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I’m a professional with a group plan policy and several private policies. How do they relate to each other?
Depending on the terms of the plan or policy, group policies generally do not offset their benefits by the amounts offered under private policies. Despite this fact, some insurance disability companies will assert an offset even in the absence of supporting contractual provisions. It is very important to read your plans or policies and make certain you consult with an experienced ERISA lawyer about the proper application of offset language.

I’ve been a nurse for over 15 years and am now being told I can work in a “sedentary” clerical position. What can I do?
This scenario usually happens when your policy transitions from an “own occupation” definition of disability to an “any occupation” definition. At that time, the disability insurer will try to characterize your capabilities as sedentary in nature. There are many provisions in the law, in your policy, and/or mandated by State Departments of Insurance which can prohibit or restrict an insurer from forcing you to work in a position which is inconsistent with your physical abilities and with your “background, training, and experience.”

I worked in the financial sector and most of my earnings were bonuses and commissions. Can I still receive the maximum disability benefit to which I am entitled?
The calculation of your disability benefit is a matter of contract interpretation relative to how, how much, and when you were compensated. If your income was a combination of a fixed salary with variable bonuses and commissions, it may be useful to engage an ERISA lawyer to work with your accountant in determining your full rights under the applicable policy.

I am a doctor practicing in my medical corporation. I’ve heard that ERISA doesn’t cover one-person businesses.
ERISA preemption, or whether ERISA governs a particular policy or plan, is a very complex area of the law. Sometimes, a practice involving one person can be governed by ERISA; sometimes not. The inquiry is best answered by examining the plan documents relative to the applicable law of that jurisdiction. Additionally, the answer to the question is very pertinent in that ERISA-preempted plans offer a narrower set of rights to the claimant than do those plans exempt from ERISA.

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