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Disability Claim: Disability Claims
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The disability claim process is confusing and frustrating. For over twenty-five years, attorney David Gantt has worked hard to obtain favorable outcomes for disabled clients. As your lawyer, Mr. Gantt will provide responsive legal services, taking time to listen to your concerns. This responsiveness coupled with his successes has many clients saying "Thanks David !"
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In addition, the Company received a letter in September 2003 from the office of the New York State Attorney General indicating that it is reviewing the disability claims-handling procedures of the Company and its insurance subsidiaries. The Company is cooperating and is in the process of gathering and providing information in response.
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In Gilbertson, the plan administrator failed to render a decision on a disability claim prior to the deadline, leading to the claim being “deemed denied” pursuant to ERISA regulations. The Tenth Circuit held “when substantial violations of ERISA deadlines result in the claim’s being automatically denied on review, the district court must review the denial de novo, even if the plan administrator has discretionary authority to decide claims. . . Deference to the administrator’s expertise is inapplicable where the administrator has failed to apply his expertise to a particular decision.”
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Aetna's core disability services provide market-leading claim management and reporting capabilities from its state-of-the-art Workability® system. As all disabilities are health events related to injury or illness, Aetna takes a return-to-health/return-to-work approach to managing disability claims. The company's clinically based disability model ensures that duration guidelines are fact-based with objective benchmarks.
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NOSSCR and the Consortion for Citizens with Disabilities (CCD) have issued a position paper in response to the Commissioner’s plan for changes to the disability claim process. The paper, which has been signed by over 20 national disability advocacy groups, is available below in PDF format. NOSSCR is an organization of 3500 claimants’ representatives, helping people win disability claims.
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