Disability Claims in a Down Economy
Why Attend?
In a dwindling economy and reduction-in-workforce-world, disability claims are on the rise, but building a disability case can be a treacherous task. With insurance companies merging, vanishing and feeling pressured to reduce reserves, how does that impact the claim handling process? Are claimants truly disabled or simply unemployed? Handling a disability claim, more than ever, requires familiarity with emerging legal trends, deciphering difficult medical and legal issues, and evaluating the validity of your client’s position to impact the outcome in a favorable way.
What You Will Learn
Leading plaintiff and defense counsel and a vocational expert offer their experience, perspectives, and insights on litigating ERISA and non-ERISA disability claims and what you need to know to prevail. Various aspects and challenges involved in the process of adjudicating and defending against disability claims, as well as practical strategies and techniques to use on your next disability case are considered, alongside case management tactics, practice pointers, and cost-effective approaches to verify claims.
Topics discussed include:
Independent Medical Evaluations (IME) versus Functional Capacity Evaluations (FCE): When to use them and how to support or refute their findings
Neuropsycholgical evaluations are on the rise, but are their results valid and relevant to the claim?
How to get to the bottom of the occupational duties assessment in this economy where jobs are shrinking and duties changing
Policy provisions and limitations - how to analyze and apply them to specific cases
Who Should Attend
This program is designed for both plaintiff and defense counsel, attorneys representing insurance companies, claims managers, and general practitioners. It also is valuable to corporate lawyers assessing ERISA litigation, non-ERISA specialists who handle occasional ERISA issues, and non-lawyers who must consider the implications of possible disability claims.
Planning Chairs
(also on faculty)
Bryan D. Bolton, Funk & Bolton, P.A., Baltimore, Maryland
Bonny G. Rafel, Bonny G. Rafel, LLC, Livingston, New Jersey
Faculty
Daniel W. Maguire, Burke, Williams & Sorensen, LLP, Palm Desert, California
Jason A. Newfield, Frankel & Newfield, PC, Garden City, New York
Mala M. Rafik, Rosenfeld & Rafik, P.C., Boston
Edward S. Rooney, Jr., Eckert Seamans Cherin & Mellot, LLC, Boston
John E. Sargent, MS, CCMHC, LCMHC, Portsmouth, New Hampshire
Program Schedule
All times Eastern Daylight
12:00 noon Important Occupational Issues and Using a Vocational Expert
Physicians, including specialists (ie, ob/gyn)
Executives – Reduction in force vs. disability
"Own" occupation vs. “any” occupation
National and local standards
Vocational evaluations, including physical capacity, training, and job availability
Other relevant considerations
Benefit and Burden of Residual Disability
1:00 p.m. Medical and Legal Issues
Treating Physician vs. Peer Review Physician
Independent Medical Evaluation (IME) and Functional Capacity Evaluation (FCE)
When are they appropriate and required under the contract?
Parameters of appropriate testing and assessment
Third party vendors
Video/audio or witness attendance at testing
Claim denial for failure to schedule or attend IME
Psychological and Neuropsychological evaluation
Malingering issues
Testing environment, validity, and reliability
What to do with test results
1:30 p.m. Break
1:45 p.m. Medical and Legal Issues (continued)
2:15 p.m. Legal and Contractual Issues
Mental and Nervous Disorder Benefits
Diagnostic standards
When is the 24 month limitation period applicable
What if the physical condition is causing psychiatric symptoms – does the limitation apply?
What about co-morbid psychiatric and physical conditions – does the limitation apply?
Objective vs. subjective evidence
Relevant plan language and standard of review
Proving or challenging subjective disability claims
“Self-reported” conditions and benefits
Limitations
Statute of limitations
Laches
Creative Proofs of Disability
3:15 p.m. Adjournment
Total 60-minute hours of instruction: 3.0
Suggested Prerequisite: Some experience in legal practice in subject matter or completion of Basic CLE Course in subject matter
Educational Objective: Acquisition of knowledge and skills to develop proficiency as a practitioner; maintenance of professional competence as a practitioner; provision of information on recent legal developments
Level of Instruction: Intermediate
Times
Eastern 12 noon - 3:15 pm
Central 11 am - 2:15 pm
Mountain 10 am - 11:15 am
Pacific & Arizona 9 am - 12:15 pm
Alaska 8 am - 11:15 am
Hawaii 6 am - 9:15 am
