Social Security Administration Adopts New Criteria for Evaluating Mental Disorders

In addition to dealing with short term disability benefits, long term disability benefits, and health insurance denials, many of our clients are also tasked with applying for Social Security Disability benefits. On January 17, 2017, the Social Security Administration adopted new rules for evaluating mental disorders.  These rules reflect the most comprehensive revision in over […]

April is Parkinson’s Disease Awareness Month

April is Parkinson’s Disease Awareness Month, which makes it a fine time to talk about the organization that provides information, support and education for those who suffer from Parkinson’s Disease (PD) as it provides a wealth of information useful in a disability claim. The Parkinson’s Disease Foundation (PDF) works to find a cure, to advance […]

If you are currently receiving long-term disability benefits from your insurance carrier you may be able to receive a lump sum buyout

A lump sum buyout, also known as a disability settlement, is one payment for the agreed upon value of a claimants disability insurance policy. After this onetime payment is made, the claimant will no longer be paid benefits on a monthly basis. Additionally, the claimant no longer has an obligation to provide documentation that he […]

In-Network versus Out-of-Network: What you need to know when selecting a medical provider

One of the first questions we ask clients calling about the denial of medical benefits is whether the provider (i.e. hospital, treatment center, doctor) was an in-network or ­out-of-network provider. Some insurers use different terms such as participating provider or contracted provider. These terms all mean that the insurance company, or its claims administrator, has […]

WORKPLACE DISABILITY MORE COMMON THAN WORKERS BELIEVE

A 2014 study of Canadian workers revealed that most individuals vastly underestimate the likelihood that they will become disabled. While nearly half of workers surveyed believe that disability occurs rarely, in reality over 14% of Canadians are currently on disability, while roughly 33% of individuals will experience a period of disability lasting longer than 90 […]

Trumpcare will cut mental health care and substance addiction treatment for 1.3 million people

Trumpcare, the Republicans’ proposed plan to replace the Affordable Care Act (ACA) — also known as “Obamacare” — will cut mental health and addiction treatment for 1.3 million people, just as the country is struggling to cope with an epidemic of opiate addiction. The Washington Post reported on March 9, 2017, that House Republicans admitted under questioning […]

Top 7 Benefits of the Affordable Care Act…Some of Which May Soon Disappear.

As health care litigators, we are often asked about the benefits of the Affordable Care Act (“ACA” aka Obamacare). The bottom line is that more people have received more comprehensive coverage through the Affordable Care Act because of the following measures: No preexisting exclusion. Health plans can no longer charge more or deny coverage to […]

Michigan District Court overturns denial of benefits by Liberty Life Assurance Company of Boston

People often contact us asking how they can be approved for Social Security Disability benefits yet be denied by their insurance company. Another recurring question is how the insurer can rely on the opinion of a physician hired to perform a file review over the opinion of a treating physician. While insurance companies are allowed […]

If you have insurance, you need to know about the “notice-prejudice” rule!

Every insurance policy requires that you give notice of your claim for benefits to the company before benefits can be paid.  It doesn’t matter if the claim is for medical services, disability benefits, life insurance, fire, flood, theft, etc. Obviously, notice and information about your claim is necessary before the insurance conpany can process and pay the claim. Policies […]