ERISA Disability and Life Insurance Litigation

This is a case that Ben Glass argued in the 4th Circuit Court of Appeals in November. It involved a former Cox Enterprises employee who's benefits were terminated by Aetna, the plan administrator, after seven years of payments.Ben argued that Aetna violated ERISA claim regulations in several ways, including ignoring the social security determination that the claimant remained disabled. Ever wondered why insurance companies can suddenly terminate benefits after years without warning? Here we argued that Aetna failed to engage in meaningful dialogue with Smith. Discover how these missteps can affect unrepresented individuals and the critical role of clear communication and adherence to regulatory standards in protecting their rights.Join us as we dissect the complexities of remanding long-term disability cases and the intricacies involved in evaluating chronic pain patients' work capacity. With cases like Harrison and Gagliano, we highlight the contentious issue of paper reviewers challenging in-person medical opinions and the importance of a thorough review of all medical evidence. The discussion sheds light on the standards insurance companies must meet and emphasizes the need for fair and unbiased determination of work capacity and benefits entitlement.We also delve into the distinct differences between Social Security and ERISA evaluations, exploring how these systems impact claimants' ability to perform gainful activity. With a focus on fiduciary responsibilities, this episode underscores the importance of objective evidence and the need for insurers to remain unbiased and curious throughout their decision-making processes. We aim to equip you with invaluable insights into the legal landscapes of disability claims, ensuring that individuals like Jeremy Smith receive the fair treatment they deserve.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this episode, we explore a financial advisor's battle against the wrongful termination of his long-term disability benefits. He was a financial advisor at Fulton Financial Corporation, where he began working in 2009. In 2014, he started experiencing severe pain and numbness in his legs and feet, progressively losing his ability to stand, walk, and drive. By 2015, his condition had deteriorated to the point where he could no longer work. After consulting with specialists, he was diagnosed with neurogenic muscular atrophy and diabetic polyneuropathy.Following his diagnosis, the claimant filed for long-term disability benefits, which Reliance Standard initially approved, acknowledging his inability to work. However, in October 2017, despite no improvement in his condition, Reliance Standard ordered an independent medical examination (IME), which concluded that he was still capable of working. As a result, Reliance Standard terminated his benefits in December 2017.The claimant challenged this decision through the company’s internal appeals process, submitting updated medical records that confirmed his ongoing disability.Curious about the full story and its potential impact on others facing similar challenges? Listen to our podcast as we delve into the court's ruling and the broader implications for long-term disability claims.This is the oral argument in the third circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The episode revolves around the denial of the claimant's claim for long-term disability benefits. The claimant was an employee at Procter & Gamble for many years. His role required him to perform various duties, which he could no longer carry out due to medical issues. Specifically, in June 2012, he underwent gallbladder removal surgery for gallbladder cancer. Following his surgery, he was initially approved for total disability benefits under the company’s Disability Benefit Plan.However, in April 2013, after undergoing an Independent Medical Examination (IME) and a Functional Capacity Evaluation (FCE), it was determined that he was only partially disabled. The evaluations indicated that while the claimant could not perform the tasks required for his line operator position, he was capable of performing medium-demand-level work on a full-time basis, subject to certain limitations. Consequently, Procter & Gamble transitioned him to partial disability benefits, which ended after 52 weeks.The claimant appealed the decision on several grounds:Failure to produce the correct plan documents, specifically a 2012 plan which was referenced but never provided.Inconsistencies in the definition of "totally disabled" provided to treating doctors versus the plan's definition.Failure to consider new evidence submitted during the appeal, including vocational assessments and additional medical records.The core of the case rests on whether the denial of benefits was handled appropriately, both procedurally and substantively. LET'S TUNE IN!This is the oral argument in the Eighth circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Can an insurance company really decide you're no longer disabled based on just one medical record? This episode begins with the story of Dr. Rohr, an anesthesiologist who had to stop practicing due to crippling hand and finger tremors in 2007. After a decade of receiving long-term disability benefits, a controversial 2017 reassessment by Sun Life concluded that his tremors had ceased, causing a heated debate about who must prove that the disability continues. Hear about Dr. Potts, who initially claimed the tremors were gone, and Dr. Honig, who later confirmed their persistence. We discuss how these discrepancies impacted Sun Life's decision to terminate benefits and their failure to seek further evaluations. The episode examines the internal biases within Sun Life's communications and the flawed reasoning behind their conditional offer to reconsider the decision if additional proof was provided.TUNE IN for a straightforward look at how these issues connect in the world of disability benefits.This is the oral argument in the Eighth circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

DISCOVER how one woman's struggle with her insurance company highlights the difficulties of getting long-term disability benefits. Occupation: Insurance sales agent.Medical Condition: Persistent and severe pain in the neck, shoulders, upper extremities, and lower back.Despite extensive treatments like surgery, injections, medication, acupuncture, and physical therapy, the claimant's pain persisted, making it impossible for her to perform essential job tasks such as prolonged sitting and frequent typing.She filed for long-term disability benefits with Lincoln Life Assurance Company due to severe pain impacting her ability to work. However, Lincoln denied her claim, stating that the medical evidence did not support a finding of total disability and suggesting ergonomic accommodations as a solution. THE CLAIMANT APPEALED, arguing that Lincoln failed to consider substantial medical evidence and her subjective symptoms. Join us as we break down the issues, explore the legal arguments, and discuss what this means for anyone trying to get disability benefits.This is the oral argument in the Ninth circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

LISTEN TO THIS EPISODE to find out how a founder and innovator fought against his insurance company for his long-term disability claim. The primary issue was whether Aetna's denial was random and unfair, particularly when their own hired consultants acknowledged Daniel's severe limitations. The CLAIMANT suffered from neuromyelitis optica (NMO), a severe neurological condition also known as Devic's Disease. Despite extensive treatments, including chemotherapy and various medications, his condition progressively worsened, leading to significant impairments that he claimed prevented him from working.He applied for a long-term disability claim, but Aetna denied his application on the basis that the medical evidence did not support a finding of total disability as defined by their policy. This decision was made despite the opinions of the claimant's treating physicians, who provided consistent evidence of his inability to work. The claimant's team filed an appeal against Aetna, arguing that the insurance company ignored substantial medical evidence and failed to consider his subjective symptoms, which were well-documented by multiple physicians. JOIN US as we unravel the complexities of this case and discuss the broader implications for those seeking disability benefits. This is the oral argument in the 2nd circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

