New York Disability Lawyer & Attorney : Turley, Redmond & Rosasco : Brooklyn, Queens, Long Island, Nassau, Suffolk, Bronx, Staten Island

Congratulations to my friend and fellow long term disability attorney Eve-Lynn Gisonni on her significant victory at the New York State Court of Appeals in Benesowitz v. MetLife.  This decision is a great victory for long term disability claimants who are denied benefits due to a "pre-existing condition clause" in their employer's LTD Summary Plan Description.  Credit is also due to Eric Dinallo, Governor Spitzer's new Superintendent of Insurance, who supported Eve-Lynn's position in an Amicus brief to the Court.

In Benesowitz, the Court ruled that claimants who apply for long term disability benefits in part due to a preexisting condition which was present at the time disability coverage began only have to wait 12 months before they can collect disability benefits.  Up until now, many disability insurance companies, including Unum, MetLife and Cigna , used preexisting condition clauses to unfairly deny claims forever.  Now, the Court has ruled that claimants in these fairly common situations will have a 12 month "waiting or elimination period" before being able to collect benefits.  For a 30 year old with a pre-existing history of cancer which reoccurs and causes permanent disability for the rest of her life, this will be an economic life saver if she is claiming long term disability benefits. 

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That's the rumor in the latest business press.  Having just digested the giant Travelers Insurance, MetLife is apparently on the prowl for its next corporate meal, and Unum Group might be ripe for swallowing.   But what impact would such a acquisition have on individuals claiming long term disability benefits from the "new undisputed disability insurance king"?  Probably not much.

As it stands now, neither MetLife nor Unum Group are great claims payers.  In the last month, I've had employees of these companies come to my office for representation because their own employers unfairly denied their ERISA disability claims.  If this is how MetLife treats its own employees, can you imagine how you will be treated. These two titans are motivated primarily by shareholder profits, not policyholders interests.  From a long term disability lawyer's perspective, it would be a perfect marriage in which both naysayers deserved each other.    But then again, it might be a good stock?!

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Patricia Kitchen of Newsday did a nice article on business professionals who blog in the cover story to the Money and Careers section of last Sunday's paper.  My good friend and fellow attorney Diane Pfadenhauer, who writes the Strategic HR Lawyer Blog, was featured along with my blog on long term disability claims.  We both have Kevin O'Keefe at Lexblog to thank for hosting and designing our blogs and keeping them easy to navigate for our readers.

The article stressed the roles our blogs play in providing useful information on specific topics to the public while also allowing us to express our professional "spin" on the issues.  Of course, I have suffered some ribbing from fellow attorneys since publication - mostly along the lines of "what is a blog?"  The print edition unmercifully had my mug shot front and center, and one good "friend" informed me that he stuck it on the refrigerator door right next to the plumber's magnet!   

I have since spoken to Steve Levy, a professional recruiter who was also profiled in the article and discussed employment opportunities for individuals with disabilities.  We will talk again. I haven't spoken to career strategy coach Deb Dib yet who was also profiled, but am sure we will have similar synergies.  See you in the blogosphere! 

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I was reading the magazine section of my Sunday paper this weekend and ran across a great article on online support groups by Peter Waite, the founder of HealingWell.com, a website devoted to online discussion groups for individuals with chronic illnesses.  I have always been a big fan of support groups for those with particular medical conditions, whether they be cancer, diabetes heart disease or some less common but equally disabling conditions.  However, I have always been dubious of recommending specific online disease forums due to the proliferation of bad medical information and questionable "lurkers".  Up until now, about the only Internet medical site I have recommended is MedlinePlus, sponsored by the National Institute of Health.  MedlinePlus is the starting place for my medical research.

Mr. Waite makes an excellent suggestion that anyone considering participation in an online support group first check out who sponsors the site (is it a drug company that wants to sell you its latest multiple sclerosis medication?) and if the site is accredited by the Health on the Net Foundation.  He also discussed proper online etiquette and the always sound mantra to check everything with your doctor.

My curiosity piqued, I got out of the recliner, sat down at my computer, and went to the HealingWell.com website.  It is well organize and has a user friendly interface.   More importantly, it has well attended discussion forums on diseases such as fibromyalgia, chronic pain, lupus, depression, arthritis, Crohn's Disease and ulcerative colitis, to name a few.  For those of you who are fighting a Social Security Disability claim or ERISA long term disability claim, this helpful site may give you some much needed support in the interim.  

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I was recently interviewed by a reporter for AM New York in an article on disablity insurance claims.  The article is a good overview of the reasons to have long term disability insurance and the potential problems that may arise when you make a long term disability claim.  It also appeared in the always excellent Disability Insurance Forums. Good reading!

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Last week, the New York Daily News published a sad article about disability benefits and our client's 3 1/2 year struggle to obtain the Social Security Disability benefits she deserved entitled "Filing for Disability, but Finding Discouragement".   As detailed in the article, our client was mentally retarded and could not read or write. 

