The exhaustion of administrative remedies requirement basically forces the claimant to engage in the administrative appeal process set up by the Plan Administrator. While there are federal regulations governing the process, the end result is typically untoward delay in addressing the issue of entitlement. The process is supposed to one in which the Plan Administrator is required to consider all of the evidence but typically the process is just one which allows them to gather further evidence in their favor and fill in those places where mistakes were made in past handling of the claim. It is apparent to the undersigned that the merits of the case are not the primary concern but instead there are policy decisions made about certain claims and no amount of supportive evidence will change whatever policy decision has been made regarding a benefit denial.

Case law governing the “exhaustion of remedies” requirement is clear even though there is no express provision in ERISA requiring as much. Exhaustion of remedies is a requirement imposed on the claimant as a matter of case law grafted onto the ERISA statute’s language. In the 11^th Circuit, where most claims of the writer pend, the court has specifically held the administrative remedies must be exhausted prior to the filing of a lawsuit. Perrino v. Southern Bell Tel. & Tel. Co., 209 f.3f 1309 (11^th cir. 2009). However, the rule is not without exception. Generally, if the administrative process can be shown to be futile or inadequate then the requirement will be waived. Curry v. Contract Fabricators, Inc. Profit sharing Plan, 891 F.2d 842 (11^th Cir. 1990). Another basis for waiver of the requirement would exist if there is language in the governing Plans Documents which reasonably leads the claimant to believe he can proceed directly to Court. Watts v Bellsouth Telecomm., Inc., 316 F.3d 1203 (11^th Cir. 2003).

In any event, the administrative appeal process set up by the Plan Administrator must be followed. The governing federal regulations allow a claimant 180 days to appeal the initial denial of claims involving disability benefits. Other time frames may apply for other appeals or types of benefits. See, generally, 29 C.F.R. §2560. The claimant must be careful to comply with these deadlines as the failure to appeal within these deadlines could be the death knell to the claim. One must, under no circumstance allow the deadline to pass without affirmatively placing some form of document in the possession of the Plan Administrator claiming the right to appeal. Sending the document with some proof of delivery is important.

The appeal should include all evidence which supports the claimed entitlement together with a rebuttal of the points made in the letter of denial. Remember that doctor’s records generally address medical issues and the specific issues governing the entitlement to the legal claims made the subject of the benefit entitlement to be enforced. Some specific input from your doctor would be appropriate in claims with medico/legal issues. Please keep in mind that the appeal will likely be your last chance to get evidence before the Plan Administrator and, ultimately, the Judge. It must been done with thoroughness.

Please keep in mind that the foregoing is not intended as legal advice applicable to any individual person’s legal situation. Its sole purpose is to give a general idea of the existing status of the law as it applies to the point of law addressed above. You cannot rely on the foregoing as legal advice. You cannot make legal decisions based on its contents. If you have questions arising out of this point of law, you should contact an attorney who routinely handles claims involving policies of disability insurance. The law offices of Herbert M. Hill, P.A. handles such cases and would welcome the opportunity to discuss your case with you, at no charge.

Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida and the southeastern United States. Areas of practice include disability and employment benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (known and referred to as “ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.

The first subject is written communications. I do not want to suggest the letters you send the insurance company end up in the trash can but I have had numerous complaints from clients that the insurance company has denied receipt of documentation or correspondence which they have sent. All written communications should be sent in a way in which delivery can be verified. This can be by Certified Mail, Return Receipt Requested or by way of courier service. Ensure that you keep a copy of what was sent as well as the document which evidences delivery. Facsimile transmittal can be used as long as there is a cover sheet indicating the number of pages sent . When using facsimile also ensure you keep copy of the “transmission report” which every facsimile machine can generate. This will evidence the telephone number to which the document was sent, as well as the date and time. If your doctor or anyone else on your behalf sends documentation directly to the insurance company, get a copy of what was sent and then send it again yourself.

Regarding written communications from the insurance company, please keep not only the letter or documents received but also keep the envelope and mark on the face of the envelope the date you received it. More often than not, the insurance company’s letters are not mailed on the date found on the face of the letter. The postmark on the envelope evidences the date of mailing. The reason it is important to know the date you received some letters is because some time frames commence from the date of receipt.

