The Disability Application

In Cline v. Aetna Life Insurance Co., a North Carolina District court overturns a denial of own occupation benefits to Mr. Cline, who was employed as a commercial pilot for NetJets. Mr. Cline suffered from lumbar stenosis and other musculoskeletal impairments which caused him to file for disability in 2014. Unfortunately, Aetna denied the claim under the own occupation definition of disability finding that Mr. Cline’s impairments were not severe enough to preclude him from working as a pilot.
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The overwhelming majority of ERISA governed, employer provided disability insurance policies contain a 24 month limitation on benefits due to disabilities caused by a Mental Health condition. Although the language and extent of the limitations can vary depending on the insurance carrier there will almost always be some limitation written in your policy. Despite efforts by insureds and lawyers to challenge these limitations under the American with Disabilities Acts, Courts throughout the country have deemed them enforceable. However, a recent federal court opinion in Montana may have opened the door as to how to effectively challenge these limitations.
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The Center for Disease Control has recently and quietly removed controversial treatment information from its website pertaining to the treatment of Chronic Fatigue Syndrome (CFS). Specifically, the long standing recommendation that became a de facto standard of care by doctors throughout the country: increased exercise and psychotherapy in the form of cognitive behavioral therapy. As medical research has shown there was no clinical evidence to support these treatments as an effective way to combat CFS, and the CDC appears to finally acknowledge this.
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In this video learn about Disability Management Services (DMS). DMS is a 3rd party turnkey disability claim administrator that handles the management of disability insurance claims for individual and group disability policies. DMS is outsourced by AXA Equitable and the MONY Life Insurance Company (“MONY”) to administer disability claims to include, but not limited to:

• Claim management
• Disability case review
• Appeals
• Negotiation settlements
• Special investigative resource

Contact any of our lawyers for a free consultation to discuss your claim with DMS.

In this video, Disability Insurance Attorneys Gregory Dell & Cesar Gavidia discuss a recent appeal victory against Prudential insurance company. Our client, an IT professional with inner ear cancer was denied long term disability benefits by Prudential’s in house staff, but following an ERISA appeal submitted by attorney Cesar Gavidia, the disability denial was reversed. The disability insurance attorneys outline how insurance companies know how to use the laws of ERISA to have nurses review case files to deny claims even when the claimant has support of disability from their own treating medical specialists.