MLS Website Supports Fibromyalgia Disability Claims

Typically insurance companies hire Medical Services Companies to have one of their physicians review a disability claimant’s medical records to confirm that the claimant can work.  MLS, MES, PDA, PRN, UDC, BMI, PsyBar are some of the Medical Service Companies frequently used by insurance companies to perform a “record review” to bolster a denial of benefits.  These third party vendors claim to be independent but in truth are anything but.  In fact, many of these vendors have been formed by prior employees of insurance companies.  To try to support their claim of independence they produce Websites that claim their impartiality [...]

By |2014-05-20T11:07:52+00:00May 20th, 2014|Legal Updates|0 Comments

Court Declares That Unum Has A History of Biased Claims Handling

The 9th Circuit Federal Court of Appeals, in the case of Stephan v. Unum Life Insurance Company, 697 F.3d 917 (9th Cir. 2012) overturned a trial court’s finding that the public record did not demonstrate that UNUM had a history of “biased claims administration.”  The Stephen Court specifically stated “Numerous courts, including ours, have commented on Unum’s history “’of erroneous and arbitrary benefits denials, bad faith contract misinterpretations, and other unscrupulous tactics.’”  Indeed, in Saffon, we attributed the trend of state prohibitions on discretionary provisions in insurance contracts to ‘the cupidity of one particular insurer, Unum-Provident Corp., which boosted its [...]

By |2013-10-09T10:10:10+00:00October 9th, 2013|Insurance Companies, Legal Updates|0 Comments

Lyme Disease Disability Claims Targeted by Insurance Companies

Lyme Disease is difficult to diagnose.  Although there are some laboratory tests that can confirm the diagnosis, the condition is mainly diagnosed clinically.  As a result, insurance companies often sieze upon the opportunity to argue that there is not objective proof of disability. Lyme Disease is a bacterial infection transmitted by the bite of an infected tick. A person may be aware of the bite; however, he may not be aware that the tick was infected. In its early stages, Lyme Disease may be a mild illness with flu like symptoms such as fever, chills, swollen lymph nodes, headache, fatigue, [...]

By |2013-01-17T11:26:35+00:00January 17th, 2013|Legal Updates|0 Comments

Why Fibromyalgia and Chronic Fatigue Patients Are Often Denied LTD Benefits

We have noted higher denial rates for disability claims from clients who suffer from fibromyalgia and chronic fatigue syndrome.  In order to combat these denials it is important to understand why insurance companies deny these claims.  Fibromyalgia and Chronic Fatigue - though two separate diagnoses - have several similarities.  The medical community has not yet come up with any objective testing to confirm the diagnosis of either condition.  They are diagnosed based on the subjective symptomology and the exclusion of other possible explanations for the symptomology.  The overriding symptoms are joint and muscle pain and incapacitating fatigue often referred to as [...]

By |2012-10-19T13:11:41+00:00October 19th, 2012|Legal Updates|0 Comments

Perfecting Your Rights With Lupus Disability Insurance Claims

Lupus is an autoimmune disease that can affect various parts of the body, including skin, joints, heart, lungs, blood, kidneys and brain.  Normally the body's immune system makes proteins called antibodies, to protect the body against viruses, bacteria, and other foreign materials.  In an autoimmune disorder like lupus, the immune system cannot tell the difference between foreign substances and its own cells and tissues.  The immune system then makes antibodies directed against itself, causing inflammation, pain and damage in various parts of the body. Lupus can cause unique problems in proving that one is disabled from returning to full time work.  [...]

By |2011-09-13T09:43:41+00:00September 13th, 2011|Legal Updates|0 Comments

Multiple Sclerosis Flares & Disability

A multiple sclerosis "flare" is a sudden worsening of one or more symptoms of the disease or the appearance of new symptoms which can last anywhere from days to weeks to months.  These exacerbations although temporary can be disabling, precluding a patient from gainful employment. Many clients who apply for disability benefits may be observed by an insurance company during a period when a patient is not experiencing a MS "flare."  However, since these "flares" can occur as frequently as once a month, a worker may be precluded from continuous gainful employment because the worsening or new symptoms frequently causes a [...]

By |2011-09-08T11:23:01+00:00September 8th, 2011|Legal Updates|0 Comments

Multiple Sclerosis Cognitive Dysfunction & Disability Insurance Claims

In addition to the very obvious physical symptoms of multiple sclerosis, such as loss of muscle function, problems with walking, vision disturbances, tremors, etc., there is a more debilitating symptom that often goes unnoticed - that of cognitive dysfunction.  This is separate and apart from the symptoms of fatigue and depression which also plague the MS patient. Common Disabling Conditions of Cognitive Dysfunction slowed speed of performance ability to retrieve memory affected reduced ability to recall words slowness in thinking impaired planning skills All of these non-physical impairments are not easily observable but have the most detrimental affect on being able to [...]

By |2011-09-07T10:38:18+00:00September 7th, 2011|Legal Updates|0 Comments

Disability Insurance Claim: County of San Diego (SDCERA)

Denial of Disability Retirement Reversed Stennett & Casino's client was employed by the County of San Diego for over 10 years in a clerical position.  She had to stop work because of an injury to her knee resulting from continued banging against a desk when she was placed in an awkward work station.  Despite the fact that she underwent 4 unsuccessful knee surgeries that left her with severe standing and walking limitations and severe pain with extended sitting, the County asserted that it could accommodate her limitations and continue to provide her a sedentary position. The County denied the client's [...]

UNUM & Paul Revere Life Insurance hit with 4.2 Million Verdict

A Los Angeles Superior Court jury awarded plaintiff Laura Kieffer 4.2 million in damages in her civil lawsuit against Paul Revere Life Insurance Company and Unum Group.  The award represented $600,000 in past and future disability benefits, $600,000 in emotion distress and $3 million in punitive damages. Ms. Kieffer was a dental hygenist in 1988 when she purchased an individual disability policy from Paul Revere.  Beginning in 1996 she developed several disabling medical conditions, including carpel tunnel syndrome and cervical pain radiating into her upper extremities, preventing her from being able to perform the repetitive motions and fine hand manipulations [...]

By |2011-05-27T08:32:13+00:00May 27th, 2011|Insurance Companies, Legal Updates|0 Comments

Hartford Insurance Company Found To Have Abused Its Discretion In Termination of Long Term Disability Benefits

Ms. Mennucci underwent spinal fusion surgery for cervical neck pain that radiated into her right arm. Hartford initially paid short term and long term disability benefits to Mennucci. However, when she failed to fully recover from her surgery and complained of continuing neck pain radiating into her right shoulder Hartford Insurance terminated her benefits based on a medical record review by Dr. Richard Kaplan.

By |2011-01-24T14:49:31+00:00January 24th, 2011|Insurance Companies, Legal Updates|0 Comments
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