Keep a copy of all documents to and from the insurance company in a file in one place, in a chronological order.

The second subject is oral communications. These should be handled with your personal “case diary” before you. Note the date and time of the conversation. Before you engage in the substance of the conversation, ensure that you get the representative’s full name (”Bob” is not enough). If they will not give it, either get their employee number or refuse to talk to them. They know your full name. You must be able to get back in touch with them or at least be able to identify with whom you spoke.. Along these lines, get a return telephone number with a direct extension. Again, if they will not give this, refuse to talk to them. They know how to get in touch with you easily. You should not be forced to work your way through the impenetrable telephone maze which many insurance companies have in place. Only after you are on a level playing field should you talk with them. Again, these things should be done at the beginning of the conversation. During the conversation, keep notes on what was said, letting them know you are doing so. One good way to do this is to get them to repeat something they said “just so I make sure I understand.” Also, make sure your questions (the ones you have noted in your case diary) get answered.

Oral communications are problematic because at the beginning of the claim, the claims representative will try to be your “buddy,” as if they are on your side. This is especially so when benefits have been approved. In fact, when a new claims representative later calls you, please ask why the change. What has probably happened is that a adverse decision has already been made and now you will deal with the “hatchet” man (or woman). They will not remember all the fair weather representations made by your “buddy.”

Take these communications seriously. Insurance companies are not really in the business of paying benefits. That costs them money. They are in the business of collecting premiums and keeping pay outs to a minimum, to the point of a lawsuit, if necessary. Indeed, insurance companies are as much in the litigation business as are attorneys. Their representatives are highly trained to this end, even the “buddies.” Remember that insurance companies already have attorneys on staff who direct the claims handling process. When your case becomes too expensive or looks like there may be a long pay out, efforts will be made by the insurance company to reduce its exposure. Yes, an insurance company is an “it” which has no care whatsoever for you, despite the friendly voice on the telephone line. An insurance company is a legal fiction which by its nature is heartless and soulless whose only reason for existence is to generate a profitable bottom line for its shareholders. If you want to read a chilling comment on the subject, I offer one from Abraham Lincoln from almost 150 years ago which I believe is coming to pass these days before our very eyes: 

 ”I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. As a result of the war, corporations have been enthroned and an era of corruption in high places will follow, and the money power of the country will endeavor to prolong its reign by working upon the prejudices of the people until all wealth is aggregated in a few hands and the Republic is destroyed. I feel at this moment more anxiety for the safety of my country than ever before, even in the midst of war. God grant that my suspicions may prove groundless.”

– U.S. President Abraham Lincoln, Nov. 21, 1864 (letter to Col. William F. Elkins)

When talking with a claims representative, always keep in mind with whom you are really dealing!

Please keep in mind that the foregoing is not intended as legal advice applicable to any individual person’s legal situation. Its sole purpose is to give a general idea of the existing status of the law as it applies to the point of law addressed above. You cannot rely on the foregoing as legal advice. You cannot make legal decisions based on its contents. If you have questions arising out of this point of law, you should contact an attorney who routinely handles claims involving policies of disability insurance. The law offices of Herbert M. Hill, P.A. handles such cases and would welcome the opportunity to discuss your case with you, at no charge.

Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida and the southeastern United States. Areas of practice include disability and employment benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (known and referred to as “ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.

As discussed elsewhere on this website, the Insurance Company is typically entitled to an offset of at least part of the benefits you receive from the Social Security Administration. I say “typically” because this is often the case; however, the Plan Documents governing your benefit entitlement should be examined to determine whether the Insurance Company can rightfully claim this offset. The Plan Documents and securing a copy thereof is also a topic addressed elsewhere on this website.

One reason the Insurance Company requests the Social Security Reimbursement Agreement is to ensure that you understand the offset (presuming it exists). Also, it is not unusual for group Long Term Disability benefits to be paid prior to an award and payment of Social Security benefits. The Insurance Company will agree to pay the gross or full amount (before the offset) of group Long Term Disability as long as the Social Security Reimbursement Agreement is signed evidencing an understanding of the entitlement to an offset and, more importantly, the potential obligation to “reimburse” the Insurance Company for any overpayment resulting from a subsequent award of Social Security benefits.

