Blog - ERISA and Disability Rights and Benefits - Alabama - The Martin Law Group, LLC

The Right to Respond The third change that the new claim procedure regulation will require is the right to respond to newly-considered or newly-generated information. Many times, plans “sandbag” – that is they wait until the final appeal to require an independent medical evaluation or send the fi...

Pain can limit people from working. We all know that. If you hit your thumb with a hammer, you will see how difficult it is to focus on other matters. The problem for long-term disability insurers is that pain is subjective and varies between people. You cannot take an x-ray or a blood test to me...

What happens if your employer switches providers for an ERISA benefit? It can mean that you start over in meeting certain terms, such as a pre-existing condition exclusion or some other limitation. This recently happened with a two-year suicide exclusion in Cole v. American Heritage Life Insuranc...

For claims filed after April 1, 2018, there have been some changes that will be helpful to claimants and hopefully make the claim process fairer: Change #2: The Explanation For ERISA long-term disability claims and pension disability claims, the insurance company or plan administrator must now ex...

Mr. Williams, who suffers from numerous physical illnesses and can no longer work, found out the hard way how confusing and unfair it can be to calculate the deadline for filing an ERISA lawsuit. His lawsuit “blew up” before it was filed! Williams v. Hartford, 2018 WL 1885783, (S.D. Miss 2018). M...

Over the next few weeks, we will be discussing the five ways that the new claim procedure regulations will impact your long-term disability claim. For claims filed after April 1, 2018, some changes have been made that could be helpful to claimants and will hopefully make the claim process fairer....

Many experienced litigators have gotten caught in the speed trap known as ERISA. As with any other speed trap, ERISA has some unexpected provisions that can catch even the experienced litigator off guard. Just as “Police Jurisdiction” signs can provide some warning when travelling unfamiliar road...

In the world of long term disability insurance carriers, managers of claims departments are constantly looking for a way to make the company more profitable. One way is to push the boundaries regarding offsets written in the plan. What is an offset? An offset is the reduction of the long-term dis...

Employee benefit claims usually arise under a federal law called the Employee Retirement Income Security Act (ERISA). As we explain on our website, ERISA has very specific, hard and fast deadlines, and many unique statutory provisions. Since ERISA is a federal law, this means that employee benefi...

Mr. Earl Bryant, a retired VP of Human Resources for General Electric has recently learned a hard lesson from a federal court in Georgia. The Lesson? His former employer, which is the plan administrator, can state misleading information in a summary plan description, as long as the plan document ...

In ERISA litigation, one of the first things the plaintiff's counsel will hear when discussing discovery with defense counsel is that there doesn't need to be any discovery at all. This is suggested because the case must be decided on the administrative record, which the defendant contends it has...

Some people honestly believe that if they are transparent and honest, their long-term disability adjustor will pay their claim. Unfortunately, that is usually not the case. Following are actual examples of things we have heard clients say to their adjustors, few ended up actually derailing their ...

Many long term disability claimants have severe, disabling medical conditions from which they will obviously never recover. Despite this sad reality, we have to remind such clients that in litigation, a court cannot award future benefits. Many clients are surprised to learn that despite winning t...

They all provide timely advice to prevent clients from being negatively impacted by accepting severance payments. One of the harder choices an employee makes when terminating employment is whether to accept a severance payment which usually requires the signing of a release of all claims. That in...

A recent case, Popovich v. MetLife Ins., 2017 WL 6546920, Dec. 21, 2017, hot off the press from the Central District of California, reflects the common, impervious attitude of insurance carriers. They typically believe they have few limits on their decision-making and that a court has to agree wi...

Alice in Wonderland – “I give myself very good advice, but I very seldom follow it.” In a recent ERISA case, Magistrate Judge David Baker explained that if an insurer uses a doctor to deny a claim, it has to also follow the doctor's advice. (See Schultz v. Aetna life Ins. Co. et al, 2017 WL 48038...

Most lawyers know that an ERISA benefit claim is similar to a breach of contract action. The Supreme Court has said as much in Firestone v. Bruch. As a result, most lawyers also assume that there is plenty of time before it is necessary to file a lawsuit regarding an ERISA claim. However, a recen...

Though not originally a part of ERISA, a significant later amendment was the COBRA notice requirement. While no employer is going to mistake this COBRA for a snake, many have been bitten by it nonetheless, with penalties of up to $110 per day. That can paralyze a small business if one or more yea...

Cobras are known to be deadly, but truth be told, they don't always strike – even when provoked. COBRA here refers to the law that requires employers to offer an employee the option to continue health insurance coverage at a little more than the group health insurance rate for a period of time af...

Though most attorneys have to attend law school and pass the Bar exam to practice law, Reliance Standard Insurance Company decided that the ability to walk a dog was sufficient enough for one attorney to practice law. In a recent case, an attorney who suffered from numerous debilitating medicial ...

We took a long hard look at our website. It did not provide the information that you most often needed in an easy-to-access format. So, we changed it. WHAT'S NEW? For Attorneys. You are important to us. So, we created a tab especially for attorneys. Click it, and you will see the types of claims ...

They were both in a recent case opinion written by Magistrate Judge Jonathan Goodman in Johnston v. Aetna Life Ins. Co., 2017 WL 4654431(M.D. Fla. 2017). Judge Goodman pulled lyrics from No Doubt's song “Don't Speak” to illustrate the Plaintiff's case wherein he was seeking an explanation as to e...

When an employer terminates an employee's healthcare coverage, that employee often earns healthcare protection rights under the Consolidated Omnibus Budget Reconciliation Act, or COBRA. Now, COBRA coverage is confusing—we often encounter questions regarding COBRA, a worker's rights to COBRA cover...

What is a top hat plan? Do I have one? If you are a well-compensated executive in a company, then you might have a top hat plan. Top hat plans are unfunded plans maintained by an employer primarily to provide deferred compensation for management or highly compensated employees. These plans are no...

Many employers offer accidental death and dismemberment insurance, a form of life insurance for employees. If the loss of life or limb is the result of an accident, then a lump sum will be paid. However, one court found that if someone, in the chain of events resulting in loss of life or limb, wa...