The Technical Rules That Decide ERISA Disability Claims episode artwork

EPISODE · Jun 9, 2026 · 24 MIN

The Technical Rules That Decide ERISA Disability Claims

from Winning Isn't Easy: Long-Term Disability ERISA Claims · host Nancy L. Cavey

Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode.Welcome to Season 6, Episode 20 of Winning Isn't Easy. In this episode, we'll dive into The Technical Rules That Decide ERISA Disability Claims.ERISA disability claims are often decided not only by medical evidence, but by technical policy provisions that many claimants never realize will determine the outcome of their case. Terms that appear straightforward (such as “active employment,” “regular attendance” of a physician, or whether a condition is classified as an “injury” or a “sickness”) can significantly affect eligibility for benefits and how long those benefits will last. In this episode, attorney Nancy Cavey examines three real disability cases that illustrate how seemingly minor policy language can have life-changing consequences. She discusses a physician who unknowingly lost his disability coverage after reducing his work hours, an insurer’s attempt to deny benefits based on its interpretation of a treatment requirement, and a surgeon whose lifetime benefits hinged on the distinction between an accident and an injury. Together, these cases reveal how technical definitions and policy language can shape the outcome of ERISA disability claims, and why understanding these rules before making critical decisions is essential to protecting disability benefits.In this episode, we'll cover the following topics:One - The Danger of Reducing Your HoursTwo - What Does the Term “Regular Attendance” Mean in an ERISA Disability Claim and How Disability RMS Weaponized “Regular Attendance” to Deny a Valid ClaimThree - How the Difference Between the Terms Accident and Injury Can Impact How Long You Get Your ERISA Disability BenefitsWhether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Listen to Our Sister Podcast:We have a sister podcast - Winning Isn't Easy: Navigating Your Social Security Disability Claim. Give it a listen: https://wiessdpodcast.buzzsprout.com/Resources Mentioned in This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://mailchi.mp/caveylaw/ltd-robbed-of-your-piece-of-mindLINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://mailchi.mp/caveylaw/professionals-guide-to-ltd-benefitsFREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

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Have a comment or question? Click this sentence to send us a message, and we might answer it in a future episode. Welcome to Season 6, Episode 20 of Winning Isn't Easy. In this episode, we'll dive into The Technical Rules That Decide ERISA Disability Claims. ERISA disability claims are often decided not only by medical evidence, but by technical policy provisions that many claimants never realize will determine the outcome of their case. Terms that appear straightforward (such as “active empl...

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The Technical Rules That Decide ERISA Disability Claims

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This episode was published on June 9, 2026.

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