Disability Benefits

News & Analysis as of

What You Have To Do To Get More Disability After Your Case Closed

You may be entitled to additional disability compensation, even if the adjuster is telling you that your case is closed, if you can show two things. First, you have to show that you have a compensable case that you haven’t...more

Just Because You Hurt Isn't Enough To Establish You're Entitled To Benefits

As we’ve discussed, you have to prove that you’ve been injured as a result of your work-related accident to get medical treatment for that injury. One of the common misconceptions that can arise out of workers’ comp claims...more

Getting More Treatment

A lot of times we’ll get calls from injured workers saying that the adjuster has told them their case has been closed and they can’t get anymore treatment or disability benefits. Sometimes, the adjuster’s right. But a lot...more

Concurrent Causation from "A Medley of Interesting Disability Cases"

Facts and holding: Rita Kruk (“Kruk”), a Human Resources Specialist, was a participant in an ERISA plan provided through her employment that provided disability benefits. Kruk’s Plan stated that if a disability was due to a...more

You Should Know - October 2014

In This Issue: - Veterans Still Waiting - Five Errors to Avoid - Readers on Seventh Amendment - Excerpt from Five Common Errors to Avoid When Filing Claims: Backlog Improves, But Vets Still Struggle for...more

When a Parent Retires, a Child with Disabilities Could Qualify for SSDI

When the parent of an adult with disabilities retires, the child may qualify for federal disability benefits, even if the child has never worked. This benefit, known as the Disabled Adult Child program, allows the...more

One Big Issue That Can Endanger Your Child’s Special Needs Trust

One of the major reasons to create and fund a special needs trust for your disabled child is so that your child can still receive means-tested government benefits, including Supplemental Security Income (SSI), Medicaid, and...more

A Court’s Review of a Disability Benefit Claim May Hinge on the Meaning “Satisfactory to Us”

Twenty-five years ago, the U.S. Supreme Court ruled that courts should review an ERISA participant’s claim for benefits under a de novo standard of review unless the plan gives the plan fiduciary discretionary authority to...more

District Court Certifies Class Challenging ERISA Plan Amendment

The Eastern District of Michigan has certified a class of ERISA plan participants challenging an amendment which, in attempt to address the plan’s underfunded status, reduced their monthly disability payments. The Court...more

ERISA: 2nd Circuit — Tough to Appeal District Court’s ERISA Remand Order

What happens when the district court orders a remand to the ERISA plan administrator? Can you appeal it? It depends on the circuit. FACTS: Mead sought ERISA-governed long term disability benefits, which were...more

Documentation important in proving workers’ compensation claims

Under the state of Illinois’ Workers’ Compensation Act, employees who suffer occupational injuries or illnesses may, under most circumstances, be eligible for benefits. The types of benefits that may be provided include...more

Autoimmune diseases and workers’ compensation

Many people in Illinois, and throughout the United States, suffer from autoimmune diseases. According to the American Autoimmune Related Diseases Association, approximately one in five people in the U.S. suffer from an...more

May v. AT & T Umbrella Benefit Plan No. 1: Independent Physician Reviews of the "Paper File" Under Fire

On August 25, 2014, the Ninth Circuit upheld a District Court decision that an ERISA administrator’s denial of a short-term disability (STD) benefit claim may not be based solely on an independent physician’s review of the...more

What's An Apportionment of Your PPD Award?

Forgive me for not explaining the word apportionment sooner in my past blog posts about permanent partial disability awards on Nevada workers' compensation claims. It's a bad word, and it means subtraction from the...more

LTD insurance requirements coming soon for Ontario employers

As part of the 2014 Ontario budget, which was passed on July 24, 2014, the Ontario government proposed to amend the Insurance Act (Ontario) by requiring mandatory insurance of long-term disability (“LTD”) benefits provided by...more

Sixth Circuit Affirms Dismissal of Class Claims Regarding Disability Benefits

ERISA benefit claims are frequently of only modest size individually, but can become overwhelming in a class context. A decision this week from the Sixth Circuit affirms the dismissal of a putative class-wide disability claim...more

ERISA: Plaintiff’s Attorney Fees Denied — Filing Of Lawsuit Was Not Reason Why Benefits Were Granted

You already know that in ERISA cases a court may, in its discretion, award attorney fees if a party achieved “some degree of success on the merits.”...more

District Court in Fourth Circuit Rejects Extension of Amara-like Remedies to Benefit Cases

The Honorable Martin Reidinger, sitting in the United States District Court for the Western District of North Carolina, declined Plaintiff’s invitation to extend the applicability of Cigna v. Amara, 131 S. Ct. 1866 (2011), to...more

Ontario Employers Must Insure Long-Term Disability Benefits

The Ontario Budget introduced by the newly-elected Liberal government on July 14, 2014 includes a proposal for mandatory insurance of long-term disability (LTD) benefits. The Budget was accompanied by Bill 14, Building...more

More Disabled Employees But Fewer Employees Covered With Long Term Disability Coverage

Here is a recent news item showing the scope of the employee disability problem. In a nutshell...more

North Carolina Supreme Court Allows Termination of TTD Benefits on General Economic Conditions

Employees injured on the job who are terminated by their employer are generally entitled to collect temporary total disability (TTD) benefits under the Workers’ Compensation Act until they are able to locate suitable...more

Proving eligibility for workers’ comp benefits

Any number of incidents, including falls, auto accidents, machine entanglements and repetitive motion, can contribute to employees in Illinois, and throughout the U.S., suffering a serious injury or illness in the workplace. ...more

Tenth Circuit Says a Leave of Absence of More than Six Months Is Virtually Never a Required Accommodation

“[R]easonable accommodations…are all about enabling employees to work, not to not work.” This fundamental insight guides the recent decision by the U.S. Court of Appeals for the Tenth Circuit, holding that a six-month,...more

I Can’t Get No SATISFACTION-- In the Eleventh Circuit, Is Discretionary Language Still "Satisfactory to Us"?

Ever since the United States Supreme Court addressed the question of whether a wholesale adoption of the "arbitrary and capricious" standard of review would be appropriate for judicial review of denial of benefit...more

Employee Benefit Plan is Governmental Plan, Even Though Employees are Not, says District Court in 11th Circuit.

It is a deceptively simple statement: Governmental employee benefit plans are exempt from ERISA. 29 U.S.C. § 1003(b)(1). But what about an employee benefit plan of an entity affiliated with a governmental entity, but whose...more

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