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Are you facing one of the following ERISA, employee benefit, or private disability, health, or life insurance problems?

 

  • You've received a claim denial or termination from your disability insurance company or plan, with regard to your short term disability benefits, your long term disability benefits, or your disability income benefits?
  • Your disability insurance company says that your treating doctor's opinion is no longer sufficient to support your disability claim, and demands that you undergo a functional capacity evaluation (an "FCE"), a neuro-psychological evaluation (an "NPE"), or an independent medical evaluation (an "IME")?  Or your disability insurance company wants to send a claim representative or investigator to conduct an interview at your home?
  • You were receiving disability benefits, but your insurance company is now terminating your disability claim because its vocational consultant or rehabilitation counselor has conducted an occupational assessment (an "OA"), a labor market survey, a transferable skills analysis (a "TSA"), or some other vocational review and determined that you are no longer disabled and are now able to return to work in your own occupation, your regular occupation, or any occupation for which you are qualified by education, training, and experience?  Or you've been told that undercover video surveillance allegedly shows that you are capable of work activity or proves that you have misrepresented your level of activity?
  • Your disability claim was denied or terminated because there was allegedly no objective medical evidence to support your disabling pain, fatigue, brain fog, or other so-called subjective symptoms?
  • Your health plan or medical insurance is refusing to pay your claim for medical treatment because the treatment was not pre-authorized, was not medically necessary, was for a pre-existing condition, was experimental or investigational, was out of network, exceeded the usual and customary rates charged by other doctors?
  • Your health insurance or COBRA continuation coverage was suddenly terminated (or terminated retroactively) due to a missed or late payment?  Or you were late filing for COBRA coverage because your employer failed to give you a timely notice of your COBRA rights and a COBRA election form?
  • Your claim for life insurance benefits was denied because of an improper beneficiary designation, or some other technical formality?  Or because the insurance company ruled that the death wasn't accidental, or was the result of a pre-existing condition?
  • You think you are entitled to disability waiver of premium benefits so that you can keep your life insurance for free while disabled, but your insurance company has denied or terminated these benefits, or your benefits were never considered and approved in the first place? 
  • Your disability claim was cut short because your insurance company determined that it was the result of an illness, rather than an accident, or that it was the result of a mental illness or nervous disorder, rather than a physical illness or disease?
  • You're in business for yourself, as a professional (physician, lawyer, accountant, chiropractor, podiatrist, etc.), and have paid for business overhead expense or private disability income insurance, but your claim is being delayed (or has been denied), while insurance company makes intrusive demands for tax returns, office calendars, and other similar internal business and billing records?
  • You are suffering from a chronic progressive illness -- such as multiple sclerosis, HIV disease, Parkinson's disease, chronic fatigue syndrome, post-Lyme disease, degenerative disc disease, cardiac disease, congestive heart failure, etc. -- which is starting to affect job performance, and you are wondering whether it may be an appropriate time to consider a disability claim under your employer's plan and/or a private insurance policy (and, if a claim pursued, what will happen to your health insurance, life insurance and retirement plan benefits)?
  • You are already receiving long term disability benefits, but are considering a trial work effort or taking on some volunteer activities, and you are wondering whether this will have any effect on your disability benefits?
  • You were working with a disability or progressive illness and were recently laid off or terminated as part of a reduction in force and you believe you were selected for the lay-off or termination because of poor job performance due to your illness or disease, and are wondering whether you can still make a disability claim under your employer's long term disability plan?

If you are experiencing any of these situations, let our lawyers answer your questions and help you to secure the benefits to which you are entitled.  Our attorneys are experienced in ERISA, employee benefits, and private life, health, and disability insurance matters.  Please fill out the email form below to describe your case, and one of our attorneys will be in touch with you shortly.  Or, call us today by telephone, at 212.406.9606.


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Mark Scherzer Law :: Disability Income Insurance Claims :: Business Overhead Expense Claims
New York City Attorneys (including Manhattan, Brooklyn, Queens, Staten Island and the Bronx)


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