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Your Erisa Benefits

Standard

Your Disability Benefits Have Been Denied Or Terminated By Standard. What Can You Do? The ERISA Law Center Can Help You.

Most disability benefit claims are governed by ERISA. Some disability benefit claims, those based on government plans and some church plans, are not governed by ERISA. Either way, the ERISA Law Center can help you. We regularly represent persons who have been denied both and ERISA and non-ERISA disability benefits by Standard.

Disability benefit claims denied by Standard often follow a common pattern. Sometimes Standard denies disability benefits because you or your doctors did not complete and submit to Standard forms or medical records it requested. You can often fix that problem yourself by completing the forms, seeing your doctor, and getting your doctor to do complete forms, and provide medical records.

Sometimes Standard denies disability claims without paying any benefits or after paying only short-term disability benefits. A common Standard practice in such denials is that Standard only obtains a few months of your medical records and does not get records from all of your doctors. Then its in-house doctors and nurses “cherry-pick” those records, resulting in a denial of your benefits. You can sometimes correct that problem yourself by submitting all of your medical records and having one or more of your doctors provide letters explaining why you cannot work.

In most Standard disability policies, the definition of “disabled” changes after you receive 24 months of benefits. For the first 24 months, you are entitled to benefits if you are unable to do your own occupation. After 24 months, you are entitled to benefits only if you cannot do any occupation. Standard will often terminate disability benefits with just a few months of “own occupation” benefits to be paid. Another common pattern is that Standard terminates benefits after paying all the “own occupation” definition of disability benefits.

Often Standard will deny or terminate disability benefits during the “own occupation” definition of disabled not because it claims you can do your own job but because Standard claims you can do a similar job. Most Standard policies define “your occupation” not as what you actually do for your employer but what people doing similar jobs generally.

Most Standard disability policies have a change of definition to the “any occupation” definition after you receive 24 months of benefits. Often Standard terminates benefits at the end of 24 months, claiming you can do some other job. Often the jobs Standard claims you can do are make-believe. Often the wages Standard claims you can earn are also make-believe. But, Standard has a report from a vocational expert – employed by Standard who says you can perform these jobs and earn these wages.

When Standard denies or terminates benefits it invites you to request a review and file and “appeal.” Typically, after the appeal is submitted Standard obtains new medical or vocational reports and invites you to review those new reports and comment on those. When you only have a few months left of benefits under the own occupation standard and it denies those benefits, it forces you to do a full appeal and to comment on its new medical and vocational reviews for just a few months’ benefits – and then typically denies benefits again when the definition of disabled changes to the any occupation definition.

Standard uses a variety of medical professionals – nurses and doctors it employs and nurses and doctors employed by others to review your records. These nurses and doctors often “cherry-pick” your medical records – picking bits and pieces out of context to support the conclusion that you are capable of working.

Sometimes Standard will require that you attend an “independent medical examination” or a “functional capacity evaluation.” Often Standard secretly surveils you while you are going to and from these examinations and on the days before and after these examinations – and then claim that because you can walk to your car, drive your car, and maybe fill it with gasoline, you are capable of working.

In reviewing claims and appeals Standard uses a great many “independent physician consultants” who often no longer practice medicine, often work at Standard’s offices and routinely write reports which Standard uses to deny claims. The reports are usually well written, usually well organized, and often very persuasive. Since the “independent physician consultants” are on contract with Standard, Standard often uses outside doctors on appeal reviews. Most Standard policies entitle a claimant to benefits if the claimant cannot work “with reasonable continuity” in his or her own job or in any occupation which he or she is reasonably able to perform. Standard often only pays lip service to the “reasonable continuity” requirement: if you are incapable of working two days out of five, then, according to Standard, you can work with reasonable continuity; if you are regularly sick and need weekly medical care, then, according to Standard you can work with reasonable continuity. Standard’s doctors often “spin” their reports to support Standard’s position.

The law – whether ERISA or if not an ERISA claim, state law – gives you the right to fight back to recover your disability benefits. The ERISA Law Center can help you. We know the law. We know Standard’s common practices. We know what evidence you need to demonstrate either to Standard or in court if your internal appeal is not granted to recover your disability benefits.