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

Patterson v. Aetna – Court Rules Own Occupation And Regular Occupation Are Interchangeable

The present case involves an appeal by Aetna Life Insurance Company (“Aetna”) from a successful motion for summary judgment granted in Christopher Patterson’s (“Patterson”) favor. Regarding the same case, the court had also denied a motion for summary judgment filed by Aetna. Patterson was covered under a long-term disability policy by Aetna through his employer Fire Consulting Group, …

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Fleming v. Unum – Court Rules That Unum “Cherry-Picked” The Record

In Fleming v. Unum, Pamela Fleming (“Ms. Fleming”) was a litigation attorney at the firm Kern & Wooley, LLP (“Kern & Wooley”). She was in a serious car accident in 1998, which caused injuries to her thoracic spine and neck. After receiving a cervical spine fusion around 2003, Ms. Fleming kept having back and neck pain, which led …

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Okuno v. Reliance Standard – Court Rules In Favor Of Reliance

Okuno has not established that she satisfied the requisite conditions to obtain disability benefits beyond what Reliance has already paid. Reliance’s denial of continued long-term disability benefits appears to have been the result of a principled and deliberative reasoning process. Accordingly, Reliance is entitled to judgment on the administrative record.

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Shaw v. LINA – Plaintiff Refused To Follow Recommended Treatment Plan

In this case, the medical reports in the administrative record were not sufficient to show by a preponderance of the evidence that Shaw was unable to perform the material duties of her regular occupation. The only reports that supported her claim were conclusory, and provide insufficient information concerning Shaw’s functional capacity.

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Nieves v. Prudential – Prudential Failed To Provide A Full And Fair Review

The Court’s task is not to decide whether Plaintiff was disabled. Prudential denied benefits because Plaintiff was not covered by the Plan when his claim arose. Thus, the question is not whether Plaintiff had a valid disability claim but when his disability claim (whether valid or invalid) arose.

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Neno v. Aetna – Court Finds There Was No Abuse Of Discretion

The medical evidence available does not suggest that Aetna abused its discretion by determining that Neno is able to perform the “material duties” of his “own occupation” as defined under the employee welfare benefit plan. Aetna’s decision was supported by substantial evidence and was made with deliberate and principled reasoning, as it reviewed Neno’s medical records and sought opinions from independent sources.

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There Are Not More People Going On Disability Than Getting Jobs

This post is in response to a comment in a local newspaper. In the “Spout Off” section of the Northwest Florida Daily News, a commentator complained: “There are more people going on disability than getting jobs. Apparently it is easier to qualify for disability than get a job.  Something [sic] really wrong with this situation.” …

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Nagy v. Hartford – Court Rules Hartford Acted Properly In Denying Benefits

In the present case, Dave Nagy (“Nagy”) was a Quality Assurance Analyst employed by Oracle America, Inc. (“Oracle”). Around September 8, 2011, he began experiencing symptoms of Chronic Fatigue Syndrome (CFS) as well as other mental health and possibly autonomic dysfunctions. Nagy applied for short-term disability (STD) benefits but was denied by Hartford Life and Accident Insurance Company, …

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Murphy v. Aetna – Claim Terminated Under The Any Occupation Standard

When considering the record as a whole, the Court finds that Aetna’s denial of LTD benefits to Murphy was supported by substantial evidence therein and that Murphy has not met her burden to establish that such denial was arbitrary and capricious. Accordingly, Murphy’s objections to Aetna’s denial cannot withstand Aetna’s motion for summary judgment.

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