ERISA Long Term Disability Case Citations and references

DISCLAIMER: Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case.

When You Appeal to the Insurance Company, What Doctor is Supposed to Review the File?

When you appeal, they are supposed to consult with an appropriate medical expert (of course it could be someone who gets their paycheck from the insurance company, so don't expect big things!) (§ 2560.503-1(h)(3)(iii), (h)(4) requires an appellate body to consult an appropriate medical expert in reviewing a claim of this nature); id. § 2560.503-1(h)(3)(v), (h)(4) (requiring that the Board's medical expert on review be an expert not consulted in the initial benefits determination).