IN THIS EPISODE, we take a closer look at the story of a former employee at a dental supply company who suffered a traumatic brain injury from a fall down a flight of stairs. Despite thorough treatment, she continued to suffer symptoms that ended her career.The claimant applied for long-term disability benefits but was denied on October 17, 2019. However, she didn't give up and appealed the decision, but unfortunately, her appeal was also turned down on August 31, 2020.Subsequently, she took her case to court, arguing that the insurance company wrongly refused her benefits. Claiming that Sun Life Assurance wrongly denied her benefits from her job's benefit plan, she took legal action under the Employee Retirement Income Security Act (ERISA) in December 2020. Her case exemplifies how complicated and tough it can be to deal with insurance companies.JOIN US as we break down her case, explore why her claims were denied, and discuss what this means for others trying to get disability benefits. Hear about her journey and the challenges she faced in getting the support she needed.This is the oral argument in the 2nd circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

THE CLAIMANT was a former employee at Wright Medical Technology. He was suffering from the side effects of prostate cancer treatment when he applied for long-term disability benefits. But, his insurance company, Hartford Life and Accident Insurance Company DENIED HIS CLAIM because they stated they did not have enough proof of loss to evaluate his disability, specifically citing missing medical records necessary to make a decision.On April 11, 2020, the claimant filed an administrative appeal with Hartford, providing additional evidence to support his claim. Despite being required to issue a final decision within 45 days, Hartford failed to do so. HE ARGUED that this failure meant his administrative remedies should be deemed exhausted, allowing him to bring his case to federal court. Substantial evidence included additional medical records supporting his disability claim.LISTEN NOW to learn how to handle similar situations and protect your rights with long-term disability claims. Don't miss the INSIGHTS from our LEGAL EXPERTS. This is the oral argument in the 2nd circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

TUNE IN to find out why the DSM (Diagnostic and Statistical Manual of Mental Disorders), often seen as the ultimate guide, might not be as reliable as we think. Discover why re-evaluating these standards could be key to making insurance claims fairer.  The claimant, employed by the School of Visual Arts, began receiving long-term disability benefits from Hartford Life Insurance Company in May 2010 due to her bipolar disorder. Bipolar Disorder: This condition led to her becoming disabled in 2009, and she subsequently began to collect long-term disability benefits in May 2010. Bipolar disorder, classified as a mental disorder under the DSM-IV, was the primary reason for her disability​.In May 2012, Hartford terminated her benefits based on the Plan's 24-month cap for disabilities resulting from mental illnesses. The Plan, which incorporates the long-term disability insurance policy issued by Hartford, has a provision that limits benefits for disabilities resulting from mental illness to 24 months. Since bipolar disorder is listed as a mental disorder in the DSM-IV, Hartford applied this 24-month cap and terminated her benefits accordingly.The claimant filed an internal appeal, arguing that bipolar disorder is a biologically based illness and should be considered a physical condition, not subject to the mental illness cap.This is the oral argument in the 2nd circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this episode, the claimant was employed as a Security Director at Manhattanville College, where he experienced several health conditions, including:Aortic valve replacement in August 2010Paroxysmal atrial fibrillationFatigue and dizzinessChest pain and shortness of breathAnxiety and sleepless nightsThese conditions collectively contributed to his disability and inability to perform his duties as a Security Director.However, UNUM Life Insurance denied his long-term disability benefits, citing multiple medical reviews indicating improvement, an occupational analysis showing that his national economy role did not require the specific tasks he performed, and independent reviews that disagreed with his physicians. Appeal ProcessThe claimant filed an appeal to the 2nd Circuit Court of Appeals, arguing that substantial evidence showed he was completely disabled and accusing UNUM of ignoring critical medical evidence. His attorney emphasized the claimant's inability to perform essential job tasks and submitted comprehensive medical records from Dr. Joseph Tartaglia and Dr. Fusco, which included detailed descriptions of the claimant's conditions and limitations. They also criticized UNUM for not conducting an independent medical examination. The appeal aimed to overturn UNUM's decision and prove his continued disability.This is the oral argument in the 2nd circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

According to the physical demands analysis submitted by his employer, the claimant's job at Tower Hill Insurance Group required him to:Sit for a maximum of two hours at a time, for a total of seven hours a day.Stand or walk for thirty minutes at a time, for a total of one hour a day.Perform tasks that did not require lifting anything heavy.Claimed Disabling Conditions:Knee Injury: The claimant sustained a knee injury on May 15, 2016, which led to knee replacement surgery on July 19, 2016.Polymyalgia Rheumatica (PMR): The claimant claimed that his disability was primarily due to stiffness, pain, and fatigue resulting from PMR.Reasons for Claim Denial:Due to these medical conditions, the claimant applied for long-term disability benefits under his insurance policy with Hartford Life & Accident Insurance Company. Unfortunately, his claim was denied due to the policy required the claimant to prove that he was continuously disabled throughout the entire Elimination Period (from May 15, 2016, to August 27, 2016). Hartford determined that Benson was not disabled during this entire period based on the medical evidence. The insurance company relied on the opinions of two doctors who conducted a file review of the medical evidence.Appeal Process:The claimant then filed an appeal, arguing that Hartford's final decision to deny his long-term disability benefits was based on a different rationale than the initial denial. Specifically, he claimed that the initial denial was based on his failure to prove disability on a specific date (August 28, 2016), while the final decision was based on his failure to prove that he was disabled throughout the entire Elimination Period. The claimant contended that this change deprived him of the opportunity to challenge the new rationale effectively.This is the oral argument in the 11th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

