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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Gailey v. LINA – Court Upholds Long-Term Disability Claim Denial

The Court held that Life Insurance considered all relevant information, including Abbey’s treatment notes, treatment notes from Plaintiff’s treaters at Philhaven, and the notes from the board-certified psychiatrist based on his peer review of Plaintiff’s medical records. The Court concluded that in light of the foregoing thorough review and subsequent basis for its denial, Life Insurance’s decision to deny long-term disability benefits to Plaintiff was not without reason and did not meet the required arbitrary and capricious standard. The Court further held that Life Insurance did not engage in any action violating Section 503 of ERISA and that Plaintiff did not have a separate, private cause of action for attorney’s fees and litigation costs.

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Filthaut v. AT&T – Court Rules STD Denial Meets Arbitrary And Capricious Standard

The Court addressed several issues within the Plan’s determination that the Court found did meet the required arbitrary and capricious standard. (1) Whether the Plan ignored favorable evidence from the Plaintiff’s treating physicians. (2) Whether the Plan conducted a selective review of the evidence from Plaintiff’s treating physicians. (3) Whether the Plan failed to conduct its own physical evaluation of Plaintiff. (4) Whether the Plan relied too heavily on non-treating physician consultants.

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Evans-Carmichael v. Liberty Mutual – Federal Court Remands Non-ERISA Case To State Court

The parties’ supplemental briefing clarifies that, as an initial matter, they dispute the applicable policy to Plaintiff’s disability claim. Defendant argues that the Los Alamos National Security, LLC (“LANS”) Group Disability Income Policy (“LANS Policy”) applies to Plaintiff’s disability claim. Plaintiff disagrees and maintains that a University of California (“UC”) Supplemental Disability Policy (“UC Policy”) applies.

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Khan v. Provident – Court Disagrees With Insurer’s Interpretation Of Policy

Farooq Khan, M.D. (“Khan”), is a neurologist who filed for long-term disability insurance benefits. Provident Life and Accident Insurance Company (“Provident”) denied Dr. Khan’s LTD claim. After exhausting his appeals directly with the insurance company, Dr. Khan filed suit against Provident for breach of contract, asking the court to award payment of his long-term disability benefits. Dr. …

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Denney v. Unum – Court Remands Unum LTD Claim For Further Review

Cara R. Denney (“Denney”) was an employee of Wagner Equipment Company (“Wagner”) where she was a Computer and Technology Instructor.  Her job duties “required extensive computer use” and “the ability to instruct employees on the use of various computer systems.” She was also required to travel up to fifty percent of the time, be able to …

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Krysztofiak v. Boston Mutual – Court Rules Clinical Coordinator Is Entitled To LTD Benefits

Dana Krysztofiak (“Krysztofiak”) works as a registered nurse, but was previously a Clinical Coordination Manager for the company HomeCare Maryland, LLC. In 2016, Krysztofiak ceased working because of problems with fibromyalgia and psoriatic arthritis. She then filed for long-term disability benefits with Boston Mutual Life Insurance Co. (“Boston Mutual”). According to the language of the policy: Further, payments only …

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