June 16, 2013

The Pitfalls of Handling Your Own ERISA Appeal

by Kantor & Kantor LLP

The Kantor & Kantor website contains useful information to guide an insured if he or she elects to handle their own ERISA appeal. In some circumstances, this may be appropriate. However, we frequently see problems created by insureds who have handled their own appeals. These problems are usually due to the fact that an insured is unfamiliar with the claim review process. The errors we frequently see are:

• The insured is under the misconception that a request for a “written explanation” or “a narrative” from the insurer will be satisfied with a detailed letter from the insured describing his disability. Although an insurer may request an “explanation” or “a narrative,” it rarely gives any weight to statements by the insured. Rather it relies upon medical or vocational evidence by experts, such as physicians and vocational counselors.

• The insured believes that an insurer’s designated “independent medical examination” is truly “independent.” Insurers routinely hire physicians who will support the financial interests of the insurers. These physicians obtain repeat business from the insurers and are motivated to support the entity who is paying for their report. In reality, the examinations are far from “independent.”

• There is misinformation in the attending physician’s records. Often clients will downplay their true medical condition when describing their ailments to their attending physicians. We often see notes in medical records indicating that the insured is “about the same” or “doing better.” These notes do not give the full picture of the ailments which are currently being experienced and may give the false impression that one has improved to the point of being able to return to work. When a physician inquires how the patient is doing, the better response is to accurately describe all current symptoms. The patient should also give a full description of any medication side effects he or she is experiencing. Without a full description of the problems, the necessary information will not be contained in the attending physician’s records.

• The insured does not supply adequate evidence of the true job duties he or she was required to perform. Often, job descriptions are vague or outdated. Merely advising the insurer of the job requirements is not sufficient. Rather, the information should come from the employer or a vocational expert.

Although one’s attending physician and/or employer believes that a patient/employee is truly disabled, they may not have the time to advocate on the insured’s behalf. If this is the case, we strongly recommend that the insured retain an attorney to ensure that supportive, credible evidence is submitted with the appeal. If you find that you need assistance with your ERISA appeal, please call us for a no-cost consultation at (800) 446-7529 or visit www.kantorlaw.net.

June 7, 2013

The Impact of Sleep Disturbances on Rheumatoid Arthritis Pain

by Kantor & Kantor LLP

New research by Cathrine Austad, MD (Department of Rheumatology Diakonhjemmet Hospital, Oslo, Norway) calls attention the impact of sleep disturbances on pain and functional status in rheumatoid arthritis (RA) patients. This new research, presented at the annual meeting of the American College of Rheumatology http://www.rheumatology.org/, found poor sleep quality to be independently associated with increased pain. See: www.painmedicinenews.com

Sleep disturbances in RA – most likely due to factors such as inflammation, corticosteroid usage or pain itself- has been a relatively understudied issue. Based on these findings, Dr. Austad and her team suggest that clinicians address sleep disturbances with RA patients in their daily practice. In doing so, physicians might help improve sleep quality and reduce the effects of RA. Theodore A. Omachi, MD, assistant professor at University of California San Francisco School of Medicine predicts that“…addressing this issue more directly may allow providers to take a large step forward in treatment.”

At Kantor & Kantor, many of our clients living with RA have been adversely affected by the various painful (and cognitive) symptoms of their illness. Although a challenging and complex task, addressing and improving sleep patterns could potentially ease some of the pain and discomfort associated with RA. Living with an autoimmune disease can present many debilitating struggles. Unfortunately, restful sleep is one of them.

In 2011, researchers from the University of Pittsburgh's School of Nursing questioned 162 people with RA and found that their pain and fatigue levels were higher during days when they didn't sleep well the night before. See: http://www.upmc.com/media/NewsReleases/2011/Pages/pitt-school-of-nursing-study-finds-poor-sleep-associated-with-greater-pain-ra-patients.aspx. Leading researcher on this study, Faith S. Luyster, Ph.D., assistant professor, School of Nursing, explained that “not sleeping well at night can contribute to greater pain sensitivity and fatigue during the day, which in turn can limit a patient’s ability to engage in activities of daily living and discretionary activities.”

Though not effective for everyone, there are many suggested techniques for improving quality of sleep for patients with RA. Read more about them here: www.everydayhealth.com/

As attorneys who represent clients who have been denied Long Term Disability benefits for RA, we understand how life changing this illness can be. If you have questions about your RA and Long Term Disability benefits, do not hesitate to call us for a no-cost consultation. We work on a contingency basis, meaning that we do not collect a fee unless we get your claim paid.

We understand, and we can help.
www.kantorlaw.net (800) 446-7529

June 6, 2013

Cigna Cited and Fined for Improperly Handling Long Term Disability Claims

by Kantor & Kantor LLP

After extensive examination, Cigna (aka LINA) faces major consequences for improper denials of long term disability claims. In a settlement with five state insurance regulators (California, Connecticut, Maine, Massachusetts, and Pennsylvania), Cigna is responsible for setting aside $77 million to fund a re-evaluation of previously denied claims.

Cigna has agreed to review a subset of past long-term disability claims which were denied in 2009 and 2010 (California residents will have claims reviewed for 2008 through 2010) to see if they meet updated claims standards. Preparing for a possible payout to policyholders, Cigna has set aside $48 million as they review their procedures for gathering information and documenting decisions in claim files.