How to Buy Long-Term Disability InsuranceIn today's podcast, listen in to a recording of a presentation long-term disability attorney Ben Glass recently gave to a national gathering of nurse anesthetists. During the session, Ben shared invaluable insights on how to navigate the complex world of long-term disability insurance. Here are the key takeaways from his talk:Understanding the Importance of Individual PoliciesBen emphasized that individual long-term disability insurance policies generally provide superior benefits compared to group policies offered by employers or associations. One of the primary advantages of an individual policy is its portability; your coverage goes with you if you switch jobs or move to a different practice. Additionally, benefits from individual policies are typically non-taxable, provided you pay the premiums yourself. This can offer a significant financial advantage if you ever need to make a claim.Evaluating Group PoliciesGroup policies are often included as part of an employment benefits package. These policies are generally cheaper and do not require health underwriting, making them accessible to all employees regardless of their health status at the time of enrollment. However, group policies come with several limitations. They may include pre-existing condition exclusions, meaning any medical conditions you had before the policy started may not be covered. Additionally, these policies often offer shorter own-occupation coverage periods—usually only for the first two years. After that, benefits are only paid if you cannot perform any occupation, not just your own specialty. Furthermore, benefits from group policies are taxable if the employer pays the premiums.The Pitfalls of Association PoliciesBen warned that association policies, like those offered by the American Medical Association, tend to provide the least favorable terms. These policies are often inexpensive and do not require medical underwriting, but they offer minimal benefits. Given the choice, it's better to prioritize individual and group policies over association policies unless health issues prevent you from obtaining better coverage.Navigating Elimination PeriodsAn elimination period in a disability policy is similar to a deductible in health insurance. It represents the amount of time you must wait before you start receiving benefits after a disability occurs. The length of the elimination period can significantly affect your premiums. Longer elimination periods result in lower premiums but may not be practical if you don't have substantial savings to cover the gap. When choosing an elimination period, consider how long you can sustain yourself financially without an income.Dealing with Pre-existing ConditionsBen stressed the importance of being completely honest about your medical history when applying for an individual disability insurance policy. Insurers will uncover past health issues, and failing to disclose them can lead to denied claims. Depending on your health history, insurers might exclude certain conditions from coverage or impose waiting periods before coverage kicks in for those conditions. A good broker can help you finThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was a former respiratory therapist and a director at Athens Limestone Hospital before she ceased working on October 12, 2012, due to multiple health issues.The disabling conditions she claimed included:FibromyalgiaRheumatoid ArthritisChronic PainHer disabling conditions severely impacted her ability to perform her job. Specifically, her conditions led to:Intractable pain at multiple sitesAdrenal fatigueReduced range of motionFibromyalgia pain that confined her to bed one to three times a weekThese health issues made it impossible for the claimant to carry out the material duties of her occupation and significantly impaired her functional capacity, preventing her from returning to work.Due to her worsening health, she applied for long-term disability benefits. However, her insurance company, Life Insurance Company of North America (LINA), turned down her claim. They said she didn’t fit their definition of 'disabled,' which affected her chances of getting benefits after the first two years. This decision was backed up by various doctors and specialists, who said that the claimant could still do desk jobs and wasn’t limited in ways that would make her eligible for disability under the policy’s terms.Not happy with this decision, the claimant challenged LINA’s refusal to grant her benefits under the life policy's waiver of premium and long-term disability benefits. She argued that the insurer's view of her ability to work certain jobs didn't truly reflect her medical condition.This is the oral argument in the 11th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant, a former truck driver, was diagnosed with two primary medical conditions. Initially, he was diagnosed with Posterior Vitreous Detachment (PVD) in his right eye. Subsequently, a retina specialist diagnosed him with Macula-off Retinal Detachment, a more severe condition where the retina detaches from its normal position. In the claimant's case, this led to significant vision loss after three unsuccessful surgeries.Following this diagnosis, the insurance company, Life Insurance Company of North America (LINA), denied the claimant's claim for long-term disability benefits, citing the Pre-Existing Condition limitation outlined in the disability plan. LINA contended that the PVD, diagnosed during the look-back period, was highly likely to have caused a retinal tear, which in turn led to the retinal detachment and the claimant's subsequent vision loss. This presumed causal connection between the pre-existing PVD and the later disability was pivotal in their decision to deny the claim.In response, he appealed the denial of his long-term disability benefits by adhering to the procedures set under the Employee Retirement Income Security Act (ERISA).  The appeals revolved around disputing the insurance company's interpretation of the Pre-Existing Condition clause and their assertion of a direct causal link between his diagnosed PVD (considered a pre-existing condition) and the subsequent retinal detachment that resulted in his disability.This is the oral argument in the 10th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was a former salesperson, experienced serious physical and cognitive limitations following a car accident. These impairments, which affected his sustained attention, information processing speed, and neuromotor functioning, significantly impacted his ability to manage tasks and time, and he was given a poor prognosis for improvement.Subsequently, his insurance company, Reliance Standard Life Insurance, reduced his long-term disability benefits. This decision was based on information suggesting that he had returned to work in a limited capacity. The insurer's decision was influenced by notifications from the company, indicating that he was back at work "with limitations," and further communications suggested a resumption of some employment activities.In response, the claimant filed a formal appeal with the United States Court of Appeals, Second Circuit. He contended that the reduction of his disability benefits was improper, as he had not actually returned to work. Furthermore, he raised concerns about procedural fairness and potential conflicts of interest in Reliance's decision-making process, highlighting the need for a more thorough and impartial review of his case.This is the oral argument in the 2nd circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant, a plant manager, left his job due to a series of strokes and heart problems. His medical conditions included high-grade stenosis (narrowed blood vessels), hypertension, diabetes, two strokes, serious coronary artery disease leading to triple bypass surgery, numbness and neuropathy, slurred speech, facial droop, poor balance, memory problems, arteriosclerotic heart disease (hardened arteries), stage three kidney disease, hives and swelling due to an allergic reaction to diabetes medication, and nerve damage.He experienced a range of significant health issues leading to his claim for long-term disability benefits. Subsequently, the insurance company, Reliance Standard Life Insurance Company, terminated his claim for long-term disability benefits, determining that he was not totally disabled despite contrary opinions from every treating physician who had evaluated him. Reliance insisted that the claimant could perform the material duties of any occupation.The claimant appealed the termination of his long-term disability benefits after his insurance company, focusing on challenging Reliance's decision under the Employee Retirement Income Security Act of 1974 (ERISA) and seeking reinstatement of his benefits.This is the oral argument in the 4th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was an Enterprise Storage Engineer who encountered severe health challenges due to hydrocephalus, requiring surgery to remove a brain cyst. Following this, he applied for long-term disability benefits, but his insurance company, Prudential, eventually terminated his claim