There are couple of points to keep in mind. First, there typically is no offset against Short Term Disability benefits because the Social Security Administration does not pay benefits from the date of disability. Second, the amount of the offset which the Insurance Company can claim is limited to the “Primary Insurance Amount” which, for present purposes, can be described as the amount of Social Security benefits due in the first month of entitlement thereto. The effect of this is that the Insurance Company is not entitled to offset any subsequent “Cost of Living Adjustments” paid by the Social Security Administration.

One point which must be kept in mind is the hiring of an attorney for purposes of pursuing your Social Security claim. If you get to the point of needing to do so, it is suggested that you do not use the attorney recommended by the Insurance Company even though they suggest they will pay the attorney’s fee. It is disingenuous for them to make this suggestion. First, you should have your own local attorney represent you rather than one of the nationwide, impersonal Social Security attorney firms. Second, any fee you incur as a result of representation will ordinarily be deducted from any amount you are required to reimburse the Insurance Company from any overpayment resulting from receipt of Social Security benefits.

Please keep in mind that the foregoing is not intended as legal advice applicable to any individual person’s legal situation. Its sole purpose is to give a general idea of the existing status of the law as it applies to the point of law addressed above. You cannot rely on the foregoing as legal advice. You cannot make legal decisions based on its contents. If you have questions arising out of this point of law, you should contact an attorney who routinely handles claims involving disability policies of insurance. The law offices of Herbert M. Hill, P.A. handles such cases and would welcome the opportunity to discuss your case with you, at no charge.

Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida and the southeastern United States. Areas of practice include disability and employment benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (known and referred to as “ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.

Having an investigator follow you is not the only type of surveillance which insurance companies use. If the insurance company sends you to a doctor for an Independent Medical Examination or for a Functional Capacity Evaluation, the office staff will be asked to watch and see if your physical actions are consistent with your effort during the evaluation. It is the opinion of this writer that the insurance company cannot rightfully ask the evaluator’s office to go above and beyond the evaluation itself. This would make the medical evaluator also a fact witness. This is something to which the claimant did not agree by cooperating with the request for the evaluation.

There is an additional problem with surveillance in cases governed by the federal statute commonly referred to as the Employee Retirement Income Security Act (”ERISA”), found at 29 U.S.C. §10101 et seq. As discussed elsewhere on this website, there is case law which may limit the evidence which a claimant can present in Court to support the claim for benefits under ERISA. There may never be the opportunity to cross examine the fact witness who provides surveillance evidence. For example, the investigator whose only training consists of being taught how turn on and point a camera will routinely make medical opinion statements in the “reports” he files even though he is grossly unqualified to do so. The same is true of the medical staff which suggests that claimant’s actions were different in the parking lot than in the office. These unsubstantiated statements are not subject to cross examination yet there they are in the documents submitted by the insurance company to the Judge in support of the benefit denial.

Fortunately, the Courts have recognized that surveillance has a limited use in benefit determinations. An example of a case which addressed the issue is Cross v. Metropolitan Life Ins. Co., 2008 WL 4216555 (11^th Cir. 2008). That case properly recognized that surveillance is but a mere “snapshot” of activity which fails to take into account the increased pain due to those activities. While the Cross case included overstatement by the insurance company regarding the surveillance, the case of Ridge v. Hartford Life & Acc. Inso. Co., 239 F. Supp. 2d 1323 (M.D. Fla. 2004) demonstrates the lengths insurance companies will go on these matters. In the Ridge case, the Court found that the insurance company had surreptitiously secured a prescription from a treating physician for a Functional Capacity Evaluation. On the point of surveillance, the Court found the surveillance film was not proof, standing alone, of disability. It is noted that the opinion of the Court in Ridge was vacated after the parties later settled the case. Ridge v. Hartford Life & Acc. Ins. Co., 2005 WL 889964 (M. D. Fla. 2005).