In mid-2003, she applied for Social Security Disability benefits.  Unbelievably, her claim was denied about 6 months later.  Our office filed an appeal called a "Request for a Hearing before an Administrative Law Judge" in the Queens Office of Disability Adjudication and Review.  Our client eventually appeared for a hearing before an Administrative Law Judge after waiting an additional 12 months.  At the hearing, the law judge called a special Social Security medical expert to testify.  The medical expert testified that our client was disabled under Social Security regulations.  End of story - right? No!

Despite  the testimony of his own medical expert saying our mentally retarded client was disabled, the judge again denied the claim in a poorly written decision a few months later.  This particular judge is known for horrible decisions. We then immediately appealed our client's case to the Social Security Appeals Council (a panel of reviewing judges) in Falls Church, Virginia.  Finally, in January 2007 the Appeals Council  fully reversed the original judge's decision and granted our client disability benefits, some 3 1/2 years after her initial application. 

As the claimant's mother said in the article, "when we needed the system, it wasn't there for us".  When the mentally retarded need retain disability attorneys to get the Social Security Disability benefits they deserve, you can only imagine the challenge the rest of you might have, especially in the New York City area.   

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Once again, Mark Harrington of Newsday continues to do a superb job of  uncovering previously unreleased documents about the dangers still lurking in the soil and air surrounding the former Hicksville Sylvania nuclear fuel rod fabricating plant, now owned by Verizon.  Yesterday, he published the fourth article in an ongoing series about the Hicksville nuclear site and its impact on thousands of workers. Harrington details the most recent March 2007 Army Corps of Engineers report about the proposed future cleanup of this "dirty" site contaminated with both radiological waste and chemicals such as TCE and PCE. Updating the health of my client, the article goes on:

Troy Rosasco, DePascale's Hauppauge-based attorney, said his client is preparing for surgery on May 17 to remove a tumor even as he recovers from the removal last month of half of the other lung. At the same time, he said, continued testing raises questions about assurances that the site was completely safe.  "It tells me that the State Department of Health...is operating fast and loose with data the US Army Corps says is missing" Rosasco said.

Despite winning his case after a trial over two months ago, Gerard DePascale is still without any workers' compensation payments due to the frivolous appeal filed by his employer, Hudson News Group.   All the while, every day another present or former employee who worked at this toxic "glow in the dark" work site calls my office to get on the list of potential future plaintiffs in a future major litigation to provide medical monitoring for all those exposed.  Even if you are currently healthy, you may be entitled to future medical monitoring.  If you are currently sick, you may have additional legal remedies.  If you would like your name placed on the contact list for any future litigation or discuss any other potential claim, please call Troy Rosasco at 631-582-3700, ext. 123.

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US Senator Charles Schumer announced in a Newsday article yesterday that treatment, medical monitoring and potential compensation are on the way for potentially thousands of workers who formerly worked atop the nuclear waste site owned by Verizon in Hicksville, New York.  In addition to announcing the new benefits for workers, a frustrated but determined Senator Charles Schumer stated that "I will hold the Army Corps' of Engineers feet to the fire" and "the site should have been cleaned up yesterday", referring to his previous efforts in 2004 to achieve a full cleanup.   

Shocked that their efforts in 2004 to secure a federal cleanup of the Hicksville, Long Island,  New York nuclear waste site have not been completed to date, both Senator Charles Schumer and Congressman Pete King vowed to to cut through the bureaucracy and finger pointing.  Both Schumer and King were reacting to a letter request for intervention from Troy Rosasco, the attorney for Gerard Depascale, who the New York Workers' Compensation Board recently found contracted a rare cancer while working for the Hudson News Group on this site and was awarded lifetime workers' compensation and medical benefits.  In a previous Newsday artcle on Mr. Depascale, Mr. Rosasco compared the illnesses facing the Hicksville workers as similar to the ilnesses facing 9/11 workers who were exposed at Ground Zero.   "Over the course of the next 10-20 years, I believe we are going to see more cases of cancer and other illnesses related to radiation at this site", said Rosasco.

This new aid promised by Senator Schumer will be especially welcome to those workers who were exposed to ionizing radiation  and other toxins on the site and are now in fear of getting sick in the future.  In addition, the Army Corp of Engineers promised to return to the site this May for more investigation.    Turley, Redmond & Rosasco, LLP is compiling a list of  workers who ever worked on this site and may have been exposed to radiation and other chemicals.  Please call Troy Rosasco, Esq. at 631-582-3700, ext. 123 if you worked at this site and would like to be on the list for possible testing, treatment and/or compensation.   We will keep you posted on further developments. 

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Shocking.  Revolting.  Sad.  Tragedy.  Anger.  Way off the seemingly inconsequential topic of long term disability and social security disability claims today, but we feel compelled to offer our sympathies and prayers to all those impacted by the horrific shootings at Virginia Tech today.  May God be with you all. 

