The Disability Application

In this video, attorneys Gregory Dell and Stephen Jessup discuss the problems many doctors face when they need to apply for disability benefits due to a disabling medical condition. Often, when doctors develop an illness, they either self-treat, or seek informal off-the-record treatment from a peer. This means there is no medical record documenting their inability to work due to their disability. With no medical records to review, insurance companies are almost certain to deny the claim.
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In this video disability insurance lawyers Gregory Dell and Cesar Gavidia discuss the recent Hartford purchase of the Aetna Disability Insurance Company and what impact that may have on Amazon employees who file claims for long-term disability. They conclude that the claims review process will likely not change since both companies already do everything they can to avoid paying a claim.
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The case of Chris Bunger v. Unum Life Insurance Company of America, is an example of how hard an insurer will fight in order to avoid paying a claim for short term and long term disability benefits. This was the second district court opinion on this case out of Seattle, but it will not be the last one.
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Diahann L. Gross v. Sun Life Assurance Company of Canada is a decision from the U.S. Court of Appeals for the First Circuit. It is the second appeal for a case that began in August 2006 when the Plaintiff, an optician and office manager, became too sick to work. She suffered from chronic and severe debilitating pain which was substantiated by numerous medical reports.

Sun Life rejected her claim for disability benefits on the grounds that surveillance video conducted over a nine-day period of time showed three instances when the Plaintiff acted in apparent conflict with the medical reports. After exhausting her administrative remedies, Gross filed an ERISA lawsuit in the District Court of Massachusetts, which held she was entitled to disability benefits and Sun Life appealed.
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In Margueritte Kibel v. Aetna Life Insurance Company, the U.S. Court of Appeals for the Ninth Circuit, in a unanimous opinion, ruled that Margueritte Kibel had met her burden of proof and was entitled to long-term disability benefits. It remanded to the District Court with instructions to enter an award of benefits to her.

Kibel’s problems started in 2011 when she collapsed two separate times at work. Once in a meeting with a supervisor, and another time while entertaining clients. In January 2012, she was diagnosed with multiple sclerosis. Even so, she returned to work in March 2012, but after only a month, she had to quit. She made several other attempts to work before finally quitting in November 2013 and applying for long-term disability benefits. Aetna denied her claim.
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