There are the highly publicized situations in which an insurance company has discovered, through surveillance, a claimant who is performing in a manner grossly inconsistent with the reports to the treating physician. Those cases do exist but in the vast majority of cases involving surveillance shows nothing of significance. In fact, “nothing of significance” should indicate that surveillance supports the claim for benefits. Insurance companies rarely see it that way. Insurance companies routinely uses surveillance to support a predetermined conclusion not actually supported thereby. While all surveillance materials are taken quite seriously, the author has practiced law over 30 years and has only seen surveillance which required him to specifically confront a client with the contents thereof on three (3) occasions. On two (2) of those occasions, the client truthfully said the doctor knew of the activity and had okayed it (one including scuba diving!). This means that out of the many hundreds of surveillance films reviewed, only once did it prove of any significance to the case. Notwithstanding, all surveillance must be taken seriously.

The only legitimate conclusion is that insurance companies routinely use surveillance to support predetermined conclusions. My clients can rest assured that they will be carefully advised about surveillance and issues arising as a result thereof.

The law office of Herbert M. Hill, P.A. represents clients throughout the southeastern part of the country. We would be happy to assist if you are having difficulty with any issue arising out of your private short term disability or long term disability policy claim or any claim arising under the Employee Retirement Income Security Act (ERISA), including claims for short term disability benefits, long term disability benefits, pension benefits, 401k claim, group medical claim or any other employer provided benefits which you believe you have been wrongfully denied.

You can contact Herbert M. Hill at www.herbertmhill.com or at (407)839-0005. You are also welcome to Email Herbert Hill directly at hmh@herbertmhill.com.

If you have questions about the contents of the “Plan Documents,”please see my writings on that subject found elsewhere on this website.

In any event, after 24 months, two (2) important issues may arise. First, at the 24 month point in time, there typically is a change in the definition of the term “disability” relative the occupation to which it applies Second, there are typically certain medical conditions for which benefits are limited to a 24 month entitlement. I will address the second issue in this writing. The first is addressed elsewhere on this website under a writing entitled Benefit Limitations – “Own Occupation” v. “Any Occupation”

In any event, most Plan Documents (but certainly not all) provide for a limitation on the period benefits are paid, usually 24 months, for disability involving mental or nervous conditions. As to what constitutes a mental or nervous condition, there may or may not be a definition of the meaning of this term. As far as that definition is concerned, the legal maxim of contra preferentum, which stands for the proposition that a vague or ambiguous documents will be construed against the author, would result in a narrow construction and application of any such limitation.

The specific language of the Plan Documents needs to be carefully reviewed because there are two (2) types of clauses currently in use in the industry. The first is a clause which provides for the limitation in benefits is the disability “is caused by” or “due to” a mental or nervous condition. The approach here would be to ensure that any underlying medical or physical problems is properly addressed so as to make it clear that, if it can be done, the mental or nervous condition is secondary to or an adjunct of the truly disabling condition, the underlying physical condition. Of course, the medical evidence may not lend itself to this proposition but the point must be carefully explored and presented to party charged with rendering the benefits determination.

The second type of clause which might be found in Plan Documents is more problematic. This is a clause which provides for the limitation if the mental or nervous condition “causes, or contributes to,” the disability, or words that effect. However, the undersigned would suggest that every disabling physical condition is, at first, a medical problem. Then it becomes an economic problem when it prevents us from working. Working goes at the core of our self identification. It is how we support ourselves and our loved ones. When we are unable to do so because of a medical condition it almost always becomes an emotional issue as well. If so, the insurance company might use this as a way of limiting benefits under this second type of clause. Indeed, just about every employee who is off work because of a physical medical condition might end up falling under this clause. Now, please understand that I am not suggesting that you not seek treatment for mental or nervous conditions in this circumstance. It is just that it will be necessary to carefully present the claim in a manner which makes it clear that the mental or nervous would not be present but for the underlying physical problem or that the employee could work if the mental or nervous condition were the only problem.

Either way, claims involving mental or nervous must be approached very carefully to avoid these tender traps laid by the insurance companies for the unwary.

There are other conditions which might also fall under a similar type of benefits limitation clause. The undersigned has seen Plan Documents limiting benefits in a similar manner for claims involving fibromyalgia, chronic fatigue syndrome and other conditions which insurance companies think involve only self reported symptoms. Again, the contra preferentum legal maxim would apply but the approach on such claims must, nonetheless, be made very carefully.

