ERISA Experience You Can Rely On.

Attorneys Raquel Busani + Robert Rosati

Long-term disability denials often deny plain facts

On Behalf of | Sep 23, 2019 | Firm News

There are laws “on the books” meant to guarantee your long-term disability insurance will be there for you if you’re unable to work due to a health condition. But too often, laws are one thing and business is another.

A Chicago CBS affiliate recently profiled Glenn, a senior vice president at a prestigious interior design magazine until his heart condition made it impossible to continue his career. According to the profile, an insurance company denied his claim by saying simply that he actually could keep working, despite what his doctors say.

Quintuple bypass and multiple heart attacks not enough

Today, Glenn sometimes loses his breath just from making breakfast. He says he loved his job but found himself having to hide his chest pains while talking to clients. He wasn’t always sure he would make it through presentations, and his heart forced him to retire early, according to the CBS story.

He’s had two heart attacks and is at high risk for a third. His doctors found the state of his heart justified five-way bypass surgery. They consider their patient to be permanently disabled.

Insurance company disagrees with doctors and evidence

The insurance company argues that there is “no evidence” that being a senior vice president at a major publication “involves more than occasional standing and walking,” as quoted by the report.

Glenn’s counsel cites the problem as insurance companies deliberately denying payment until the customer settles for a tiny fraction of the insurance benefits which they are entitled.

It’s a question of people being worn down by an entity that doesn’t get worn down, counsel says. Insurance companies don’t experience t financial and emotional stress. Businesses don’t have heart attacks. All too often, the only way to counter such a business model is to fight back.

Fighting back against denial of long-term disability

The Employee Retirement Income Security Act (ERISA), which this year marks 45 years of protecting America’s workers, requires employee-sponsored disability insurance to meet its obligations.

Unfortunately, Glenn’s experience with his insurance company is disturbingly common.

ERISA is federal law. If your employer-sponsored insurance provider has denied your disability claim, federal law requires that the insurer follow specific guidelines in administering your long term disability claim.

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