based on neuropsychological tests suggesting possible malingering. These tests showed failures in nearly all validity measures, with specific tests indicating he might have underperformed deliberately, leading Prudential to question his claim of being unfit for work due to cognitive issues.Challenging this decision, the claimant appealed, supported by a statement from his therapist. This statement highlighted his exhaustion during testing and his difficulty maintaining the necessary focus and concentration for his job. This appeal was a key effort to contest the insurer's denial, arguing that his medical condition genuinely prevented him from working.This is the oral argument in the 8th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was a physician, who transitioned from part-time to full-time disability due to her deteriorating health condition. But her application for long-term disability benefits, which is governed under the complex umbrella of ERISA was denied by her Insurance company - UNUM.At the heart of this dispute lies a contentious debate over the definitions of "full-time employment" versus "active employment." UNUM forwards a compelling argument, positing that the essence of full-time employment transcends the simplicity of a numerical hour threshold. According to them, it should mirror the employer's expectations and the specific demands of the occupation. They critiqued the district court's approach, accusing it of merging the distinct notions of full-time employment status with the active employment criterion, thereby diluting the stringent requirement of being a full-time employee to qualify for eligibility.This is the oral argument in the 9th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant appealed the district court's decision to deny his motion for attorney's fees under ERISA  after Unum Life Insurance Company of America terminated his long-term disability benefits. The claimant argued he deserved to have his legal fees paid because he somewhat succeeded in his case due to causing a change, a concept known as the "catalyst theory." However, the court didn't agree with him. The court looked at several factors to decide whether he should get these fees, including whether Unum (the insurance company) acted badly or in bad faith, whether Unum could afford to pay the fees, if paying the fees would prevent Unum from acting similarly in the future, the importance of the legal issue regarding the law known as ERISA, and how strong each side's case was. This is the oral argument in the 9th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant, a former accountant, was diagnosed with mild cognitive impairment by a board-certified neurologist and determined by a medical doctor specializing in occupational medicine to be unable to work due to his condition. These diagnoses led him to stop working as of October 31, 2015, and he has not resumed working since. He then found himself at odds with Prudential Insurance Company of America after the company denied his disability claim, asserting he wasn't sufficiently impaired. Undeterred, the claimant mounted a legal challenge to reclaim the $375,000 in benefits he firmly believes were unjustly withheld from him.Transitioning from this initial confrontation, the claimant's appeal focused on disputing Prudential's rationale for discontinuing his benefits. This challenge was primarily grounded in their evaluation, which questioned the severity of his impairment necessary for policy collection. He countered by asserting his disability was due to cognitive impairments that rendered him unable to work—an assertion Prudential contested, relying on their file review.This is the oral argument in the 1st circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant, a former sociology professor at Rollins College, dedicated her career to teaching, advising students, developing courses, grading papers, and contributing to academic research and writing. Unfortunately, her career and daily life were significantly impacted by Chronic Fatigue Syndrome (CFS), fibromyalgia, and a spectrum of associated symptoms, including persistent pain and fatigue.When the claimant applied for long-term disability benefits due to her debilitating conditions, she encountered a significant challenge. Unum Life Insurance Company of America, her insurer, denied her claim based on a provision in her employer’s plan. This provision limited benefits to a 24-month period for disabilities "due to mental illness and disabilities based primarily on self-reported symptoms." Unum determined that the claimant's conditions—CFS and fibromyalgia, characterized by symptoms such as pain and fatigue—fell under this limitation because they were primarily based on self-reported symptoms.In response to the denial, the claimant filed an appeal, determined to overturn Unum's decision. She meticulously compiled additional medical information for review, including office notes from a gastrointestinal specialist and updated records from her treating physicians. She also submitted results from the CPET conducted by an exercise physiologist. This test was specifically designed to objectively measure functional capacity and assess the recovery response to physical stressors. The appeal aimed to demonstrate that her disabilities were not solely based on self-reported symptoms and that she had indeed provided objective evidence of her functional limitations.This is the oral argument in the 1st circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The claimant was a former social worker at Intermountain Health Care Inc.​ Her medical conditions included Chronic Fatigue Syndrome (CFS), hypersomnia, obstructive sleep apnea, severe depression, and anxiety. Her treatment for these conditions was documented, and during the appeals process, these conditions were considered in the evaluation of her claim for long-term disability benefits.Hartford Life and Accident Insurance Company denied claimant's claim for long-term disability (LTD) benefits based on their assessment of her condition and the medical evidence provided. Hartford argued that the medical evidence, including APRN Jones's assessment, did not support the claimant's Chronic Fatigue Syndrome (CFS) diagnosis as preventing her from performing a sedentary occupation. Therefore, Hartford decided that based on the medical records reviewed, including those of her treating physicians, and the definitions of disability within the policy, the claimant did not meet the criteria for LTD benefits​.The claimant appealed the termination decision. In her appeal, she acknowledged receiving treatment for Depressive Disorder, Anxiety Disorder, and Panic Attacks during the period considered under the pre-existing condition limitation. She appealed the initial claim decision specifically regarding her "primary condition" of Chronic Fatigue Syndrome (CFS) and other disability conditions mentioned in the denial letter, specifically hypersomnia and obstructive sleep apnea​.This is the oral argument in the 10th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The Supreme Court has established a principle for cases challenging the denial of benefits under the Employee Retirement Income Security Act (ERISA). According to this principle, such denials should generally be examined anew (de novo) unless the benefits plan specifically grants the administrator or fiduciary the power to decide on eligibility for benefits or interpret the plan's terms. The claimant, who worked as an Executive Sous Chef at the Hyatt Corporation in San Diego, California, started having symptoms of osteomyelitis, which is an infection in the spinal cord. Even after getting treatments like antibiotics and surgery, he still had a lot of pain because of the ongoing infection, degenerative disc disease in his lower back, and spinal stenosis. These health issues made him quit his job because he couldn't stand for long times, which his job required.After over eleven years of receiving long-term disability (LTD) benefits, the claimant's payments were stopped by his insurance company, Hartford. The insurer decided that the claimant no longer met their criteria for being disabled. This conclusion was based on a functional capacity evaluation and the opinion of a medical professional