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

Wittman v. Unum – LTD Denial Was Not Arbitrary And Capricious

Anne Wittmann (“Wittmann”) was an attorney at Baker, Donelson, Bearman, Caldwell, Berkowitz PC (“Baker Donelson”). Unum Life Insurance Company of America (“Unum”) administered and underwrote the long term disability (LTD) plan that covered Wittmann. Wittmann filed a claim for disability benefits on April 7, 2014, since she had not worked from December 31, 2013. Under the …

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Bigham v. Liberty Life – In De Novo Review Court Should Conduct Bench Trial On The Record

Case Name: Rose Bigham v. Liberty Life Assurance Company of Boston Court: United States District Court for the Western District of Washington at Seattle Type of Claim: Long-Term Disability Insurance Company: Liberty Life Assurance Company of Boston a/k/a Liberty Mutual Insurance Company (hereinafter “Liberty Life”) Claimant’s Employer: Amazon, LLC Claimant’s Occupation / Job Position: Security Technical Program Manager Disabilities: chronic intractable pain, fibromyalgia, …

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Williams v. Standard – Court Upholds Plan Administrator’s Decision

Defendant advances two grounds for terminating the plaintiff’s long-term disability benefits. First, the defendant contends the plaintiff does not qualify for an exception to the “Other Limited Conditions” provision under the Plan because he does not have a herniated disc with documented neurological abnormalities. Second, the defendant claims the plaintiff is not disabled from all occupations and thus does not qualify for benefits during his policy’s “Any Occupation” period. If established, either of these grounds would provide a recognized justification for the termination of the plaintiff’s benefits under the terms of the Plan.

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Wilkinson v. Sun Life – Sun Life Abused Its Discretion By Denying Benefits

The Fourth Circuit held that Sun Life abused its discretion when it terminated Wilkinson’s benefits because he provided sufficient evidence to support his eligibility for coverage and because Sun Life’s decision to terminate benefits was not the result of a principled reasoning process and not supported by substantial evidence. The Fourth Circuit, therefore, affirmed the district court’s decision.

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Till v. Lincoln – Claimant Failed To Provide Adequate Documentation To Support Claim

Lincoln denied the Plaintiff’s LTD claim. The plaintiff filed a lawsuit in Federal Court. Lincoln filed a motion for judgment as a matter of law, to which Till responded with a motion for summary judgment. After a full briefing, the district court entered an order granting Lincoln’s motion and denying Till’s. The district court also subsequently denied Till’s motion to reconsider. After carefully considering the record on appeal, the parties’ briefs, and the relevant law, the Eleventh Circuit concluded that the district court decision is due to be affirmed.

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Smith v. Reliance – Reliance Committed An Abuse Of Discretion

In this case, Fredrick Smith (“Smith”) was employed as a plant manager for Charles Craft, Inc. (“Craft”) reaching back to the 1970’s. Through his job, he held group policies with Reliance Standard Life Insurance Company (“Reliance”). Two of these polices included a long term disability benefits plan and a life insurance policy. If an employee is considered …

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Mayer v. Mercy And LINA – Court Unable To Determine Whether Plan Is Church Plan Or Not

Ursula Mayer (“Mayer”) was an employee of Mercy Health Services, LLC (“Mercy”) and was covered under a long-term disability insurance policy that was issued by Cigna Group Insurance (“Cigna”). She claimed that she was totally disabled according to the definition within the policy, that she applied for benefits with Cigna, and that her claim was denied. …

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Tash v. MetLife – Court Holds That MetLife Undermined The ERISA Process

The Court held that MetLife undermined the ERISA process by failing to issue a proper denial and, further, by failing to notify the insured about the issues in dispute. The Court ordered MetLife to pay past-due benefits, with interest, and to continue paying benefits so long as they continue to remain due under the provisions of the Plan, unless and until MetLife issues a denial that is in full compliance with the requirements contained in ERISA.

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Slaton v. Standard – Claimant’s Failure To Report Symptoms Led To Claim Denial

The Court concluded that Defendant did not act in an arbitrary and capricious manner in denying Plaintiff’s claim for long-term disability benefits. Accordingly, the Court overruled Plaintiff’s Motion for Judgment on the Administrative Record, and sustained Defendant’s Motion for Entry of Judgment on the Administrative Record.

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New Department Of Labor Rule Strengthens Protections For Long-Term Disability Claimants

On December 16, 2016, the Department of Labor announced the release of a Final Rule to strengthen consumer protections for private-sector workers making long-term disability insurance benefit claims for benefits from their workplace disability insurance plans. This action ensures that disability claimants will receive a full and fair review of their claims, as required by …

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