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

Strategy Erisas Claims Procedure Regulations

How Long Do I Have to File a Long Term Disability Appeal?

Strategy - Appeal a Denial Strategy - ERISA's Claims Procedure Regulations Strategy - Deadlines

If your long term disability benefits have been denied or terminated, you may be feeling overwhelmed and unsure of what to do next. One of the most important things to understand is that you have a limited time to file an appeal. Whether your claim falls under ERISA (the federal law that governs most employer-sponsored disability plans) or is based on a private policy, the appeal process is often your last and best chance to secure the benefits you deserve without going to court.

If you’re navigating a claim denial, understanding your rights and how to protect them can make all the difference. Below we’ll answer common questions about long term disability appeal deadlines and why it’s so important to make your appeal count. 

 

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American Bar Association (ABA) Publishes Riemer Hess LLC Article on ERISA Disability Claims Regulations

ERISA News ERISA's Claims Procedure Regulations Strategy - ERISA's Claims Procedure Regulations

We are pleased to share that Partner Jennifer L.  Hess and Associate Ryan J.  McIntyre of Riemer Hess LLC have authored an important article in the American Bar Association’s Tort Trial & Insurance Practice Law Journal.  The piece, titled “Assessing the 2018 ERISA Long-Term Disability Claims Regulations: Five Years Later,” provides a critical analysis of the major regulatory changes made in 2018 under the Employee Retirement Income Security Act of 1974 (ERISA). 

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Riemer Hess Convinces NY Court That First Reliance Violated ERISA’s Regulations

ERISA News Success Stories Standard of Review First Reliance DOL Regulations Success Story ERISA's Claims Procedure Regulations Strategy - ERISA's Claims Procedure Regulations

Riemer Hess Secures Legal Victory on Behalf of Financial Engineer with a TBI

Riemer Hess LLC is proud to announce a significant legal victory in Rhodes v. First Reliance Standard Life Insurance Company, No. 22 CIV. 5264 (AKH), 2023 WL 3099294 (S.D.N.Y. Apr. 26, 2023).  The Court’s decision sends a powerful message to long term disability insurance companies: they will be held accountable for failing to follow the regulations provided by the Employee Retirement Income Security Act of 1974 (ERISA).

The plaintiff, Mr. William Rhodes, a Financial Engineer for a major financial institution, filed a claim for disability benefits after suffering a traumatic brain injury (“TBI”).  First Reliance initially approved Rhodes’s claim but later terminated his benefits and denied his appeal.  After the appeal denial, Mr. Rhodes consulted with Riemer Hess to sue First Reliance on his behalf.

In the litigation, Judge Alvin K. Hellerstein granted Rhodes’s motion for a de novo standard of review, holding that First Reliance failed to “strictly adhere” to ERISA’s claims procedure regulations.  As a result, the Court would apply no deference to First Reliance’s previous decision, even though the plan granted discretion to First Reliance.

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ERISA LTD Policies vs. Individual LTD Policies: Your Rights and Remedies

Individual Policies Strategy - ERISA's Claims Procedure Regulations Group Policies

Remedies

All employer group long term disability (“LTD”) plans are covered by ERISA unless the employer is a governmental or religious entity. ERISA is short for the Employment Retirement Income Security Act, a federal law originally enacted to protect employees and their beneficiaries. Unfortunately, over time ERISA has become more of a protection for insurance companies than employees.

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What Is ERISA and Long-Term Disability Insurance?

ERISA Coverage Strategy - ERISA's Claims Procedure Regulations

It is unfortunately common for those who have taken out disability insurance policies in good faith to find that their benefits are denied when it comes time to file a claim. Whether a person purchased an insurance policy through their employer or through a separate insurance agent, the process of obtaining benefits does not always go as smoothly as one may hope.

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