Disability Claim Help:
ERISA Lawyers / California Long-Term Disability Insurance Attorneys

If your California or ERISA disability insurance claim was denied or payment has been long delayed, the San Diego law office of Stennett Casino can help you. We represent only insurance policyholders and injury victims, and we have years of experience in obtaining the benefits owed to our clients by disability insurance carriers and ERISA plans.

We have helped clients with claims against almost every disability insurance company. We've had repeated successes, both in court and out of court, in obtaining benefits from:

The denial of a long-term disability claim is devastating. People who are totally disabled can't earn money to support their family or themselves, and greatly need their disability insurance benefits. Despite this, insurers and plan administrators routinely deny valid claims. They do not limit their denials to hard-to-prove illnesses like fibromyalgia, chronic fatigue, depression, and back pain. Even clients with terminal illnesses such as cancer and AIDS have needed Stennet Casino's help to obtain benefits. We handle both ERISA disability claims and California long-term disability claims.

Insurance companies and claim administrators routinely use standard excuses for denying disability claims. These excuses usually fall into one of the following categories:

The excuse that your medical records do not show that you can't work in your job may be given because the insurance company or Plan has misinterpreted your medical records, or because your medical records don't adequately document your limitations because of your medical condition. Physicians are trained to diagnose and treat medical conditions. They are not necessarily the best at documenting physical or mental limitations associated with a physical injury or illness. In these situations, Stennet Casino will need to assist the doctor to document your condition.

Most policies do not require “objective medical evidence” to substantiate a disability. Nevertheless, administrators constantly deny cases based on a lack of objective medical evidence. Often, there is objective medical evidence, but the insurance company doesn't view it as such. At other times, we need to have further testing and evaluation performed so that your limitations are objectively verified. If these efforts fail, then we point out the legal insufficiency of the Plan or company's position that there is “no objective medical evidence.”

T he insurer may acknowledge that you have a physical injury or illness which restricts your abilities. However, their vocational expert will report that even with your limitations, you can perform the duties of your occupation. This situation requires a thorough analysis of the duties of your occupation versus your limitations. It often requires the hiring of a vocational expert who can analyze your ability to perform your occupation.

Disability policies typically define disability as an inability to perform your “own occupation.” They do not define disability as the inability to perform your “job.” For example, if your job requires you to keyboard 90% of the day and your disability allows you to keyboard only 50% of the day, then the insurer will typically point out that you can work in your occupation for another employer who requires less than 50% of the day at a keyboard. This again is a situation that usually requires the hiring of a vocational expert who will perform a job analysis, job surveys and/or a physical capacity evaluation.

Asecond definition of disability often found in disability policies is an inability to perform the duties of “any occupation.” Many policies define disability as an inability to perform your “own occupation” and then change to “any occupation” after 24 months. When there is a change in the definition of disability after 24 months, this is often when a person’s benefits are terminated. This situation requires the review of your work history, training, and education to determine whether you are able to perform the duties of the occupations the insurer claims you are able to perform.

Mental illness or mental conditions are typically not covered or have only limited coverage under long term disability policies. Coverage is usually limited to 24 months. Depression is associated with virtually every long-term disability. Administrators and insurers use this to their advantage by claiming that your diagnosis of depression is the cause of your disability, not just a symptom of your underlying illness or injury. There are numerous effective arguments that can be made to overcome this defense, depending upon the specific facts of your case and the terms of your policy.

Unfortunately, most Plan administrators and insurance companies work to find reasons to deny your claim rather than help you prove it. It can make a tremendous difference in the result if you are represented by an attorney who specializes in disability claims during the claim submission and/or appeal process, and any court proceedings.

When you retain the San Diego law firm of Stennett Casino, we expertly evaluate your claim. We determine the documentation and evidence needed to help avoid or rebut common grounds for claim denial: insufficient proof of your job requirements, your medical condition, or how your medical condition prevents your job performance. We work with your doctors, employer, co-workers, and any outside specialists (such as medical or rehabilitation experts) to obtain the necessary evidence and documentation. We conduct investigations and interviews where useful, obtain any studies and reports that support your claim, and review, organize, and summarize every item in your file for the Plan administrator or insurance company. We also present the legal arguments needed if the Plan conflicts with California or Federal law.

A simple phone call to Stennett Casino often can start you on the correct path toward obtaining your benefits. Your initial phone consultation is free. Although the result in each case depends on its unique facts and law, we've had many successes in obtaining disability benefits for our clients.

* UNUM PROVIDENT CLAIMS: If you are one of the 26,000 California residents whose disability claim was denied by Unum Provident between January 1, 1997 and September 30, 2005, we can help you. The California Department of Insurance has ordered UNUM Provident to review ALL of these claims again. For more information, please see: Unum Provident Disability Claims.

We are experienced claim attorneys and can help you by: