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.
// by Nick Ortiz
Brenda Counts (“Counts”) previously worked as an employee of Denver Wholesale Florist-Flint as a flower sales specialist. Her job title was formally known as “Inside Sales Associate” which required “making sales calls, pulling product[,] and packing.” Through her job, she held a disability insurance policy with United of Omaha Life Insurance Company (“United”). Under this …
Counts v. United of Omaha – Court Rules That United Of Omaha Must Pay LTD BenefitsRead More
// by Nick Ortiz
Lisa Conner (“Conner”) was a perioperative nurse at St. Vincent’s Medical Center. Through her employment, she held a policy under the Ascension Health (“Ascension”) Long-Term Disability plan. Sedgwick administered this plan. The language of the plan explained that: On May 20, 2013, Conner was in a car accident that left her with injuries to her neck, left arm and left …
Conner v. Sedgwick – Court Rules LTD Claim Denial Was Reasonable And SupportedRead More
// by Nick Ortiz
Keyton Benson (“Benson”) was employed by Tower Hill Insurance Group. Through his employer, Benson was eligible for long-term disability benefits through a policy issued by Hartford Life & Accident Insurance Company (“Hartford”). The policy language states that it will provide a policyholder with monthly payments if he has: In addition, the policy defined “disability” or …
Benson v. Hartford – Court Upholds Hartford’s Decision To Deny LTD BenefitsRead More
// by Nick Ortiz
MetLife forwarded responses from Santana’s treating physicians to Dr. Simon, an “independent physician,” who reviewed them and concluded that the MRI was normal for a person of Santana’s age and that Santana had still failed to submit clinical evidence showing that he had either radiculopathy or any limitations due to neuropathy. By a letter dated August 19, 2011, MetLife denied Santana’s administrative appeal and upheld its earlier decision to deny him continuing long-term disability benefits. The Court agreed with MetLife that.
Santana-Diaz v. MetLife – Court Rules Clinical Is Not An Ambiguous TermRead More
// by Nick Ortiz
None of Liberty’s arguments persuade the Court that denying long-term disability benefits to Ms. Rouleau is appropriate. The preponderance of the evidence – indeed, the great weight of the evidence – reflects that Ms. Rouleau remained “disabled” as the Policy defines it even after the expiration of the “own occupation” period and is therefore entitled to the long-term disability benefits she seeks.
Rouleau v. Liberty Life – Court Assigns No Weight To Surveillance VideoRead More
// by Nick Ortiz
Drew A. Carson (“Carson”) was an attorney employed by Miller Goler Faeges LLP. Through his employment, he was covered by a long term disability benefits plan which was administered by Unum Life Insurance Company of America (“Unum”). The plan explained that: “‘Disability’ and ‘disabled’ mean that because of injury or sickness: Further, proof of continuous disability and regular visits …
Carson v. Unum – Court Finds Nothing Wrong With File-Only Review By Qualified PhysicianRead More
// by Nick Ortiz
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 …
Zaeske v. Liberty Life – Appeals Court Reverses District Court Decision And Denies ClaimRead More
// by Nick Ortiz
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. …
// by Nick Ortiz
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.
Young v. Aetna – Aetna Commits Abuse Of Discretion In Denying Plaintiff’s LTD ClaimRead More
// by Nick Ortiz
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.
Sumpter v. MetLife – Court Rules Lawsuit Against MetLife Is FrivolousRead More
Ortiz Law Firm is a national disability law firm specializing in long-term disability appeals, disability insurance lawsuits, and Social Security Disability claims. Contact us for a free case review.
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