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ERISA LAW BLOG

Offsets and Other Income Benefits – What are they, and what do they mean for your short term and long term disability benefits?

Offsets and Other Income Benefits – What are they, and what do they mean for your short term and long term disability benefits?

One of the important issues that I think every ERISA short term/long term disability claimant needs to know about is what offsets or “other income benefits” are and how they affect short term and long term disability benefits.  Basically, the insurer gets credit for any other income that a claimant receives from other sources.  Here ...

Self-Funded Plans vs. Insured Plans: What is the Difference?

Self-Funded Plans vs. Insured Plans: What is the Difference?

If a person is covered by an ERISA governed employee benefit plan through a private employer, chances are that the plan is either self-funded or insured.  What is the difference? A self-funded plan means that the benefit plan is funded by an individual’s employer.  In other words, benefits are paid through a plan which is ...

Denial of a Long Term Disability Claim Due to Pre-Existing Condition

Denial of a Long Term Disability Claim Due to Pre-Existing Condition

One of the most difficult and complicated areas of ERISA law is a reversing a disability denial based upon a pre-existing condition exclusion. These types of exclusions are found in most every disability policy, and they contain language that states benefits will not be payable for pre-existing conditions that are the cause of a claimant’s ...

ERISA Life Insurance Benefits and Divorce Decrees

ERISA Life Insurance Benefits and Divorce Decrees

Do Divorce Orders Preempt ERISA Life Insurance Beneficiary Designations? In the last year or so, I have had clients with this question. The short answer is most likely no.   The reasoning is twofold. First, ERISA requires that insurance company’s pay out benefits consistent with the terms of the plan. Most life insurance policies state that ...

Independent Medical Exams

Independent Medical Exams

Independent medical exams (IME), neuropsychological testing, and functional capacity exams (FCE) have long been a part of disability reviews.  However, in the last couple of years, I have noticed a great increase in the numbers requested by insurers and I expect, because of some court rulings, for that number to rise.  These exams can be ...

I’ve appealed my South Carolina disability case to the SC Public Employee Benefits Authority.  Now what?

I’ve appealed my South Carolina disability case to the SC Public Employee Benefits Authority. Now what?

A question that I frequently receive from clients is “why does this process take so long?”  When an individual has been denied his or her disability benefits, the financial situation can often go from bad to worse. As with most types of civil litigation, ‘speedy’ is rarely a word that can be used to describe ...

What is the difference between short term disability (STD) and long term disability (LTD)?

What is the difference between short term disability (STD) and long term disability (LTD)?

I am writing this post because I think it is important for clients and potential clients to be able to distinguish between a claim for STD (short term disability) benefits and a claim for LTD (long term disability) benefits.  An individual should file a STD claim when he/she anticipates being out of work for a ...

Why Surveillance Can Make or Break Your Disability Claim

Why Surveillance Can Make or Break Your Disability Claim

I am writing this blog to follow up on my previous blog on social media and short term/long term disability claims.    Another insurance company tactic that all short term/long term disability claimants should be aware of is surveillance.  Insurance companies can and do hire outside investigators to perform surveillance on claimants.  Insurance companies also very ...

The Wheels of Justice Grind Slowly at Times

I had a professor in law school that would frequently use that quote when describing various components of the legal process. As unfortunate as it may be sometimes, it often rings true.  We live in a fast-paced society that is only getting faster. Between two-day, online delivery and lightning-quick smartphones, consumers want, and expect, everything ...

Social Media and Short Term/Long Term Disability Claims

Today’s world is dominated by social media.  Many clients do not realize, however, that social media can have an adverse effect on a short term/long term disability claim.  There has been an increasing trend by insurance companies to use social media, in part, to deny an individual’s disability claim.  It is an important trend that ...

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