The law office of Herbert M. Hill, P.A. represents clients throughout the southeastern part of the country. We would be happy to assist if you are having difficulty with any issue arising out of your private short term disability or long term disability policy claim or any claim arising under the Employee Retirement Income Security Act (ERISA), including claims for short term disability benefits, long term disability benefits, pension benefits, 401k claim, group medical claim or any other employer provided benefits which you believe you have been wrongfully denied.

You can contact Herbert M. Hill at www.herbertmhill.com or at (407)839-0005. You are also welcome to Email Herbert Hill directly at hmh@herbertmhill.com.

If you have questions about the contents of the “Plan Documents,”please see my writings on that subject found elsewhere on this website.

In any event, after 24 months, two (2) important issues may arise. First, at the 24 month point in time, there typically is a change in the definition of the term “disability” relative the occupation to which it applies Second, there are typically certain medical conditions for which benefits are limited to a 24 month entitlement. I will address the first issue in this writing. The second is addressed elsewhere on this website.

Definition of Disability. During the first two (2) year period of Long Term Disability benefit entitlement, the definition of disability typically provides that you are disabled if you are unable to perform each of the material duties of your own occupation. (The “own occ” phase of the claim.) Thereafter, the definition typically changes to “any occupation for which you are reasonably qualified by way of education, training and experience.” (The “any occ” phase of the claim.) The insurance company will have one of its “in house” vocational “specialists” perform a review of the medical records and attempt to locate a job you could perform in the “Dictionary of Occupational Titles.” Keep in mind, they do not have to find a job for you, only identify one you could do. In performing this task, it is the experience of the undersigned that the vocational specialist will “cherry pick” the medical records to understate your limitations, overstate your job skills and then locate a job you have never had any experience doing, if it even exists in your locality. Further, they will typically ignore the medications you are required to use to maintain even a modicum of daily functioning. Governing case law requires them to do so but the medications issue is one which is routinely ignored.

There are many other issues arising in connection with particular issue which have been or will be addressed elsewhere on this website. As an example, those issues include how the term “occupation” is defined and what occupations are reasonable based on education, training or experience (i.e., can a person educated and employed as a professional engineer be considered not disabled because she can perform the job requirements of an office receptionist?).

Insurance companies will typically try to define the claimant’s occupation by use of the definition thereof found in a book entitled “Dictionary of Occupational Titles.” Unfortunately, the definitions found in this “dictionary” are rather generic and do not typically accurately identify all of the requirements of the “Own Occupation” which the claimant is performing. The insurance company will take whatever generic job title the claimant has been given and claim that the job duties are the one listed in the “DOT,” as it is called. More often than not, however, the claimant does far more, typically including whatever the employer needs done and the faithful employee does just that. The rub is this issue is not presented until after the employee becomes disabled. Also, after the first two (2) years of disability, the insurance company will use the DOT to identify jobs which the claimant can do as an “any occupation” which would then be relied upon to deny future benefits.

There are different tacks which can be taken to defeat the defenses by the insurance companies. The insurance companies’ own Claims Manual can be helpful. Sometimes it is necessary to fight fire with fire by securing the services of a vocational rehabilitation specialist to demonstrate the faulty reasoning relied upon by the insurance company to deny benefits. However, when these issues arise, it is time, if you have not already done so, the employ the services of an attorney to guide you through the potential pitfalls associated with these issues.

The law office of Herbert M. Hill, P.A. represents clients throughout the southeastern part of the country. We would be happy to assist if you are having difficulty with any issue arising out of your private short term disability or long term disability policy claim or any claim arising under the Employee Retirement Income Security Act (ERISA), including claims for short term disability benefits, long term disability benefits, pension benefits, 401k claim, group medical claim or any other employer provided benefits which you believe you have been wrongfully denied.

You can contact Herbert M. Hill at www.herbertmhill.com or at (407)839-0005. You are also welcome to Email Herbert Hill directly at hmh@herbertmhill.com.

