant manager for Charles Craft, Inc. (“Craft”) reaching back to the 1970’s. Through his job, he held group policies with Reliance Standard Life Insurance Company (“Reliance”). Two of these polices included a long term disability benefits plan and a life insurance policy. If an employee is considered …

Court Reinstates Plant Manager’s Long Term Disability BenefitsRead More

Plaintiff is Entitled to a Description of Additional Material Necessary to Perfect the Claim

Case Name: Annina Puccio v. Standard Insurance Company Court: U.S. District Court for the Northern District of California Date of Decision: February 20, 2015 Type of Claim: Long Term Disability under the Employee Retirement Income Security Act (“ERISA”) Insurance Company: Standard Insurance Company Claimant’s Employer: NetApp Inc. Claimant’s Occupation / Job Position: Senior Manager of Assessments and Certification Disabilities: An unsuccessful gastric bypass …

Plaintiff is Entitled to a Description of Additional Material Necessary to Perfect the ClaimRead More

Court Holds That Aetna’s Denial of Benefits Was Reasonable

Case Name: Armando Mercado v. Federal Express Corporation and Aetna Life Insurance Company Court: United States District Court Southern District of Florida Type of Claim: Long Term Disability Insurance Company: Aetna Life Insurance Company Claimant’s Employer: Federal Express Corporation “Fed Ex” Claimant’s Occupation / Job Position: Operations Manager Disabilities: Plaintiff suffered from avascular necrosis in his hips, back pain, spinal stenosis, obstructive sleep apnea, and gastroesophageal reflux …

Court Holds That Aetna’s Denial of Benefits Was ReasonableRead More

Is It A Pre-Existing Condition or Unspecified Medical Problem?

Here, Marcia L. Smith (“Smith”) worked for Arlington Properties, Inc. as a property manager. Through her employment, she was covered under a long term disability plan starting on March 1, 2016. United of Omaha Life Insurance Company and Mutual of Omaha Insurance Company (collectively, “United”) was the administrator of the plan. The plan provided the …

Is It A Pre-Existing Condition or Unspecified Medical Problem?Read More

Court: Peer Reviews Were Not Arbitrary & Capricious

Here, Melissa Maher (“Maher”) was Manager of Research and Development at Bonne Bell, L.L.C. (“Bonne Bell”). Her job duties were considered to be light with sedentary demand. Further requirements were the ability to use ten pounds of force and other exertions of lesser amounts more frequently. Because of her employment with Bonne Bell, Maher was …

Court: Peer Reviews Were Not Arbitrary & CapriciousRead More