The issue centered around the claimant who was employed as a Windows Systems Administrator at the McKesson Corporation and suffered from chronic pain and
sleep disorders that greatly affected his daily life and ability to work. These
conditions formed the foundation of his request for long-term disability benefits.

Life Insurance Company of North America (LINA), the claimant's insurance provider, rejected his application for long-term disability benefits. This decision came after a thorough review of his medical records and consultations with their physicians, which, in their assessment, did not verify a disability severe enough to prevent the claimant from fulfilling his responsibilities as a Windows Systems Administrator.

The claimant then went to the court of appeals, arguing that the insurer had not acknowledged the severity of his chronic pain and sleep disorders. He maintained that these health issues substantially hindered his capacity to execute the functions of his role as a Windows Systems Administrator, underscoring a disconnect in LINA's appraisal of his condition and its impact on his professional duties.

This is the oral argument in the 7th circuit court of appeals

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

The case revolved around a claimant who challenged the denial of her long-term disability benefits from Reliance Standard, arguing that the insurer had failed to recognize the full impact of her multiple sclerosis (MS) on her role as a Financial Analyst at Adsum Inc.

As a Financial Analyst, the claimant was tasked with managing financial services, including analyzing complex systems and conducting evaluations. However, she later developed MS, which significantly impaired her work capabilities due to cognitive difficulties, fatigue, and physical impairments. These symptoms severely hindered her ability to effectively fulfill her duties.

Consequently, she filed for long-term disability benefits, attributing her inability to work to MS, but her insurance provider denied the claim, asserting that the medical evidence did not conclusively show that her MS symptoms prevented her from performing her job.

This is the oral argument in the 4th circuit court of appeals

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Overview: the employer changed life insurance companies while an employee was already out on disability. Should the new company have covered the family when the employee passed away?

The legal issue  revolved around the eligibility for life insurance benefits under an ERISA-governed policy. The main question was whether the insurer, Lincoln National Life Insurance Company, had abused its discretion in denying the plaintiff's claim for benefits. The dispute centered on whether Mr. Morris, the insured individual who died from leukemia, was "Totally Disabled" as of January 1, 2015, under the terms of the policy, and thus ineligible for coverage. The court's decision focused on evaluating the evidence to determine whether the insurer's conclusion that Mr. Morris was totally disabled and therefore not eligible for coverage was reasonable and supported by substantial evidence.

The District Court held in favor of Lincoln. This is the argument in the Fourth Circuit Court of Appeals.

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

Aetna denied the claim. The claimant appealed and then asked for her claim file. Aetna said "no," we won't give it to you. Does that violate ERISA's long term disability claim regulations?

In this oral argument from the Fourth Circuit Court of Appeals in Richmond, Virginia, long-term disability attorney Ben Glass (Fairfax, VA) represents a claimant whose long-term disability claim was unjustly denied due to procedural errors and the insurance company's refusal to provide essential documents. This case highlights the importance of claimants having access to all relevant information to effectively communicate with insurers and spot violations of ERISA regulations.

Each hearing we discuss points to the need for more transparency and fairness in the ERISA process. We emphasize why it's crucial for every claimant to be well-informed and advocate for themselves effectively. Our podcast aims to equip you with essential knowledge and insights into navigating these complex issues.

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this case, the claimant served as a plant manager for Charles Craft Inc., a position he held since the 1970s until he was compelled to leave due to a series of strokes and heart problems. Given his occupation required significant responsibility and oversight, it became untenable for him to continue in this role due to his severe health issues.

Subsequently, the claimant faced multiple medical conditions, including difficulty breathing, high grade stenosis, hypertension, diabetes, and more, which significantly impacted his daily life. 

In addition to these challenges, he underwent various treatments, such as a urological stent procedure and the placement of drug-eluting stents into his heart, indicating the severity of his health conditions.

However, when he filed a claim for long-term disability benefits, Reliance Standard Life Insurance denied his claim. They argued that he did not meet the policy's definition of "Totally Disabled," asserting that the medical evidence provided was insufficient to prove he was unable to perform his job duties, despite the extensive documentation of his health issues.

In response, the claimant contended that Reliance Standard had incorrectly assessed his condition, arguing that his severe health issues indeed prevented him from performing his occupational duties. His appeal focused on challenging the insurer's interpretation of the medical evidence and their assessment of his capacity to work.

This is the oral argument in the 4th circuit court of appeals

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

In this case the claimant worked as a writer/editor, a role considered sedentary and requiring him to sit almost continuously, with only occasional physical movements such as bending, twisting, or stooping and Zurich American Insurance Company, the claimant's insurance provider who denied his claim had concluded that the documentation did not conclusively show he was unable to fulfill his job duties as defined by the terms of the disability insurance policy.

The claimant suffered from moderate pulmonary hypertension, moderate to severe pulmonic regurgitation, and a severe heart condition that necessitated heart catheterization and open-heart surgery for aortic valve replacement.

Following his surgery, further assessments revealed a mechanical aortic valve replacement, mitral valve repair, and the absence of symptomatic reoccurrence of atrial fibrillation or flutter. Notably, his cardiologist highlighted the claimant's extensive cardiac history and the need for high doses of a diuretic, factors that significantly hindered his ability to work.

The claimant then appealed, arguing that Zurich American Insurance Company had mistakenly evaluated the medical evidence related to his heart condition and treatments, including the heart catheterization and open-heart surgery.

This is the oral argument in the 4th circuit court of appeals

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

This is the oral argument in a case involving MetLife’s two year limitation of benefits for neuromuscular, musculoskeletal, or soft tissue disorders.

In his disability claim, Penland cited several conditions. He contracted E. Coli during a business trip, leading to colon resection surgery, where part of his colon and a small intestinal cyst were removed. He also reported suffering from idiopathic gastroparesis, depression, cervical and lumbar degenerative disc disease, degenerative joint disease with osteoarthritis in both hips, IBS, cervical kyphosis, diverticulitis, restless leg syndrome, sleep apnea, psoriasis, vagus nerve damage, and altered bowel habits. Additionally, Penland underwent left hip replacement surgery.

Penland's last position was as a Regional Procurement Specialist at Continental Automotive, Inc. His role involved managing indirect procurement for plant spending under $5,000, supporting operational and tactical activities for assigned plants. He was responsible for leading efforts in payment-related issues, receiving confirmations, and handling expedites. Penland reported becoming "completely and totally disabled" on August 14, 2015, ending his tenure in this role.

The insurance company determined that the claim was subject to a two-year limitation of benefits due to the nature of the disability being categorized as a neuromuscular, musculoskeletal, or soft tissue disorder. These conditions are specifically limited under the plan. As a result, the maximum duration of benefits for this limited condition was set to expire on February 16, 2018.

The claimant asserted he had radiculopathy, but the insurance company's doctor, Dr. Pietruszka, disagreed. Dr. Pietruszka's examination found no measurable evidence of radiculopathy in the claimant's cervical and lumbar spine around December 12, 2020. Despite cervical cord compression and lumbar disc disorder, there were no motor or sensory impairments or abnormal cord signals noted. The claimant also showed improvement in mobility and responsiveness to opioid therapy. Consequently, Dr. Pietruszka concluded the claimant was not functionally impaired to an extent that would necessitate restrictions or limitations.

This podcast is brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA. To the extent that these episodes include oral argument recordings from real courts, these recordings are in the public domain and free to everyone to use as they see fit.

By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.

If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.