At Herbert M. Hill, P.A., we represent clients throughout the southeastern section of the country. We would be happy to assist if you are having difficulty with securing Plan documents or with any other issue arising out of your private disability policy claim or any claim arising under the Employee Retirement Income Security Act (ERISA), including claims for short term disability benefits, long term disability benefits, pension benefits, 401k claim, group medical claim or any other employer provided benefits which you believe you have been wrongfully denied.

You can contact Herbert M. Hill at www.herbertmhill.com or at (407)839-0005. You can also Email Herbert Hill at hmh@herbertmhill.com.

The Employee Retirement Income Security Act (”ERISA”), found at 29 U.S.C. §1001, et seq., was originally passed by Congress in 1974. Despite its name, it is, at best, only cold comfort for the employee who has a claim for any employer-provided benefits governed by the statute. By its terms, the right to a jury trial is eliminated and, as a result of judicial interpretations of its terms, the situation only gets worse. This is not intended as an adverse commentary on the judiciary. The judiciary is only doing its job in interpreting a statute which is slanted heavily (and unreasonably) in favor of the employers and insurance companies who render the initial benefits determination with which an aggrieved employee may disagree.

The starting point in any discussion concerning the case law interpreting ERISA is the Supreme Court case of Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 109 S.Ct. 948 (1989). This is the case most often cited for the proposition concerning the manner in which claims for ERISA benefits are reviewed by Courts. The starting point is that the Court’s review is “de novo” unless the Plan Documents governing the benefit entitlement provide an express grant of discretionary authority. If that grant of authority is provided the party charged with rendering the benefits determination, then concepts of Trust law will be applied to give “deference” to the benefits determination made. In the Firestone case, the employer could not rely upon application of trust law to the ERISA actions because its plan had no discretionary language. From this point, case law has blossomed over varying issues concerning what language grants discretionary authority, the procedure to be followed by the Court in rendering its decision and the impact of the conflict of interest inherent in the situation in which the party charged with rendering the benefits determination is also the purse holder, i.e., it is paying benefits out of its own money. On the subject of the conflict of interest, it is rather unusual (I will refrain from saying “silly” or “absurd”) to think about the proposition of putting an insurance company in the posture of a trustee in connection with benefit determination which it will have to pay. Apparently, Congress did not think so but I will have more on that subject later.

In handling claims involving group short and long disability benefits , pension, 401k, medical claims and other claims arising out of employer- provided benefits, the law firm of Herbert M. Hill, P.A. routinely handles cases involving all of the various legal and factual issues associated with such claims. Throughout the southeastern part of the country, representation is afforded the employee who has been unable to secure those benefits to which he or she is rightfully entitled. All inquiries are handled by way of a free initial consultation.

The strange phenomena I have experienced is that when these other benefits are received, the disability insurance company will simultaneously claim the overpayment and then soon after find a reason to deny the benefits they owe. This may seem somewhat astonishing but that is only because it is. The point being that when you receive “other benefits” from other sources, you need to proceed with caution. The first issue is the correct amount of the overpayment. This is one area in which this author can provide particular assistance because the undergraduate degree I received before going to law school was that of a Bachelor of Science in Business Administration with a major in Accounting. I am not suggesting I can assist you with tax or accounting issues; I just have no problem dealing with numbers which can get quite complicated in these situations.

You must remember that the insurance company’s claims representative is answering your questions in a manner most beneficial to the interests of the insurance company, not in your interest. Many persons with a clear entitlement to benefits either lose those rights or hamper the ability to secure prompt payment thereof as a result of trying to go it alone. Remember you are seeking to protect the very income stream on which you will rely to maintain your lifestyle. It is fair to say that this is one of the most valuable assets you have. The attempt to “go it alone” routinely results in mis-steps in the application phase of the claim or thereafter resulting from either ignorance of the intricacies of that process or misplaced reliance on representations made by the claims representative.

Remember that while this is a right you earned and paid for, that fact does not necessarily mean the insurance company has any intention of paying or making the process easy.

There are deadlines and job continuation issues which must be successfully dealt with during the application phase. These are delicate issues. In fact, there have been claims handled by this law office in which the insurance company attempted to use the claimant’s continued efforts to work as evidence that the claimant was not disabled!