Info Library

 Clear Information About Long Term Disability Claims

The Info Library is a comprehensive educational resource for people navigating long term disability claims.

Here, you can learn how disability insurers evaluate medical conditions, occupational duties, policy language, medical evidence, appeals, benefit terminations, and litigation. Each guide focuses on a specific issue that may affect your eligibility for benefits or the strength of your claim.

Use the search feature above or browse the topic areas below.

Diagnoses

A medical diagnosis can have a profound impact on your ability to work, but not every diagnosis is evaluated the same way by disability insurance companies.

Our diagnosis guides explain how specific medical conditions may affect your eligibility for long term disability benefits, the evidence insurers typically look for, and the unique challenges claimants often face throughout the claims process.

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Occupations

Your occupation is one of the most important factors in a long term disability claim. Disability insurance companies evaluate more than just your diagnosis; they assess whether your condition prevents you from performing the material duties of your specific occupation.

Our occupation guides explore the unique demands of different professions and the evidence that can help support a successful disability claim. Whether you are filing an initial claim, appealing a denial, or protecting ongoing benefits, understanding how your occupation is evaluated is essential.

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Insurers

The insurance company handling your long term disability claim can significantly impact your experience throughout the claims process. While every insurer evaluates disability claims differently, each has its own procedures, priorities, and common reasons for delaying, denying, or terminating benefits.

Our insurer guides examine the practices of major disability insurance companies, explain the challenges claimants commonly encounter, and provide insight into the strategies that can help strengthen your claim at every stage.

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Policy Terms

Your disability insurance policy is the foundation of your claim. The language in your policy determines who is eligible for benefits, how disability is defined, what limitations or exclusions may apply, and what evidence you need to provide throughout the claims process.

Our policy guides explain the key provisions found in many long term disability policies and help you understand how your policy can affect your eligibility, benefits, and claim strategy.

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Claim Strategies

Every long term disability claim presents unique challenges, and the steps you take throughout the process can have a significant impact on your ability to obtain and maintain benefits. Understanding how disability insurers evaluate claims can help you make informed decisions from the outset.

Our claim strategy guides cover important topics such as documenting your disability, working with your treating physicians, responding to insurer requests, preparing appeals, and protecting your benefits throughout the life of your claim.

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Litigation Issues

If your long term disability claim cannot be resolved during the administrative claims process, the next step may involve litigation or mediation. Understanding how these proceedings work can help you make informed decisions about your legal options and what to expect as your case moves forward.

Our litigation and mediation guides explain important legal concepts, court procedures, settlement discussions, standards of review, and other issues that may arise after a claim has been denied or terminated.

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Topic

Litigation Success Story

Riemer Hess Obtains Victory for Emergency Medicine Physician Against MetLife

Success Stories MetLife Physician Success Story

Riemer Hess Obtains Groundbreaking Victory Against MetLife: New York State Court Allows Plaintiff’s Claims of Consumer Fraud and Attorneys’ Fees to Proceed

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Court Strips Aetna's Discretionary Authority in Long Term Disability Litigation

ERISA News Success Stories Standard of Review Aetna Success Story ERISA's Claims Procedure Regulations

In an ERISA New York disability litigation against Aetna, Riemer Hess successfully argued the Court should review the case under the plaintiff-friendly de novo standard – substantially increasing the Plaintiff’s chances of prevailing.  The Court, in following the Second Circuit Court of Appeals’ ruling in Halo vs. Yale Health Plan, stripped Aetna of its discretionary authority because it failed to to strictly adhere to the ERISA claims regulations, and its violations were neither inadvertent nor harmless.

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Plaintiff Awarded Over 15 Years of Unpaid Benefits In Hotly Contested Long Term Disability Lawsuit

News Success Stories Sun Life Standard of Review Success Story Challenges

Riemer Hess aggressively litigated a hotly contested long term disability lawsuit against Sun Life – ultimately winning over 15 years of unpaid benefits for the Plaintiff, despite Sun Life’s unsuccessful appeals. The judge’s opinion in this case is a major victory for the Plaintiff, as well as future disabled claimants who are victims of insurance company abuse and delay tactics.

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Lawsuit Won for Senior Manager With Depression

Success Stories Manager Case Studies Success Story Diagnosis - Depression

“Larry” was a senior manager at a major consulting firm. As a result of a series of major stresses in both his personal and professional life, Larry was hospitalized with major depression and suicidal ideation. When the insurance company denied Larry’s claim, Larry hired Riemer Hess to prepare an appeal.

The Firm submitted comprehensive letters from Larry’s treating psychiatrists, who opined that Larry was disabled from any occupation; detailed statements of Larry’s family and co-workers, corroborating his incapacity; and an in depth affidavit from Larry describing how depression slowly but surely made him unable to function and took away all joy in his life. The insurance company still denied Larry’s appeal, asserting that Larry did not submit objective proof of his depression even though it is well known that disability from depression cannot be demonstrated “objectively.”

Riemer Hess immediately commenced a lawsuit on Larry’s behalf in Federal Court. Our persistence eventually convinced the insurer to settle the case. Larry received a substantial lump sum settlement and can now get on with his life.

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How Our NYC Disability Lawyers Win Long Term Disability Litigation

Success Story

The disability lawyers at Riemer Hess have engaged in as much hard fought federal litigation of long term disability insurance claims as any other New York City firm.  Our firm is responsible for many of the legal precedents used in the litigation of disability insurance cases under the Employee Retirement Income Security Act (ERISA).

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