Tag: Administrative Appeals
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Cude’s Short-Term Disability Claim Survives an Employment Release
An employment release signed during a pending disability appeal did not bar Cude’s ERISA claim. The court examined the release’s scope and the later final denial, leaving the benefits dispute unresolved.
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Provident Partial Disability Claims Need More Than Lost Income
Whitlock’s earnings loss met the policy threshold, but the court found insufficient proof of occupational limits. The decision shows why duties, duration, and continued work need clear supporting evidence.
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Hartford’s “Any Occupation” Review: Why Job Demands and Appeal Records Matter
A recent ERISA disability decision examines Hartford’s appeal handling, retraining assumptions, and proposed job demands. The court returned the claim for renewed review without ordering an immediate benefits award.
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A Later Diagnosis Needs a Clear Connection to Your Work Limitations
A California court upheld Unum’s termination of a lawyer’s disability benefits despite later diagnoses. The decision shows why medical evidence must explain specific work limitations at the time benefits ended.
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Prudential LTD Lawsuit Highlights the Need to Identify the Plan and Explain Entitlement
A New Jersey court dismissed a Prudential disability complaint without prejudice, leaving ERISA coverage unresolved and identifying gaps in the allegations supporting benefits.
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Lincoln LTD Denial Sent Back for Review: Why Psychiatric Evidence Must Connect to Job Duties
An Ohio court returned a Lincoln disability claim for renewed review, emphasizing psychiatric limitations and safety-sensitive work without awarding benefits.
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When an ERISA Plan Defines a Lawyer’s Specialty, Generic Job Duties Fall Short
A federal court held that Unum could not evaluate a securities lawyer’s long-term disability claim using the generic duties of an attorney. The decision shows why a plan’s exact occupational definition can shape both the claim analysis and the remedy.
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Seven Years of LTD Benefits Did Not End Aetna’s Review
A Minnesota federal court upheld Aetna’s termination of long-term disability benefits after seven years of payment. Young shows why current functional evidence can matter when an ERISA insurer reexamines an established claim.
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When an LTD Carrier Changes Its Vocational Rationale on Appeal
An ERISA appeal should address material changes in vocational evidence, especially when a carrier revises a job’s physical demands.
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When Disability Isn’t Disputed, Why Can LTD Benefits Still End?
Pankey v. Aetna shows why a financial-records dispute can threaten long-term disability benefits even when the claimant’s physical disability is undisputed.
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