When you need to apply for long term disability benefits due to a serious illness, injury, or medical condition it is very important to submit a strong claim. Working with an experienced long term disability attorney can make all the difference. This article provides general information, not legal advice … [Read more...]
Wisconsin Disability Benefits Employment Law Articles
Wisconsin Disability Benefits employment law attorneys at Alan C. Olson & Associates
Long-Term Disability Denied? What to Do Next
Employees often turn to long-term disability benefits when a serious illness, injury, or chronic pain conditions—such as severe back injury, cancer, mental-health disorders, or neurological diseases—makes it impossible to work for months or years, providing essential income replacement after short-term coverage ends. Being denied disability benefits can create intense financial pressure and leave the person feeling abandoned by the system at a time of greatest vulnerability. Yet denial is not … [Read more...]
What to Do After Final ERISA Denial Letter
Individuals may need to apply for long-term disability (LTD) benefits when a serious illness, injury, or medical condition prevents them from performing the essential duties of their job for an extended period—typically after short-term disability coverage ends. The initial process generally involves reviewing the policy details (often through an employer’s HR department or the insurance provider), completing claim forms, and submitting supporting medical documentation from treating physicians … [Read more...]
Chance of Winning an LTD ERISA Appeal in Wisconsin
Long-term disability benefits may be denied for a variety of reasons, most commonly because the insurer determines that the medical evidence does not sufficiently prove the claimant meets the policy’s definition of disability—whether that means being unable to perform their own occupation or any occupation for which they are reasonably suited. Other frequent grounds include incomplete or inconsistent documentation, failure to follow recommended treatment, the existence of a pre-existing … [Read more...]
Deadline to Bring an LTD ERISA Denial Lawsuit
Long-term disability (LTD) ERISA claims are frequently denied for a variety of reasons. Common grounds for denial include:* Insufficient Medical Evidence: Lack of clinical records or inadequate documentation to support the severity of your condition.* Policy Definitions: Failure to meet the specific definition of "disability" outlined in your policy.* Pre-existing Conditions: Exclusions based on medical history that predates your coverage.* Lack of Objective Findings: The absence of … [Read more...]
Submitting Evidence of Disability Outside of the Administrative Record
In ERISA-governed long-term disability litigation, courts generally limit their review to the administrative record—the body of evidence considered by the plan administrator when making the final benefits decision. However, several exceptions apply. Under a de novo standard of review, courts may admit limited extra-record evidence when it is clearly necessary for an adequate review, such as in cases involving complex medical issues, expert credibility questions, or evidence that could not have … [Read more...]
Long Term Disability Administrative Remedy Requirement
In a long-term disability (LTD) case—particularly one governed by the Employee Retirement Income Security Act (ERISA), which covers most employer-sponsored plans—an administrative remedy refers to the internal claims and appeals process required by the plan and federal regulations before a claimant can file a lawsuit in court. … [Read more...]
Recovering LTD Benefits During the Own Occupation Period
Recipients of long-term disability (LTD) benefits often seek clarification on the distinction between "own occupation" and "any occupation" coverage. To ensure you fully understand your policy and safeguard your claim, it is essential to consult an attorney specializing in LTD benefits. Attorney Alan C. Olson represents clients in federal courts nationwide, vigorously pursuing long-term disability benefits against major insurance carriers. Our firm specializes in securing the undeniable … [Read more...]
Submitting New Medical Evidence for ERISA Appeals
Compelling evidence and thorough documentation are critical to the success of a long-term disability (LTD) claim, especially during an appeal. Insurers and plan administrators evaluate claims primarily through the medical and supporting records submitted. Objective evidence—including diagnostic imaging, lab results, specialist reports, and functional capacity evaluations—carries substantial weight in this process.Beyond clinical data, detailed statements from treating physicians are essential. … [Read more...]
Discretionary Clauses in ERISA Long-Term Disability Policies
Discretionary clauses in long-term disability (LTD) benefits are provisions commonly found in insurance policies or employer-sponsored plan documents that grant the insurer or plan administrator broad authority to interpret the policy’s terms, determine eligibility for benefits, resolve factual questions, and decide the amount or duration of payments. In practice, these clauses give the administrator significant leeway in evaluating claims, including how to apply definitions of … [Read more...]
