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Ideas From Our Firm To Help During the Financial Struggle The majority of our clients begin the process amidst a financial struggle. By the time someone comes to Cremeens Law Group PLLC, it usually means they have been out of work, applied for disability benefits, and been denied. This means that some time has gone by since they received a pay check or benefits of any kind. Our firm does our best to get our clients money in their pockets, but we have compiled a small list of ideas to help someone while they are waiting and money is tight:
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Does Applying for or Receiving Disability Benefits From Insurance Company Mean You Have To Apply For Social Security? Some clients ask us, “Do I have to apply for social security disability?”.  For people applying for disability insurance benefits, there is no easy answer to this question. As a general rule, employer-disability insurance benefits (those governed by the Employee Retirement Income Security Act of 1974, or Federal “ERISA” statute) usually provide for what are called “Other Income Offsets“. This means most such long-term disability insurance policies give the insurance company credit for any income the insured receives from some other source
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Advice for Attending Physician Statements (APS Forms) ERISA Disability Insurance Applications generally come in three parts: Employee Statements, Employer Statements, and Attending Physician Statements. The Employee (you) completes the Employee Statement. Your employer completes the Employer Statement. Your treating physician completes the Attending Physician Statement. But there is a simple, non-obvious way to improve your disability insurance claim. Before having your doctor complete the Attending Physician Statement, make copies of the blank attending physician statement, and have as many of your doctors willing to complete the Attending Physician Statement complete one for you. As a general rule, more doctors certifying
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It’s hard to know your rights under a disability insurance contract without a copy of the contract. Fortunately, if you have a disability insurance contract through your employment, the Employee Retirement Income Security Act of 1974 (“ERISA“) provides you with access to what is called a Summary Plan Description of the contract, which answers basic questions an ERISA plan participant may have about disability insurance benefits. Plan administrators are required to make ERISA Summary Plan Descriptions available to ERISA plan participants upon request. As a general rule, the plan administrator will be your employer’s national human resource department for larger
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Offsets Explained Before we get in to offsets, let’s talk about your disability benefits that you applied for.  You finally made it! You gathered all medical evidence and doctor support to show you are disabled and the insurance company agreed and has decided to pay. When the day finally arrives, you walk to your mailbox, and there it is. The envelope with the insurance company’s name on the outside, which holds your big check on the inside. Now, when you combine this check with your [social security, pension, worker’s compensation], you will actually be able to get ahead. However, when
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Remaining Calm Despite Adversity You may find yourself so furious with the insurance company that you can barely think straight, but you will benefit immeasurably from calming down before you speak to the insurance company representatives and remaining calm during the conversation. Our staff has reviewed many thousands of denied long-term disability insurance claims over the years, and while calling an attorney is one of the best things you can do once you have received a denial letter from a long-term disability insurer, there is another thing you can do on your own that runs a close second. It is
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ERISA has one of the broadest pre-emption clauses of any Federal statute. This means that any state law seeking to regulate an employee benefit plan is likely, with very narrow exceptions, to be pushed aside by the federal statute which governs employee benefit plans, the Employee Retirement Security Act of 1974 “ERISA.” In Gobeille v Liberty Mutual Insurance Company, the United States Supreme Court held that ERISA pre-empts a Vermont statute requiring health care services to report certain information to a state agency for inclusion in a state database. The Court held that the U.S. Department of Labor has the
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Navigating through the process of private disability insurance can be disconcerting. The constant barrage of requests from the insurance company and steps you must complete can seem daunting.  It may seem like the insurance company is always making you jump through hoops. This is part of a process which makes many abandon their disability benefits claims. If you are in your initial application phase, do the best you can to keep up with the demands for information from your claim administrator. Most disability insurance policies contain cooperation clauses which require claimants to assist the administrator in gathering information. If you
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Some people may not want to pursue their disability insurance claim because of the terminology.  “I don’t want to be considered disabled. I worked hard all my life and I don’t like the stigma that comes with the word ‘disability’.” Keep in mind that policies typically specify a length of time that qualifies as “long-term disability“. The definition of “long-term disability” is usually different than that of social security, so don’t get hung up on the language. Seeking long-term disability benefits from a private insurance policy doesn’t mean you will never be able to return to work; however, obtaining benefits
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How a Remand Can Affect Your Attorney Fees An ERISA judge can remand (or send back) a case to the insurance company for further review. In Hardt v. Reliance Standard Life Ins. Co., 560 U. S. 242, 251 (2010), the United States Supreme Court unanimously held that an ERISA claimant need not be a prevailing party in order to qualify for attorney’s fees under ERISA. Instead, the Court in Hardt held that it was sufficient for the ERISA claimant to obtain “some success on the merits,” with the effect that obtaining an administrative remand rather than an award of benefits
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