who agreed with the evaluation's findings.The claimant appealed the termination decision. He insisted that he was still considered disabled when the plan was terminated because he could not continuously work in any job that his education, training, or experience would have qualified him for.This is the oral argument in the 4th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Before her health issues, the claimant was a distinguished attorney in Birmingham. Unfortunately, she developed chronic pain syndrome, fibromyalgia, and lumbar disc disease, conditions that deeply affected her professional life and daily functions.She applied for an began receiving disability benefits under her firm's LTD policy with Sun Life. That policy was replace by a new policy from Hartford. The new Hartford policy contained an exclusion clause specifying that a member of the firm was ineligible for disability-insurance payments if she was receiving “benefits for a Disability under a prior disability plan that: 1) was sponsored by [her] Employer; and 2) was terminated before the Effective Date of The Policy.” Because Sun Life was still paying Stewart disability benefits, Hartford found that Stewart was “receiving benefits for [a] Disability under a prior disability plan” that had been “terminated” before its own policy went into effect and, consequently, that she wasn't eligible for Hartford disability benefits.The claimant contended that plan documents permitted her to recover under both policies. The District Court agreed with Hartford and this is the argument in the 11th Circuit Court of AppealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Here, the claimant was a night-shift nurse at a long-term care and skilled rehabilitation center grappling with multiple health issues, including fibromyalgia, chronic fatigue syndrome, degenerative disc disease, and migraines, which significantly impacted her ability to work, particularly in her demanding role as a night-shift nurse.Despite the significant impact on her ability to perform, Principal Life Insurance Co. denied her long-term disability claim, asserting that the medical proof didn't back her incapacity for any suitable job. This decision was based on their assessment of her medical condition and the requirements of the disability insurance policy terms.The claimant appealed, arguing the insurer overlooked the combined severity of her conditions including fibromyalgia, chronic fatigue syndrome, degenerative disc disease, and migraines, on her ability to continue working as a night-shift nurse. He challenged their decision with evidence she believed demonstrated her disability, highlighting the conflict between personal health realities and insurance assessment.This is the oral argument in the 6th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The plaintiff in the long-term disability case, a dental hygienist, became disabled following a car accident. She had been receiving total disability benefits since 1997, with her condition periodically reviewed by the insurer. In 2019, the insurer reclassified her as only partially disabled, based on her continued performance of some duties related to her occupation. This reclassification led to the legal dispute over her eligibility for total disability benefits under her insurance policy.The legal issue the District Court wrestled withg  was whether the claimant, under her insurance policy with RiverSource Life Insurance Company, was entitled to either partial or total disability benefits based on her medical conditions and their impact on her ability to work. Is the insurance company prevented ("estopped") from changing it mind after all of those years?The court examined the definitions of "partial disability" and "total disability" within the policy and how these definitions applied to the claimant's situation and medical evidence provided.This is the oral argument to the 6th Circuit Court of Appeals in this caseThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In ERISA cases, the appellate review focuses on the administrative record's support for the district court's conclusions, regardless of how it arrives there, suggesting that the historical medical context is relevant but not a basis for reversing the judgment.When her multiple sclerosis (MS) progressed and began to seriously affect her career, the claimant, a vice president of health information services at Integrity Health Care, encountered significant challenges. The claimant applied for long-term disability benefits but was denied by Reliance Standard Life Insurance Company. The insurer explained that the medical evidence was somewhat inconsistent with her diagnoses and, in any case, did not establish a disability. Moreover, Reliance's preferred independent doctor concluded that, with certain accommodations and limitations on her physical exertion, the claimant could maintain a normal work schedule.The claimant then sued Reliance in federal district court under ERISA, arguing that her condition, which does not lend itself to objective evidence, was overlooked by Reliance. She pointed out that the insurer ignored relevant medical evidence, including opinions from multiple doctors who declared her disabled, in favor of its own experts who misunderstood the standard for disability.This is the oral argument in the 11th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The main legal issue argued in the argument revolves around whether evidence outside the administrative record can be submitted in cases governed by de novo review under ERISA. The appellant contended that contrary to established 11th Circuit precedents, the lower court erroneously limited evidence to the administrative record. This issue is pivotal as it affects the ability of claimants to present additional evidence in support of their disability claims during judicial review, especially in light of evolving legal standards concerning discretionary clauses in ERISA plans.The claimant's medical conditions, including chronic pain syndrome, degenerative disc disease, and radiculopathy, significantly impacted his ability to perform his job functions, leading him to file a claim for long-term disability benefits. However, his insurance provider, Lincoln National Life Insurance Company, denied his claim. Everyone agrees that Lincoln’s denial of long-term disability benefits to the claimant triggered de novo re-view because the plan did not give Lincoln discretion. The claimant, employed as an Accountant, aimed to strengthen his case with additional medical records, expert testimonies, and a more detailed account of his medical conditions.  The trial court did not allow this.He filed an appeal at the federal circuit court of appeals, hoping that the court would reverse and remand the decision of the lower court.This is the oral argument in the 11th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This is the appellate argument of a marketing executive who was either working or not working when he became disabled. The claimant was grappling with a life-altering illness amidst the uncertainty of his employment status. His fight against the insurance giant Reliance Standard insurance company centers on the interpretation of 'active, full-time employee' status in the context of his impending job termination. The story unfolds in this argument, where the ambiguity of policy language and the definition of 'active' become pivotal in determining his rightful claim to benefits.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This case arises out of the Central District of California.The issue was whether the claimant had been totally disabled during entire elimination period.This is the oral argument in the Court of AppealsHere, the trial court decided that the claimant did not prove his right to Long-Term Disability (LTD) benefits. The key issue was whether Atanuspour couldn't perform his job as a sales manager from August to November 2019 due to illness or injury. The trial court court found his medical records insufficient to prove total disability, especially since his records did not support a total disability from a mental disorder beyond October 4, 2019, and his lumbar condition didn't show total disability before October 23, 2019. Without evidence of continuous total disability during the entire period in question, Atanuspour's claim for LTD benefits was not upheld.