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Welcome to the newly designed New York Disability Law Blog!  As you will notice, I changed the official title of the blog from "The Disabled Worker Law Blog" to the  more informational "New York Disability Law Blog".  This is in keeping with the blog's purpose of providing useful information and insight regarding disability claims to fellow attorneys and the general public. 

To this end, I am excited to announce the creation of the blog's "Disability Law Library" which will be continually added to and updated.  I hope that this will eventually become the first place attorneys and claimant's turn to when researching disability claims and legal issues.  Still in it's formative stages, the library will have sections on long term disability and ERISA claims, Social Security  disability, New York workers' compensation, civil service disability pensions, scaffold /ladder /construction site lawsuits and a new section on the unfortunate expanding area of veterans' disability claims.

In addition, in 2007 we hope to do a better job collaborating with fellow bloggers such as Jonathan Ginsberg and his excellent Social Security Disability Radio Blog.  Please feel free to comment about the new design and let me know how the New York Disability Law Blog can better serve your needs.  Talk to you soon.

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Well, my seven year old son didn't get  "an official Red Ryder carbine-action, 200-shot, range-model air rifle with a compass in the stock" this Christmas, but he now has enough "weapons of mass destruction"  to justify Dick Cheney's armed search of our property (I better duck!)   My daughter is content with her yo-yo and Rubik's Cube.  Chock it up to testosterone!

All of us at the New York Disability Lawyer Blog and Turley, Redmond & Rosasco wish you and your families a very Merry Christmas and Holiday Season!  See you in the New Year!

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On Monday, November 13th, I will be lecturing at the Suffolk County Bar Association's Plaintiff's Personal Injury Committee on the always confusing subject of Workers' Compensation Law Sec. 29, liens, consent and Kelly calculations.  The Kelly calculation formula derives from the seminal New York Court of Appeals decision in Kelly v. State Insurance Fund, 60 NY2d 131 (1983).  The Kelly case said that  the workers' compensation carrier must pay it's equitable share of the claimant's litigation costs based upon their "total benefit" from the claimant's recovery.  This "total benefit" includes both the amount of the lien they recoup and the present value of future workers' comp benefits they will not have to pay (credit/offset rights) due to the claimant's recovery.  We will be handing out a Kelly Calculation Worksheets that personal injury lawyers can use and will practice on several hypothetical cases.  Bring your calculators! 

In addition, we will discuss the impact of the recent Appellate Division case of Burns v. Varriale, 2006 Slip Op. 6346 (3d Dept.) which states that Kelly may not apply in some permanent partial disability cases. My  friend and fellow New York legal blogger Matt Lerner at the New York Civil Law Blog has an excellent synopsis of Burns, as does fellow workers' comp attorney Ray Seligman in the Albany Bar Association newsletter - so the issue is hot.

The seminar panel will include notable experts such as Leonard Tartamella, Esq. giving the Personal Injury attorney's perspective and Robert Manning, Esq. giving the workers' compensation defense counsel perspective.  It starts at 6:00pm and is worth three continuing legal education credits.  Call the Suffolk Academy of Law on Monday at (631) 234-5588 if you would like to sign up.  There are still a few seats left.

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Need another reason to vote for Eliot Spitzer for New York Governor tomorrow?  This guy just keeps on working for the little guy (including one of my corporate executive clients receiving over $400,000 per year in disability payments from UnumProvident) and fighting greedy insurance companies right up to his presumptive landslide win on Election Day. This wasn't about getting votes (he doesn't need  any more at this point) - it was about doing the right thing for disabled workers.

Late last week, Unum agreed to $15.5 million dollars in restitution to over charged policyholders and a $1.7 million dollar civil penalty. This settlement with UnumProvident, the nation's beleaguered yet largest long term disability claim insurer, comes on the heels of Spitzer's prior settlement with UnumProvident requiring them to re-access tens of thousands of previous unfair long term disability claim denials.  Give Eliot Spitzer credit and your vote tommorrow - to date, he has done more to protect injured and disabled than any past NY Attorney General of recent memory.  Now let's hope he protects New York workers' compensation claimants just as well in his new role as Governor!

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I am humbled to have been recently elected by my colleagues to be their Second Circuit Court of Appeals representative on the NOSSCR Board of Directors.  I look forward to seeing many of them at our upcoming national disability lawyer conference in Phoenix, Arizona and representing the interests of all Social Security Disability claimants.  Remember - President  Bush still wants to privatize Social Security in his last two years in office.  We must prevent this ill-conceived idea.

