Ortiz Law Firm is dedicated to helping people recover the disability benefits they deserve. We handle group Long Term Disability (LTD) claims, individual disability insurance policy claims, ERISA disability claims, and Social Security Disability claims.

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Nick Ortiz

Telemedicine And Disability Claims: Are Virtual Doctor’s Visits Becoming The Norm?

The COVID-19 pandemic has brought unprecedented changes to every aspect of our lives. One area that is seeing dramatic changes is the healthcare industry. Hospitals have become trauma centers, and doctor’s offices have been overrun with patients experiencing COVID-19 symptoms. Many people are avoiding these areas for fear of contracting the virus. This has made …

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Zaeske v. Liberty Life – Appeals Court Reverses District Court Decision And Denies Claim

The case summarized here involves Damon Zaeske (“Zaeske”), who was a project manager employed by Walmart. He ceased working on April 4, 2014, as a result of chronic back pain. Walmart’s insurance plan was underwritten by Liberty Life Assurance Company of Boston (“Liberty Life”); Zaeske applied for long term disability (LTD) benefits through this plan. When reviewing Zaeske’s claim …

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Mozdziers v. Aetna – Video Surveillance May Offer Significant Support For Denying LTD Claims

In Mozdzierz v. Aetna Life Insurance Company, the plaintiff (claimant) seeks long term disability benefits from Aetna, the insurer of his ERISA-governed long term disability plan. The Federal District Court (for the Eastern District of Pennsylvania) found that Aetna did not abuse its discretion in denying plaintiff’s claim based upon the record. In other words, Aetna’s denial of benefits was upheld. …

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Traumatic Brain Injuries From Playing Football In The NFL

A fast-growing lawsuit in the Eastern District of Pennsylvania has been filed against the NFL by nearly 4,000 former football players. They claim that the NFL “propagated its own industry-funded and falsified research to support its position” that athletes cannot receive long-term brain damage from playing football. The league’s highest medical experts have for years …

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Young v. Aetna – Aetna Commits Abuse Of Discretion In Denying Plaintiff’s LTD Claim

The Court granted Plaintiff’s Motion for Summary Judgment: “As explained above, I have identified three primary reasons for determining that Aetna abused its discretion in denying Plaintiff’s benefits: Inappropriate reliance on unreliable findings by Drs. Topper, McPhee, and Polanco; failure to address Plaintiff’s qualifications and ability to engage in sedentary occupations in light of her medication requirements; and failure to address the findings in the APS and Capabilities and Limitations Worksheets showing that Plaintiff could not perform full-time sedentary work.

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Sumpter v. MetLife – Court Rules Lawsuit Against MetLife Is Frivolous

In granting summary judgment for MetLife, the district court reasoned that when Sumpter became disabled, Delphi’s plan did not provide the benefit he sought and that he was not entitled to equitable relief. The U.S. Court of Appeals for the Seventh Circuit upheld this decision.

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Gilmore v. Liberty Life – Court Finds No Reason To Doubt Claimant’s Credibility

In this case, the plaintiff noted that the Policy’s states that “‘Proof’ means the evidence in support of a claim for benefits and includes, but is not limited to, the following.” Plaintiff thus argued that, while objective medical evidence may be sufficient to support a disability claim, it was not necessary to do so.

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Glenn v. MetLife – Understanding How Courts Evaluate Long-Term Disability Lawsuits

A Court must take into consideration the conflict of interest inherent in a benefits system in which the entity that pays the long-term disability benefits maintains discretionary control over the ultimate benefits decision. This is done by weighing the structural conflict as one of the many factors relevant to the benefits determination decision. However, this conflict of interest …

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Good Morning America Host Discloses Myelodysplastic Syndrome (MDS) Diagnosis

Television personality Robin Roberts has disclosed that she has Myelodysplastic Syndrome, which can qualify an individual to receive long-term disability benefits. Myelodysplastic syndromes, commonly referred to as MDS, are not easily categorized. They encompass numerous different diseases and are a group of blood and bone marrow disorders. In MDS, stem cells do not mature normally. As such, …

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Potter v. Unum – Insurance Saleswoman Denied Disability After Selling Millions In Disability Insurance Policies

One of the hardest things I must explain to clients is how the insurance company does not care about the client’s disabling condition. Disability insurance companies are for-profit corporations constantly seeking ways to increase their bottom lines. More often than not, they accomplish this by denying long-term disability claims. In this article, we discuss an insurance …

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