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The oral argument focuses on the case of a claimant who has lived with Charcot Marie Tooth Syndrome (CMT), a degenerative neurological condition. She worked as a nurse at the Mayo Clinic Health System from 2003 to 2011. Her condition, particularly noted in her legs, led to muscle atrophy. Her treating doctor  has observed the progression of her CMT for over four years. By 2011, her condition worsened and then stabilized, meaning it ceased to worsen but did not improve. As of March 14, 2016, the claimant struggled with tasks for more than half an hour due to severe pain and fatigue.In response to the claimant's appeal for long-term disability benefits, a Rehabilitation Consultant, Kate Schrot, was hired to assess her employment prospects. Schrot's evaluation acknowledged that the claimant could perform certain tasks, as evidenced by surveillance, but only sporadically, not consistently enough for full-time employment. Surveillance confirmed the claimant's limitations, showing her limited activity and consistency with her reported disability. The treating doctor's medical opinion, noting the medication-induced drowsiness and chronic pain, further supported her claim, suggesting that the evidence for terminating her benefits is insufficient.The trial court's opinion highlighted the shortcomings in the defense expert's analysis regarding the claimant's capacity to work full-time. Despite acknowledging the severe pain and concentration issues due to Charcot-Marie-Tooth syndrome, the defense doctor failed to consider how her pain would impact her ability to perform sedentary work. This oversight was deemed unreasonable for determining her benefit eligibility. The opinion also noted contradictions in the defense doctor's assessment, particularly against Dr. Tseng's view that McIntyre couldn't work for more than half an hour on any task. The court reasoned that frequent breaks would reduce McIntyre's working hours significantly, qualifying her for benefits.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The plaintiff, a former attorney at a law firm with an array of medical conditions, ultimately leading to her applying for long-term disability (LTD) benefits. Her conditions include Ehlers-Danlos syndrome, cervicomedullary syndrome, severe depression, and other neurological and cognitive impairments, significantly impacting her ability to perform her professional duties.Why Listen:Understanding Medical Complexity in ERISA Claims: The argument offers an in-depth look at how complex medical histories are evaluated in the context of LTD claims under ERISA. It underscores the challenges in proving disability with multifaceted medical conditions and in wrestling with the standard of review.For law students and professionals, this case serves as an excellent resource to understand the intersection of medical conditions and legal standards in disability claims.Educational Value:This case is an essential listen for those specializing in employment law, disability claims, and ERISA regulations. It offers a real-world application of legal principles in complex scenarios involving medical disabilities, providing invaluable insights for both seasoned practitioners and aspiring lawyers.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This podcast episode presents the oral arguments from the case of Lisa Holden, who worked at the prestigious law firm Williams & Connolly, LLP. As an aspiring or practicing lawyer, especially with an interest in ERISA long-term disability claims, you'll find this case not only intriguing but also highly educational.Background:Lisa Holden, an employee with Williams & Connolly from 1997 to 2015, ascended from assistant controller to Deputy Director of Finance. During her tenure, she was responsible for critical financial functions, including overseeing pension plans and managing the firm's tax reporting. However, behind the façade of professional success lay a troubling workplace environment. Holden reported experiencing chronic stress due to excessive work hours and understaffing. More distressingly, she endured what she describes as years of bullying, abuse, and even sexual harassment, creating a toxic work atmosphere.Why Listen:This oral argument recording provides a deep dive into the complexities surrounding ERISA long-term disability claims, particularly in high-stress professional environments. As Holden's case unfolds, listeners will gain insights into:The challenges of proving mental and emotional distress in long-term disability claims under ERISA.The nuances of employer-employee dynamics in high-pressure job roles.The legal intricacies of handling claims involving workplace stress and harassment.Holden's situation, unfortunately, is not unique in the professional world, making this case a crucial study for anyone dealing with or interested in employment law, particularly in the realm of mental health and workplace well-being.Educational Value:This episode is an excellent resource for law students and legal professionals seeking to understand the real-world application of ERISA statutes in long-term disability claims. It also offers a rare glimpse into the intersection of employment law and mental health, an increasingly relevant topic in today's work environments.Tune in to this episode for a detailed exploration of a complex and compelling ERISA disability claim, a must-listen for anyone passionate about employment law and employee rights.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Here a claimant lost her case because both the trial court and the Court of Appeals found that Life Insurance Company of North America was correct in determining that her disability was caused, in part, by a preexisting condition.Harrison v. Life Insurance Company of North America, the court's analysis focused on the application of the pre-existing condition clause in Harrison's ERISA-governed disability insurance policy. The court examined the medical evidence related to Harrison's mental health conditions, including depression and anxiety, to determine whether these were pre-existing conditions that could legitimately exclude her from receiving benefits. The decision ultimately affirmed the denial of Harrison's claim, concluding that her pre-existing mental health issues were indeed significant contributing factors to her disability as defined by the policy.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This is the Court of Appeals Oral Argument.In the District Court, the case involves Bryce Dunham-Zemberi's challenge to the denial of long-term disability benefits under ERISA. The medical conditions involve the cervical spine, left shoulder, elbow, and bicep injuries, as well as his inability to lift more than 10-15 pounds and failed grip and pinch strength tests. The court reviewed extensive medical evidence, including physicians' and specialists' reports, physical therapy records, and a Residual Functional Capacity Evaluation. The evidence did not unanimously support the plaintiff's claimed disabilities. The court found that the plaintiff failed to provide sufficient objective medical evidence to establish his disability claim under the terms of the plan, upholding the insurer's decision to deny long-term disability benefits.