For those of you who have never attended a NOSSCR conference, I strongly recommend that you do.  Not only are the Continuing Legal Education seminars of the highest quality, but the opportunity to meet and learn from some of the sharpest disability attorneys in the US is a great asset.  In fact, I am sure I would not have developed our ERISA and professional long term disability practice had it not been for attending an eye opening seminar given by California long term disability lawyer legend, Frank Darras, at a prior NOSSCR conference

Led by Executive Director Nancy Shor, NOSSCR is the  largest disability lawyer association in the United States and is well known to our representatives in Washington, DC for protecting the rights of Social Security Disability claimants.  As part of the NOSSCR leadership team, I am committed to preserving social security disability (SSD) and supplemental security income (SSI) benefits for all individuals with disability claims.    

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In April of this year, New York joined the growing list of states banning discretionary clauses in ERISA long term disability policies, much to the benefit of disabled workers.  Unfortunately, the New York State Insurance Department recently rescinded it's prior advisory letter in favor of proceeding with formal rule making in the future.  While it is clear that New York still feels that "discretionary clauses" are unfair to ERISA long term disability plan participants, this newest circular letter does subject current disability claimants to uncertainty in the near future.

New York Insurance Department Circular Letter # 8, dated 3/27/06, required long term disability insurance companies to remove "discretionary clauses" from disability income policies within 30 days they were "unjust, unfair, inequitable,  misleading , deceptive or contrary to public policy".  New Circular Letter # 14, dated 6/29/06, super cedes and withdraws Circular #8, and states that the Department will be drafting regulations which would "prohibit the use of discretionary clauses".  In the interim, the Department "suggests" that long term disability insurers remove discretionary clauses from policies.

While the latest statement from the New York Insurance Department takes a little wind out of the initial announcement in March, it could lead to stronger permanent regulations which will have more impact in court.   In addition, the formal rule making process allows for public comment.  You can be sure the long term disability carriers will use this opportunity to water down the new regulations to their economic benefit.   You can also be sure that Turley, Redmond & Rosasco will counter all such comments vigorously to protect disabled policyholders in their long term disability claims.

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Arthritis cripples more people in the United States than almost any other chronic condition.  Therefore, it is one of the most common disabilities the attorneys at Turley, Redmond & Rosasco see when it comes to processing long term disability claims and Social Security disability claims.

Arthritis is a broad category of  disorders including degenerative arthritis,osteoarthritis, rheumatoid arthritis, and psoriatic arthritis. It also includes autoimmune disorders such as lupus, fibromyalgia, sclerodema, and mixed connective tissue disease.  All involve severe pain and functional restrictions.  When arthritis affects the hips, knees or ankles, obesity often times exacerbates the symptoms.  When the symptoms become severe enough, sometimes total joint replacement surgery is necessary.

To win an arthritis Social Security disability or long term disability claim, the key is always to document how the client's pain and/or  inflammation impacts on the ability to use hands repetitively, stand, walk or sit for long periods.    One of our main jobs at Turley, Redmond & Rosasco is to work with the client's treating rheumatologist or orthopedist to document the severity of pain induced functional restrictions.  When handled properly by a skilled disability lawyer, arthritis claims can be easily won and result in much needed disability benefits.

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New York ERISA long term disability claimants just received a big assist from New York State Insurance Superintendent Howard Mills . Following the lead of California's Insurance Department, Superintendent Mills issued 2006 Circular Letter # 8 invalidating all "discretionary clauses" in existing group long term disability policies. All insurance companies must comply by May 31, 2006.

Insurance companies frequently used discretionary clauses to unfairly deny legitimate long term disability claims by claiming their policy gave them "discretion" to decide what is and is not a disability. Discretionary clauses also handcuffed federal court judges who reviewed the unfair denials. An often heard statement by Judges might be "if I were deciding this myself, I would find the claimant disabled. But since the policy grants the insurance company discretion to decide what is disabling, and their doctor says the claimant is not disabled, I cannot say their decision was ‘arbitrary and capricious’.

Now - New York residents with ERISA group long term disability policies will have greater success challenging disability claim denials or terminations. Federal Judges will have far greater leeway in deciding who is disabled from their ‘own occupation’ or ‘any occupation’. Essentially, the playing field for long term disability claims just got a lot fairer. Sure – the insurance companies still have the big bucks to hire large law firms to fight your claim, but you just won a significant battle. Bottom Line – Turley, Redmond & Rosasco will be fighting and winning more LTD claims in the future. Have a great Memorial Day weekend!

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With all the talk of workers' compensation reform in New York lately, some of you may have thought that we forgot about the long term disability and social security disability claim side of our practice. Anything but!

On February 23th and 24th, I attended ACI’s Litigating Long Term Disability Claims conference in Coconut Grove, Florida. This is one of the best LTD claim lawyer conferences in the nation and all the "heavy hitter" plaintiff and defense attorneys in the in LTD business, from Frank Darras to Mark DeBofsky, were there. In fact, both Frank and Mark gave wonderful presentations regarding recent case law and claim filing strategies.

Given that a long term disability insurance carrier last week denied a new client who has end-stage real disease and is awaiting a kidney transplant, it looks like the good fight will continue for the foreseeable future.

