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“Home Again” vs “Home Health Care Benefits”?

By A. Christopher Wieber (Law Office of Mark Scherzer) In Clark v. Silac Ins. Co., No. 22-35685, 2023 U.S. App. LEXIS 24571 (9th Cir. Sep. 15, 2023), the Ninth Circuit Court of Appeals underscored the difference between “home again” and “home health care” benefits and — in the case of the policyholder (Mrs. Dorothy Carroll) Read More

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How Do I Establish that I am Disabled from my Recognized Professional Specialty, such as Interventional Radiologist, Ophthalmic Surgeon, or Litigation Attorney?

By A. Christopher Wieber (Law Office of Mark Scherzer) When evaluating whether you qualify for benefits under an individually-purchased disability income policy or an employer-sponsored group long term disability plan, it is important to consider not only the evidence substantiating your medical condition, but also the evidence addressing the occupational component of the applicable disability Read More

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Will My Long-Term Disability Coverage End if my Employment is Terminated While I’m Out on Disability?

By A. Christopher Wieber (Law Office of Mark Scherzer) “Will my long-term disability coverage end, disqualifying me for disability benefits, if my company terminates my employment before my claim is approved?” This is a question that I am frequently asked by clients who are in the process of filing a claim under their company-sponsored long Read More

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Long-Term Care Insurance Coverage Can Depend on the Type of Facility Where Care is Provided

By A. Christopher Wieber (Law Office of Mark Scherzer) Making use of a Long-Term Care Insurance policy can be quite tricky. In the context of a residential care facility, coverage may depend on whether the facility is designed to provide daily nursing, physical therapy, or other sorts of skilled care, or, instead, the facility is designed Read More

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Mark Scherzer Addresses Group Life Insurance Conversion and Continuation Rights

Attorney Mark Scherzer was recently consulted for and cited in an article posted May 26, 2023, on the Life Annuity Specialist website. The article, “Insurers Get Swept Up in Complaints Over Missed Policy Conversions,” discusses a recurrent problem with employees who leave their companies – typically due to illness or disability – and miss the Read More

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Lawyer Mark Scherzer Addresses Complicated Long Term Care Claim Issues in Newsday Article

The Long Island newspaper, Newsday, in an article published March 9, 2023, reported that “Long-term Care Insurance can be Complicated Answer for Long Island Seniors.” The article discusses the challenges faced by long term care insurance policyholders as they try to file claims for benefits under their policies. Mark Scherzer was cited in the article Read More

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Extension of ERISA Health, Life, and Disability Claim Deadlines During Covid-19 “National Emergency” [UPDATED: March, 2021, to Reflect EBSA Guidance Issued]

By A. Christopher Wieber (Law Office of Mark Scherzer) What if your long-term disability claim was denied and you have a 180-day appeal deadline, but — due to the coronavirus pandemic — your doctors’ offices have been closed, or short-staffed, so that it is impossible to obtain supporting medical documentation in a timely fashion?  If your Read More

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Disability Benefits for COVID-19 Patients with Persistent Long Term Symptoms

By Mark Scherzer, Esq. (Law Office of Mark Scherzer) I’m still sick with COVID-19. Can I get disability benefits? If you can’t seem to recover from COVID-19 and are unable to return to work, you may be wondering if you can qualify for disability. The answer is, “Yes, probably, if you satisfy the terms of Read More

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If I am Not Disabled, but Lose My Job in a Coronavirus-Related Layoff, What Can I do to Keep my Medical, Life, and Disability Coverage?

By Mark Scherzer, Esq. (Law Office of Mark Scherzer) If you are facing a recent or imminent layoff because of the economic impact of the coronavirus (Covid-19) pandemic, you may be wondering whether it is possible to keep some or all of your existing company-sponsored employee benefits (such as your health plan, your group life Read More

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Can I Make a Disability Claim if My Job is Threatened by Coronavirus Layoffs?

By Mark Scherzer, Esq. (Law Office of Mark Scherzer) Have you been struggling to work despite a disabling condition that has adversely affected your ability to do your job?  Do you now fear that your job may be terminated due to an imminent Covid-19-related layoff or reduction in force?  If so, this may be an Read More

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