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Here, the claimant sued her insurance company, Reliance Standard, for not paying her long-term disability benefits after a car accident. She claimed to be not able to work due to a number of medical conditions, including post-concussion syndrome, severe hyperacusis, vestibulopathy (dizziness), migraines, and cognitive problems.The District Court decided in Tekmen's favor. Reliance Standard didn't agree with this decision and appealed.Most of the argument centers on just what the roles of the District Court and Appellate court are when you have a closed administrative record and a de novo standard of review.The Fourth Circuit Court was asked by Reliance Standard to use a special kind of quick decision-making process in the Tekmen case, a lawsuit about denied insurance benefits. This process would have made it easier to decide the case based on existing records without giving the usual benefits to the party that didn't request the quick decision.However, the court rejected this idea. They explained that this approach wasn't suitable for these types of cases, especially when there's disagreement over important facts, like in Tekmen's case. In situations where facts are disputed, courts need to closely examine everything and make their own decisions about what's true.The court decided to stick to the usual way of handling such cases, as outlined in the Federal Rules of Civil Procedure. This involves a detailed review of all the information and making decisions based on that, not just a quick judgment.The court also clarified that their decision-making process was in line with past legal principles, especially when it comes to reviewing the facts of a case. They emphasized that they follow a standard approach for reviewing facts and that this approach fits well with the established legal framework for insurance benefit cases like Tekmen's.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this case, Ben Glass Law represented the claimant, a coal miner from the southwest part of Virginia. This is the oral argument in the Third Circuit Court of Appeals.This court hearing focuses on the challenges faced by a disabled coal miner from Southwest Virginia navigating ERISA and long-term disability cases. We discuss the essential fight for benefits, examining the fiduciary duties of plan administrators and the journey through the district court and appeals process. We'll look into the complexities of vocational evaluations and the importance of accurate job history information, exploring how legal precedents impact the outcome of benefit claims.We also delve into the nuances of vocational reports during the oral argument, specifically the impact of misidentified job titles on claimants' lives. The hearing examines how such errors can affect the credibility of employability assessments, and how computer-generated reports and personal discussions converge in the legal process to determine an individual's future. We explore the role of the court in reviewing these cases, with a focus on vocational mistakes, peer reviews, and the importance of medical evidence in ensuring fair outcomes.The latter part of the hearing discusses the use of social media posts as evidence in benefit denials and the legal responses to unjust decisions. We provide a straightforward look at the judicial process and its impact on individuals, emphasizing the importance of fairness in decision-making. The court hearing concludes with insights into the conclusion of a hearing and the subsequent steps, aiming to leave attendees informed about the legal battles within our system."These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This is the Sixth Circuit oral argument:Beth Jordan challenged the decision of a lower court that favored Reliance Standard Life Insurance Company in a case about her long-term disability benefits from August 2, 2016, to September 18, 2017. The Sixth Circuit Court of Appeals, disagreed with the lower court and sent the case back, telling them to grant Jordan her long-term disability benefits.Reliance Standard had been paying Jordan disability benefits since July 2009 because she couldn't work as a nurse anesthetist due to Lyme disease. However, in 2015, they stopped her benefits just before a policy change in how disability was defined. Jordan challenged this decision. When Reliance Standard didn't respond in time to her appeal, Jordan took the matter to court. The court initially told Jordan she should have completed all the required steps with Reliance Standard before going to court. Reliance Standard then asked Jordan to have an independent medical exam. By February 2018, when this happened, Jordan was already back at work. After the exam, Reliance Standard agreed to pay her benefits only up to August 1, 2016, and refused to pay after that, even though she didn't start working again until September 2017 and had been treated for breast cancer.When Jordan took her case to court a second time, the lower court found that Reliance Standard didn't properly consider Jordan's and her doctor's views and the reviews they relied on weren't good enough. The court sent the case back to Reliance Standard to give better reasons for their decision and to properly consider Jordan's situation. However, Reliance Standard didn't change its decision, and this time the lower court agreed with them.But, when Jordan appealed again, the Sixth Circuit Court found that Reliance Standard's reasons for denying benefits weren't backed up by strong medical evidence and they didn't make their decision fairly. The court said Reliance Standard didn't pay enough attention to Jordan's doctor and relied too much on their own doctors, whose opinions weren't trustworthy. The court also found it wrong that Reliance Standard didn't share Jordan's doctor's letter, which disagreed with their views, with their reviewers. The court didn't accept Reliance Standard's use of surveillance from 2015, as the dispute was about a period after August 2016, and they kept paying Jordan even after the surveillance. The court believed Jordan's doctor proved she deserved the benefits. Instead of sending the case back to Reliance Standard again, the court decided that Jordan should win the case.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This is the oral argument in the Sixth Circuit.Vickie Tranbarger sought to establish her right to long-term disability benefits under a policy governed by the Employee Retirement Income Security Act (ERISA). This policy was insured by Lincoln Life & Annuity Company of New York. The crux of the matter centered on the legal scrutiny applied to Lincoln Life’s decision to deny these benefits.Lots of discussion in the case about what the plaintiff provided to appeal the insurance company denial and how she could have done better with a lawyers.Discussion, also, about the 4th Circuit's recent Tekman case.While the district court had previously ruled in favor of Lincoln Life, applying a 'de novo' review due to the policy not granting Lincoln Life explicit discretionary power, the Sixth Circuit faced a pivotal decision. They had to determine the appropriate standard of review: whether to uphold the district court’s 'de novo' approach or to consider the possibility of a 'clear error' standard. This choice was critical, as it would set a precedent in the Sixth Circuit, which had not yet established a firm rule in such cases.Ultimately, the Sixth Circuit decided to uphold the district court's decision in favor of Lincoln Life. This decision came after a careful examination of both the 'de novo' and 'clear error' review standards. The court concluded that regardless of the standard applied, Tranbarger’s claim for disability benefits did not meet the necessary criteria, leading to the denial of her appeal. This ruling not only impacted Tranbarger’s case but also set a significant precedent for future ERISA-related disability claims in the Sixth Circuit.