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Next Wednesday, 1/18/06, my friend and colleague Justin Frankel and I will be giving a Continuing Legal Education Seminar at the Nassau County Bar Association entitled "Winning Long Term Disability and Social Security Disability Claims". It is suitable for both current New York disability lawyers and those attorneys considering branching out into either long term disability or Social Security Disability law in Nassau or Long Island.

If you are an attorney and would like to learn more about long term disability law or Social Security disability law in New York (while earning your CLE credits), please call Barbara Kraut of the Nassau Academy of Law at 516-747-4464. Hope to see you there!

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This past year has been a great experience for all of us at the Disabled Worker Law Blog. Hopefully, we have shared some useful information for the disability community regarding New York workers' compensation claims, Social Security Disability claims, and Long Term Disability claims. In addition to sharing helpful information, we have taken strong political positions to protect the rights and benefits of disabled workers, whether it be the Bush Social Security Privatization plan,the Pataki workers' compensation reform plan, or the UnumProvident long term disability settlements. Your continued readership and comments have been both encouraging and enlightening. We look forward to the continuation of our mutual conversation in the New Year.

Along the way, we have encountered many friends and fellow bloggers, such as the the always insightful New York Civil Law Blog and the simply outstanding Workers' Comp Insider. Their excellence keeps us striving to do better. Of course, none of this would have been possible without the support and encouragement of Kevin O'Keefe at Lexblog who is the preeminent authority on law firm blogs in the US. Thanks, Kev!

Finally, we would like to personally thank all our loyal readers. Since the Disabled Worker Law Blog was launched in March 2005, our readership statistics have shown steady growth, while maintaining a loyal group of regulars. We frequently receive inquiries from disability advocacy groups, disability support groups, unions, physician practices and the press, in addition to disabled individuals and their families. On behalf of all the attorneys at Turley, Redmond & Rosasco, we wish you all a happy and healthy New Year. We'll see you in the blogosphere!

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One of our workers compensation and Social Security disability clients picked up her $500 check as a result of Turley, Redmond & Rosasco's First Annual Christmas Blessing on December 21, 2005 in our Shirley office. Our staff was overwhelmed by the volume of touching and heartfelt letters we received from many of our disabled clients. Almost every single letter requested help not for themselves, but for their young children on Christmas day. Our staff did their best to select the absolute neediest among our many deserving clients.

Finally, our staff selected a single mom with three children ranging from age 2 to 6. She had a 15 year solid work history as a Nurse's Aide until she hurt her back lifting a patient at work. She recently underwent back fusion surgery but the result is still in limbo as she continues to have chronic pain. She has no car and uses sporadic bus service on the east end of Long Island to go to doctor appointments and buy groceries. Her Social Security disability claim is still pending, and her only source of income is her paltry workers' compensation benefit.

When we called her on the phone to inform her of her blessing, she began to scream in joy so loudly that her children could be heard in the background asking what was the matter. We thank all our clients who participated in the Christmas Blessing and look forward to making it an annual tradition at Turley, Redmond & Rosasco. We wish you and your families a happy and healthy New Year!

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We know that many of our New York clients with workers compensation, Social Security Disability or long term disability claims might have a less joyful holiday this year. For this reason, the attorneys at Turley, Redmond & Rosasco have instituted our First Annual Holiday Blessing. The law firm will donate $500.00 by December 20, 2005 to the neediest disabled New York client who is out of work and cannot afford presents for his/her children.

To be eligible for the Blessing, please write a short note to our Office Manager, Janou Mauro, by December 20th telling us how the $500 would make your Holiday more joyful. A committee of staff from our workers compensation, Social Security disability and long term disability departments will select the neediest client at 12 noon that day and contact the client to pick up their check that same day. Please call us if you have any questions.

The attorneys and staff of Turley, Redmond & Rosasco wish you all a Merry Christmas and Happy, Healthy Holiday Season. May next year be better than the last! In the words of Charles Dickens, "God Bless Us, Everyone!"

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In one of her farewell decisions as a Supreme Court Justice, Sandra Day O'Connor ruled for a unanimous Supreme Court yesterday that the federal government can collect delinquent student loans by withholding a claimant's Social Security Disability benefits. The full decision in Lockhart v. United States is here. While legally sound, the practical effect on disability recipients does not seem one bit fair.

Let's take the following real world example: John works for 20 years as a GM factory worker and then gets laid off. All those 20 years he paid into Social Security for disability and retirement benefits. Trying to better himself and find a new career, he enrolls in college to become an insurance claims adjuster. He takes out $7,500 per year in student loans to pay for tuition and books. In his sophomore year, he has a major heart attack which forces him to withdraw from his courses and prevents him from working. Since he is not enrolled in study, his loans come due. Because he can't work due to his disability, he falls behind on his payments. Eventually, he files for Social Security Disability. While Social Security finds him qualified medically, they don't pay him anything because they first want to recoup his delinquent student loans. Because John has no income and no Social Security Disability benefits now, he is forced to go on welfare. What's wrong with this picture?

