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DarrasLiving Blog

Your source for the latest health, disability and insurance news and tips.

Disability: It's Not Just For "Them"

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Many things in life are difficult to comprehend until we experience them first-hand, specifically, suffering a disability. Being disabled is one of them. It is easy to think of disability as something that happens to other people or "them" until you or someone you care about becomes disabled is affected by it.

Disability is much more common than many people assume. According to the United States Census Bureau, 56.7 million people - nearly 20 percent of the country's population - had a disability in 2010. More than half of those the reported disabilities were identified as being severe.

Helping service members get started on civilian life

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As summer turns to fall, changes that are even more significant are coming to the Veterans Administration's benefit enrollment program.

The end of a long military career is a life-changing time for any service member. However, the uncertainty veterans experience goes beyond a civilian future, especially when service to their country resulted in a disabling injury. Many of the individuals who filed for benefits leave active duty without a decision being made on their claims.

Tackling disability claims involving concussions

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Football season welcomes stadiums, bars and homes as they fill up with fans eager for the kind of knockdown, drag-out action that can only come from the gridiron. Football enthusiasts cheer their favorites and jeer their rivals, both for their crushing tackles.

What is becoming more difficult to overlook is the long-term effects of those jarring blows play after play and game after game. Awareness of Chronic Traumatic Encephalopathy (CTE) has increased. The NFL seems to be taking the affliction more seriously following a recent court settlement that provides compensation for players suffering from CTE.

Pre-existing problem must substantially contribute to disability

Pre-existing problem must substantially contribute to disability.pngA disability insurance policy financially protects the policyholder by making wage replacement payments, usually at the level of two-thirds of earnings, if the person cannot work because of disability. Many disability policies have a pre-existing condition clause, which excludes coverage if the insured has been seen for a medical condition during a determined timeframe called the look-back period prior to the policy's effective date of coverage.

A legal dispute may arise if the insurance company denies a disability claim based on a pre-existing condition. The particular circumstances, the insurance contract and the applicable law determine the legal and factual issues in each case.

Pennsylvania Supreme Court clarifies test for insurance bad faith claims

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DarrasLaw's experienced attorneys vigorously advocate for clients across the country to resolve disability insurance claims that have been wrongfully delayed or denied, potentially in bad faith. The definition of bad faith behavior on the part of an insurer is largely a question of state insurance law.

The legal concept of bad faith

Certain words come to mind when considering the meaning of "bad faith" - unreasonableness, unjustified behavior, malice, neglect, negligence, lack of cooperation, misrepresentation, fraud, oppression - to name a few. Every insurance contract includes the legal duty of the parties to act in good faith and with fair dealing. When an insurer breaches its duty, the insured may have a legal claim for a lawsuit based on bad faith.

Disability insurance, ERISA and state mental health parity laws

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DarrasLaw represents people across the United States who are facing severe mental and physical disabilities in claims for coverage under disability insurance policies.

Recently, we published a blog about the challenges of filing a claim for long-term disability based on depression. We discussed a common provision in these policies that restricts wage replacement payments to a finite period - usually 24 months - when the disability stems from a mental health diagnosis.

Significant federal ruling

On September 20, 2017, an important federal case was decided holding that a 24-month limitation for disability benefits based on mental impairment violated Montana's mental health parity law, after the court examined the interplay of the terms of the policy at issue, the state law and federal pre-emption.