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The issue centered around the claimant who was employed as a Windows Systems Administrator at the McKesson Corporation and suffered from chronic pain and sleep disorders that greatly affected his daily life and ability to work. These conditions formed the foundation of his request for long-term disability benefits.Life Insurance Company of North America (LINA), the claimant's insurance provider, rejected his application for long-term disability benefits. This decision came after a thorough review of his medical records and consultations with their physicians, which, in their assessment, did not verify a disability severe enough to prevent the claimant from fulfilling his responsibilities as a Windows Systems Administrator.The claimant then went to the court of appeals, arguing that the insurer had not acknowledged the severity of his chronic pain and sleep disorders. He maintained that these health issues substantially hindered his capacity to execute the functions of his role as a Windows Systems Administrator, underscoring a disconnect in LINA's appraisal of his condition and its impact on his professional duties.This is the oral argument in the 7th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The case revolved around a claimant who challenged the denial of her long-term disability benefits from Reliance Standard, arguing that the insurer had failed to recognize the full impact of her multiple sclerosis (MS) on her role as a Financial Analyst at Adsum Inc.As a Financial Analyst, the claimant was tasked with managing financial services, including analyzing complex systems and conducting evaluations. However, she later developed MS, which significantly impaired her work capabilities due to cognitive difficulties, fatigue, and physical impairments. These symptoms severely hindered her ability to effectively fulfill her duties. Consequently, she filed for long-term disability benefits, attributing her inability to work to MS, but her insurance provider denied the claim, asserting that the medical evidence did not conclusively show that her MS symptoms prevented her from performing her job.This is the oral argument in the 4th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Overview: the employer changed life insurance companies while an employee was already out on disability. Should the new company have covered the family when the employee passed away?The legal issue  revolved around the eligibility for life insurance benefits under an ERISA-governed policy. The main question was whether the insurer, Lincoln National Life Insurance Company, had abused its discretion in denying the plaintiff's claim for benefits. The dispute centered on whether Mr. Morris, the insured individual who died from leukemia, was "Totally Disabled" as of January 1, 2015, under the terms of the policy, and thus ineligible for coverage. The court's decision focused on evaluating the evidence to determine whether the insurer's conclusion that Mr. Morris was totally disabled and therefore not eligible for coverage was reasonable and supported by substantial evidence.The District Court held in favor of Lincoln. This is the argument in the Fourth Circuit Court of Appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Aetna denied the claim. The claimant appealed and then asked for her claim file. Aetna said "no," we won't give it to you. Does that violate ERISA's long term disability claim regulations?In this oral argument from the Fourth Circuit Court of Appeals in Richmond, Virginia, long-term disability attorney Ben Glass (Fairfax, VA) represents a claimant whose long-term disability claim was unjustly denied due to procedural errors and the insurance company's refusal to provide essential documents. This case highlights the importance of claimants having access to all relevant information to effectively communicate with insurers and spot violations of ERISA regulations.Each hearing we discuss points to the need for more transparency and fairness in the ERISA process. We emphasize why it's crucial for every claimant to be well-informed and advocate for themselves effectively. Our podcast aims to equip you with essential knowledge and insights into navigating these complex issues.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this case, the claimant served as a plant manager for Charles Craft Inc., a position he held since the 1970s until he was compelled to leave due to a series of strokes and heart problems. Given his occupation required significant responsibility and oversight, it became untenable for him to continue in this role due to his severe health issues.Subsequently, the claimant faced multiple medical conditions, including difficulty breathing, high grade stenosis, hypertension, diabetes, and more, which significantly impacted his daily life. In addition to these challenges, he underwent various treatments, such as a urological stent procedure and the placement of drug-eluting stents into his heart, indicating the severity of his health conditions.However, when he filed a claim for long-term disability benefits, Reliance Standard Life Insurance denied his claim. They argued that he did not meet the policy's definition of "Totally Disabled," asserting that the medical evidence provided was insufficient to prove he was unable to perform his job duties, despite the extensive documentation of his health issues.In response, the claimant contended that Reliance Standard had incorrectly assessed his condition, arguing that his severe health issues indeed prevented him from performing his occupational duties. His appeal focused on challenging the insurer's interpretation of the medical evidence and their assessment of his capacity to work.This is the oral argument in the 4th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this case the claimant worked as a writer/editor, a role considered sedentary and requiring him to sit almost continuously, with only occasional physical movements such as bending, twisting, or stooping and Zurich American Insurance Company, the claimant's insurance provider who denied his claim had concluded that the documentation did not conclusively show he was unable to fulfill his job duties as defined by the terms of the disability insurance policy. The claimant suffered from moderate pulmonary hypertension, moderate to severe pulmonic regurgitation, and a severe heart condition that necessitated heart catheterization and open-heart surgery for aortic valve replacement. Following his surgery, further assessments revealed a mechanical aortic valve replacement, mitral valve repair, and the absence of symptomatic reoccurrence of atrial fibrillation or flutter. Notably, his cardiologist highlighted the claimant's extensive cardiac history and the need for high doses of a diuretic, factors that significantly hindered his ability to work. The claimant then appealed, arguing that Zurich American Insurance Company had mistakenly evaluated the medical evidence related to his heart condition and treatments, including the heart catheterization and open-heart surgery. This is the oral argument in the 4th circuit court of appealsThese public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This is the oral argument in a case involving MetLife’s two year limitation of benefits for neuromuscular, musculoskeletal, or soft tissue disorders.In his disability claim, Penland cited several conditions. He contracted E. Coli during a business trip, leading to colon resection surgery, where part of his colon and a small intestinal cyst were removed. He also reported suffering from idiopathic gastroparesis, depression, cervical and lumbar degenerative disc disease, degenerative joint disease with osteoarthritis in both hips, IBS, cervical kyphosis, diverticulitis, restless leg syndrome, sleep apnea, psoriasis, vagus nerve damage, and altered bowel habits. Additionally, Penland underwent left hip replacement surgery.Penland's last position was as a Regional Procurement Specialist at Continental Automotive, Inc. His role involved managing indirect procurement for plant spending under $5,000, supporting operational and tactical activities for assigned plants. He was responsible for leading efforts in payment-related issues, receiving confirmations, and handling expedites. Penland reported becoming "completely and totally disabled" on August 14, 2015, ending his tenure in this role.The insurance company determined that the claim was subject to a two-year limitation of benefits due to the nature of the disability being categorized as a neuromuscular, musculoskeletal, or soft tissue disorder. These conditions are specifically limited under the plan. As a result, the maximum duration of benefits for this limited condition was set to expire on February 16, 2018.The claimant asserted he had radiculopathy, but the insurance company's doctor, Dr. Pietruszka, disagreed. Dr. Pietruszka's examination found no measurable evidence of radiculopathy in the claimant's cervical and lumbar spine around December 12, 2020. Despite cervical cord compression and lumbar disc disorder, there were no motor or sensory impairments or abnormal cord signals noted. The claimant also showed improvement in mobility and responsiveness to opioid therapy. Consequently, Dr. Pietruszka concluded the claimant was not functionally impaired to an extent that would necessitate restrictions or limitations.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.