First, the government is forgetting that John already paid for his Social Security Disability benefits through payroll deductions during the 20 years he worked at GM. It's his money! Social Security Disability is not welfare! This money was entrusted to the Social Security Administration to protect John if he became disabled. It's like a forced savings account. How do they expect him to pay back his student loans if he cannot work? How do they expect him to live now? Poor John.

I'm all for going after student loan deadbeats if they are driving a Lexus and not paying their loans. Most of them won't get hurt by the Social Security offset until retirement age. However, I would hope Congress would carve out an exception for the disabled so they can get by today. It would be the right thing to do

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I wouldn't! I think they both have major conflicts of interest. As the attached court decision Allsup v. Advantage 2000 shows here, I think Allsup and Advantage 2000 (A2K) Consultants are more interested in helping long term disability insurance companies, like UnumProvident, Cigna and MetLife, than they are in protecting the rights of Social Security Disability beneficiaries.

This is the way companies like Allsup and Advantage 2000 work: 1) You file for long term disability (LTD) through your employer's LTD carrier; 2) before the ink is dry on your LTD application, the LTD insurance company tries to solicit you to sign up with Allsup or Advantage 2000, at no financial cost to you, to help you apply for Social Security Disability. Sometimes Allsup will send you letters directly. I know - one of my LTD clients with Parkinson's Disease can't get Allsup to stop sending him annoying letters.

Why do long term disability insurance companies want you to use their handpicked Social Security Representative? A few reasons: First, most ERISA long term disability plans "offset" the benefits they pay by the amount you receive in Social Security Disability benefits. For example, if the LTD claim is supposed to pay you $3,000 per month, and you also win Social Security Disability that pays you $2,000.00 per month, the LTD insurance company now only has to pay you $1,000.00 per month. That's a whopper of a financial incentive.

And as the above case shows, they don't want you to even touch your Social Security money when you win! They want to electronically forward it to the LTD insurance company. Talk about you know what! You paid for your Social Security benefits, and they don't even want you even see it.

Even more disturbing is the relationship between Allsup (and their ilk) and the LTD insurance company. Remember - the Allsups of the world work first and foremost for the insurance company, not you. They are allowed to share any secrets, confidences and/or private medical information they obtain directly in the Social Security Disability claim with the LTD insurance company. I have seen such info used later to deny the long term disability claim. Unlike attorneys, Allsup has no ethical obligation to put your interests (and secrets) first. See here an Allsup brochure that seems to play on their trusting relationship with a client to the advantage of the LTD insurer. If you read it closely, this says it all.

To be fair to Allsup and other non attorney representatives like them, some law firms provide the same service to long term disability insurance companies. In my mind, this is even worse than Allsup's practices since an lawyer should know better. Allsup is just trying to make a buck from the insurance company.

Bottom Line - if you have a long term disability claim and need to file for Social Security disability, select an independent attorney with no relationship to any long term disability insurance companies. Most times your independent attorney can negotiate with the LTD insurance company so that the attorney's fee will be paid by the insurance company.

Thanks to the excellent Brininger Law Firm blog for publishing this info on the web.

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Turley, Redmond & Rosasco wishes all our Long Term Disability, Social Security Disability and Workers' Compensation clients (along with fellow lawyers in the disability bar) a blessed Thanksgiving! See you on Monday.

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Want to know how Workers' Comp, Social Security Disability and Long Term Disability claims inter-relate? I will be lecturing next week on 11/22/05 in Garden City at a day long seminar entitled "Advanced Workers' Compensation in New York" My topic will be "Coordinating Workers' Compensation, Social Security Disability and Long Term Disability Claims". In the past year, I have seen an increasing number of clients who wish to have all their disability related claims handled by one law firm. There are specific strategies that can be followed in order to protect a claimant's entitlement to all three benefits at the same time.

For those attorneys and workers' compensation claims professionals who have not yet signed up for next week's seminar, you can still do so by contacting Lorman Educational Services toll free at 1-866-352-9539 or at www.lorman.com. So far, we have over 30 attendees signed up, so it should be a lively and informative disability seminar. Hope to see you there.

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On October 16, 2005, my partner Chris Redmond rode in the New York City Multiple Sclerosis Association's MS Bike Tour and his group of riders raised over $20,000 for MS research! Congratulations to Chris and his team for raising an astounding amount for this great organization. The event raised over a Million dollars in total! By raising money like this, we get that much closer to finding a cure for multiple sclerosis. Although I have found our multiple sclerosis clients to be some of the nicest and most courageous people we have ever met, we would be glad to never see another MS Social Security Disability or Long Term Disability claim again.

