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ERISA LAW BLOG

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 ...

“Why is Standard/PEBA taking so long to make a decision on my State of South Carolina long term disability appeal?”

This is a question I get asked quite often by clients of mine who are State of South Carolina employees.  When a long term disability claim is denied for a State of South Carolina employee, there are two levels of appeal.  The first level of appeal is to Standard Insurance Company.  If Standard denies the ...

October 2017 Appeal Approvals

Most of the disability cases that come to us are still in the appeal phase.  What that means is we have an administrative appeal that must be exhausted prior to filing a lawsuit in Federal District Court.  While I normally explain cases to potential clients, by giving them a worst case scenario, administrative appeals are ...

Do I Need An Attorney to Appeal the Denial of My Disability Benefits?

Almost every day, I’m asked by potential or current clients, “Do I need an attorney for the appeal process?”  Invariably, that answer is “Yes.”  While the insurer or your claims person from the insurance company may tell you that you do not need an attorney and that if you simply submit your own appeal they ...

Dealing with Subrogation, Reimbursement, and ERISA Liens

Many attorneys often encounter difficult situations in dealing with ERISA plans who are asserting a lien, subrogation right, or a reimbursement action.  This is a common problem faced in many personal injury cases.  Attorney Nathan Bax was featured in the South Carolina Lawyers Weekly discussing how to tackle these tough issues.  Please see the article ...

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