Attending Physician’s Certifications of Disability: How Important Are They for Disability Insurance Claims Under ERISA?

Posted in: Disability Insurance, ERISA, Insurance Litigation Blog, Social Security Administration September 14, 2018

Many employees are covered by group short-term disability insurance and/or group long-term disability insurance.  These plans provide benefits to employees who cannot return to work because of illness or injuries that prevent them from performing their work activities.  The Employee Retirement Income Security Act of 1974 (“ERISA”) governs most of these insurance plans.  Unfortunately, sometimes an insured becomes disabled and must support his claim for disability benefits.  The insured’s attending physician typically has examined the insured and determines that he cannot return to work.  The insured will want to use his physicians’ certification of disability to support his disability by submitting it to his insurer.  A common question is:  Must an insurance company accept the treating physician’s opinion regarding the …

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National Investigation Uncovers Systemic Practice Among Life Insurers Depriving Beneficiaries of $5 Billion!

Posted in: Insurance Commissioner, Insurance Litigation Blog, Life Insurance, Social Security Administration April 29, 2016

Four years ago we blogged about Metropolitan Life Insurance Company’s (“MetLife”) inconsistent use of the Social Security Administration’s Death Master File database to deprive beneficiaries of $40 million in life insurance benefits.  See https://mslawllp.com/metlife-pays-40-million-to-settle-allegations-that-it-failed-to-properly-identify-and-pay-life-insur/.  That database, created by the Social Security Administration, is consistently updated with the names and identity of everyone for whom a death certificate is filed in the United States.  The Administration licensed it to life insurance companies so they could easily identify decedents, a necessary part of their business.…

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The Number of Disabled Employees Increase as More Employers Drop Long-Term Disability Coverage

Posted in: Disability Insurance, Disability Insurance News, Insurance Litigation Blog, Legal Articles, News, Social Security Administration August 05, 2014

A disturbing trend that has developed across the country in recent years is that, while the number of workers/employees suffering from long-term illnesses or injuries has increased, the number of employers who provide long-term disability insurance has dropped dramatically.  As of May 2014, the total number of Social Security disability beneficiaries in the United States hit an all-time high of about 11 million beneficiaries.  However, fewer employees are covered with long term disability coverage.  The number of U.S. workers with long-term disability coverage decreased 6% from 2009-2013.  Below are just a few of the worrying statistics.  From 2009-2013 nationwide:

  • The number of employers offering long-term disability coverage decreased from 220,000 to 213,000;
  • The number of employees who have long-term
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Council for Disability Awareness Follows Approvals of Disability Claims by the SSA and Private Disability Insurers

Posted in: Disability Insurance, Disability Insurance News, Insurance Litigation Blog, News, Social Security Administration January 14, 2010

Allison Bell of the National Underwriter reported on September 11, 2009 that approved disability claims rose more quickly in 2008 at the Social Security Disability Insurance program than at private disability insurers. She explained that the Council for Disability Awareness in Portland, Maine reported that findings in a summary of results from an analysis of SSDI program data and a survey of the 15 CDA member disability insurance companies were as follows:

SSDI applications rose 5.9% in 2008, to 2.3 million, and the number of workers approved for SSDI benefits increased 8.7%, to 895,000, the CDA reports.

The percentage of workers covered by the SSDI program who are receiving SSDI benefits increased to 4.8% in 2008, from 3.5% in 1998.…

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