On a different front, last Thursday I had the pleasure of attending the Long Island MS Association Chapter's 8th Annual Research Dinner. The speakers were Malcom Gottesman, MD, Director of the MS Treatment Center of Winthrop University Hospital and Susan Goelz, PhD of Biogen. Bottom Line - in addition to Multiple Sclerosis drugs like Avonex, Copaxone, Rebif and Betaseron, pharmaceutical giant Novartis is currently in Phase Two trials with a promising new drug currently labeled "FTY720". This is an oral drug which can reduce MS lesions. Finally, the drug Tysabri may soon be coming back on the American market after it was withdrawn over fears it might cause PML. All in all, it was a fascinating night filled with hope that we will conquer Multiple Sclerosis sooner rather than later.

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UnumProvident, the nation's largest long term disability insurance company, has been ordered to pay an $8 million dollar fine and change the way it evaluates long term disability claims in California in a settlement announced today. On the heels of New York Attorney General Eliot Spitzer's wide ranging Unum settlement last year and a recent stinging LA Times article highlighting the problems in the entire disability insurance policy industry, UnumProvident has suffered another embarrassing blow. Now, residents of California have the best protections in the US against unscrupulous disability insurance company practices. No more "pizza parties" for employees who deny the most disability claims. Employees will now have a fighting chance to get the disability benefits they paid for and desperately need.

Hopefully, the California reforms will spread to all 50 states. If not, Congress should step in to reform ERISA, the federal statute that regulates group long term disability claims. To Unum's credit, based upon the experiences of my clients, UnumProvident does seem to have cleaned up its act recently. This settlement insures that such reforms shall continue. Now all we need is to have companies like MetLife, Cigna, and Disability Management Services jump on the reform bandwagon. Don't hold your breath!

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How ironic? As reported in a great LA Times article, a woman who made $250,000 a year selling long term disability policies couldn't collect herself when she put in a claim with UnumProvident due to her multiple sclerosis! Remember - this is a woman who made the disability insurance companies tons of money by selling disability policies. You can't fake MS- its a progressive neurological disease documented by lesions on brain MRI's. If she has to wage a three year legal fight to get her benefits, what chance do you have? As I always tell my clients - better to plan and seek legal advice before you file your claim.

Thanks to John Wood and his excellent new ERISA long term disability law blog for bringing this article to our attention. The article is mandatory reading for anyone who wants the real scoop on UnumProvident and ERISA long term disability claims.

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My partner, and TRR's East End Managing Attorney, Chris Redmond will will be riding in New York City's 21st Annual MS Bike Tour on October 16, 2005 to raise funds for medical research to fight Multiple Sclerosis. Besides representing Multiple Sclerosis clients in Social Security disability claims throughout the years, Turley, Redmond & Rosasco has a personal interest in fighting multiple sclerosis as it has touched someone very close to us. As a result, earlier this year a number of our firm's employees participated in the Long Island MS Walk and raised a substantial sum for this worthy cause. If you would like to sponsor Chris' Bike Tour to fight Multiple Sclerosis, please click here for his personal MS Web page and make a contribution. Thank you!

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Thought President Bush’s Social Security Privatization Plan was dead? Think again! In the wake of significant Congressional victories such as the new energy bill and CAFTA, the President’s handlers are using Social Security’s 70th birthday to take another stab at private accounts. We can expect a new push this fall assuming issues like Iraq and Karl Rove don’t distract the President.

On Social Security’s 70th birthday today, we should be celebrating the spectacular success of this insurance program. Prior to its enactment in 1935, retirees and the disabled frequently lived in poverty. Social Security continues to be an important safety net for the least fortunate in society. It is not another 401k account to play the stock market. Wouldn’t it be nice to know you had this safety net if you live to be 90 and your nest egg has evaporated? As a Social Security lawyer, I think so.

Democrats and Republicans agree that private accounts do not solve the Social Security solvency problem. It’s a simple fact that people are living longer and Social Security will have to pay out more in the future. However, this fact leads me to conclude that we need the security of the Social Security program more than ever. Regardless, of your position on Social Security private accounts, we should all be grateful that President Franklin Delano Roosevelt’s foresight 70 years ago created a Social Security program that is the envy of the rest of the world. When I interview immigrant clients for Social Security Disability claims, they are overwhelmingly thankful that they moved to a country that does not let its citizens fall between the cracks. Let’s make sure we don’t tear down the security of Social Security by foisting private accounts on working class Americans. Happy Birthday, and many more, to Social Security!

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The Long Island, New York Chapter of the National Multiple Sclerosis Society has invited me to speak with their members on Thursday, August 4, 2005 on Social Security and Long Term Disability claims as part of their "Attorney One-on One" program. Located in Hauppauge, Suffolk County, this is a fantastic organization which really provides some much needed services for its members.

Over the past 15 years, I've handled over 60 multiple sclerosis disability claims before Social Security or long term disability insurance carriers, such as UNUMProvident. Although one might think that a diagnosis of a progressive illness like multiple sclerosis was all a claimant needed to win a disability claim, in fact both Social Security and long term disability carriers (including Disability Management Services - DMS) give MS claimants a particularly hard time in approving claims. However, I have found that by educating the claimant's treating neurologist about the legal standard for disability, we can win these claims in almost 100% of the cases. Winning the disability claim often reduces the claimant's stress, which then results in less serious exacerbations. I look forward to sharing some helpful tips with the membership.

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Had a great time last Thursday night at the New York Social Security Bar Dinner. Along with five other attorneys and staff from my office, we got a chance to socialize and laugh with old friends and colleagues, including Richard Morris and Vic Fusco. Judge Emanuel Poverstein from the Long Island Office of Hearings & Appeals was presented with the Lester Rosen Memorial Award - the highest honor an Administrative Law Judge in the New York region can attain. In his acceptance speech, Judge Poverstein humbly described the role of a Social Security Judge: "Helping the most vulnerable in our society - the disabled". Sounds like he was a fan of the late Senator Hubert H. Humphrey.

When I started practicing Social Security Law in 1990, both Judges Poverstein and Rosen sat together in the old Hempstead Hearing Office. Prior to his untimely death, I was fortunate to have learned the law from Judge Rosen, who was then widely considered the Dean of the New York Social Security judiciary. Judge Poverstein had just transfered from his prior assignment in Arizona and he became a "Rosen-like" Judge - compassionate and scholarly with a dry sense of humor. One of his particular strengths is evaluating mental disability claims. If you have a client with a mental disability, you hope Judge Poverstein is assigned to your case. Like former Supreme Court Justice Potter Stewart, 'he knows it when he sees it'.

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Here is New York Attorney General Eliot Spitzer's complaint alleging fraud against mega workers compensation insurance carrier AIG and its former CEO, Hank Greenberg. Thanks to Matthew Lerner and his New York Civil Law Blog for bringing it to my attention.

If the allegations are to be believed, it appears that Greenberg was a rogue CEO who would not take the legal advice of his own lawyers when they told him that AIG was defrauding the New York Workers Compensation system. If you read the complaint in detail, look at factual allegation #93. It alleges that AIG had secret "side agreements" with "customers" to disguise workers compensation premiums as auto premiums. Does this mean employers were part of a conspiracy to defraud the workers compensation system to lower their insurance rates? I wonder what the New York State Business Council has to say about this. The silence is deafening.

I've settled many claims with AIG over the years. I have always found their workers compensation adjusters tough but fair. Its a shame Greenberg has given the company a whopper of a black eye.

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You need life saving cancer treatment, but your HMO will not pay. What are your rights? Can you enforce them in time? I recently went to a great seminar on this topic at the Nassau County Bar Association given by my good friend, Susan Slavin. Susan was one of the pioneers of breast cancer litigation in the early 1990's, and continues today as a leading ERISA and disability rights attorney.

So what do you do when you get an HMO denial? In most states, including New York, you have a right to an External Appeal by an Independent Panel not affiliated with the health plan.. These appeals usually deal with the issues of "medical necessity", "experimental/investigational treatment" and/or "clinical trials". In New York, you have to complete the Health Plan's first level of internal appeal prior to requesting an external appeal. Then you have only 45 days to request the external appeal - and this is a strict deadline. There is also a procedure for Expedited Appeals in emergency cases. In cases involving other issues such as out-of-network expertise, you may have to file a separate ERISA appeal.

The Good News - statistics as of March 11, 2005 show that patients win almost 50% of external appeals. Even better, the appeal process is set up so that most patients don't need a lawyer. An excellent resource is the New York Attorney General's Health Care Hotline: 1-800-400-8882. So when your "HMO Says No", make sure you investigate your appeal rights. You might just win!

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Are you able to work after a diagnosis and treatment for cancer? Is this a better measure of treatment success for working age people? Most cancer survivors are able to stay on the job, according to a new study found in the current issue of the journal Cancer and reported by Reuters.

The nation's largest long term disability insurance company, UnumProvident, recently reported that cancer is the leading cause of long term disability claims in the United States. According to the new study, survivors of early detectable cancers ( breast, prostate, skin, thyroid and uterus) had the lowest risk of having to quit work. Survivors of other cancers, such as brain cancer, lymphoma and leukemia, had the highest rates of work disability.

The challenge for cancer specialists is to identify and help their patients with employment problems. Doctors need to " reassure employers that most cancer survivors are going to live a long time and will be just as productive as anyone else". One of my favorite organizations is New York based CancerCare. They helped my good friend Tim successfully battle Hodgkin's Disease as a young man. After beating Hodgkin's, he went on to graduate with me from St. John's Law School and became an Assistant District Attorney in Nassau County. Cancer didn't keep him down - it just made him tougher. Just ask the criminals he sent to jail!

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