“This regulatory action is intended to provide long-awaited relief for consumers who have a right to expect that their carrier will make good on contractual promises,” Connecticut Insurance Commissioner Leonardi said in a statement. “This settlement resulted from market conduct exams and encompassed issues of serious concern.”

This regulatory settlement also requires Cigna to improve their claims handling process to benefit current and future policyholders, participate in a 24-month monitoring program, and pay fines and administrative fees totaling $1.7 million. See http://www.hartfordbusiness.com/article/20130522/NEWS01/130529904

As attorneys who represent clients unfairly denied long term disability benefits, we are unfortunately all too familiar with improper decisions and wrongful denials by insurance companies. At Kantor & Kantor, we spend every working day correcting and challenging improper disability denials so that our clients have access to the disability benefits to which they are entitled. If you have questions about your long term disability insurance claim, do not hesitate to contact us for a no-cost consultation.

We understand, and we can help. www.kantorlaw.net (800) 446-7529

May 17, 2013

Our First Guest Blog: Daniel Malito writes about struggles with getting his pain medication paid for

by Kantor & Kantor LLP

Insurance woes. Many of us have heard about a “friend of a friend,” or “some guy” who has been well and truly abused by their health insurance company. We all have the same response -- “that’s horrible,” or something to that effect. Luckily, though, most never get the pleasure of dealing with insurance shenanigans first hand. Well, I’m here to tell you that real people do have to deal with health insurance B.S., for lack of a better word, and it can range from being mildly annoying to thoroughly life-changing.

I was diagnosed with Rheumatoid Arthritis when I was nine. In 1987, before compact discs, the PC, and MTV, I was a mere third-grader who, we thought, had simply caught a bad case of the flu. After several weeks of harboring this “flu” without improvement, the doctors began to look for other causes. To cut a two-year story very short, let’s just say that I was diagnosed with something called Juvenile Rheumatoid Arthritis when I was eleven. My mother diligently spent hours upon hours reading and researching the disease at libraries all over – the “Wikipedia” of the real world at the time. Unfortunately, as is still true today, doctors did not have any idea what caused the illness. So, as one of the first serious cases of the disease in my area, my parents and I went from doctor to doctor, agreeing to test after test, just on the off chance one of the procedures would provide some insight into the ailment that was previously unknown. That never happened, though, and I went from a child with Juvenile Rheumatoid Arthritis to an adult with plain old R.A.

Throughout my childhood and early adulthood, I was lucky enough to be covered by what could be called a “Cadillac” insurance plan. I was able to choose my own doctors, purchase experimental medication, and have any procedure performed without pre-authorization. I cannot imagine what would have happened if we had to fight my health insurance company in those uncertain initial years – I could have ended up in a wheelchair. I tell you this because I want you to understand that I have experienced the good side of health insurance as well as the bad, and the difference is striking.

Eventually the Cadillac plan became too expensive to sustain. Because I was officially disabled, I was also automatically enrolled in Medicare. Because Medicare is always the primary insurance, I was basically paying upwards of $12,000 dollars a year for secondary insurance. So I dropped the Cadillac plan and Medicare became my sole insurance carrier.

Now, I have to take this opportunity to tell you that Medicare is one of the best insurance carriers I have ever dealt with – but that classification comes with two corollaries. First, it must be said that I suffer from a disease that is on the Medicare short list for ailments that are allowed a very large amount of leeway when it comes to insurance claims. Second, I am only talking about hospital stays, doctor’s visits, and medical procedure coverage. Prescription coverage is an absolute and utter nightmare.

For those of you who don’t know how Medicare works here is a brief summary. Part A is the hospital coverage, which covers hospital stays and part B is the actual medical insurance, which covers doctor’s visits and the like. Both of those parts pretty much take care of themselves and are more or less painless in their execution. Part D, though, is the prescription coverage, and even understanding it is a Rubik’s Cube of donut holes, external medical insurance companies, and denial appeals.

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Continue reading "Our First Guest Blog: Daniel Malito writes about struggles with getting his pain medication paid for" »

May 15, 2013

Transparency in Insurer Claim Approval and Denial Rates - Claim Denials Seem to Lead to Greater Profit

by Kantor & Kantor LLP

Like the average consumer, we are always curious about the claim approval and denial rates of health insurance companies. A new law in Vermont satisfies that curiosity by requiring health insurers who do business in Vermont to disclose claim denial rates. Not surprisingly, the insurer with the largest profit also had the highest denial rate. Blue Cross Blue Shield of Vermont denied 7.6% of claims, MVP denied 15.5% of claims, and Cigna denied 21% of claims. Blue Cross and MVP are non-profit companies and Cigna is a for-profit corporation.

The most alarming statistic is that of the 377,352 claims that were denied last year (as reported to Vermont) there were only 456 post-service appeals. That means that 99.8% of all denied claims are never appealed. What this really means is that health insurers are winning the fight unless insureds are willing to step up and hold insurance companies accountable for benefits that are available and payable under the policy. As the Vermont Public Interest Research Group (VPIRG) reported, “These numbers confirm what we already knew, that insurers have little disincentive to deny claims when there is such a miniscule chance that these denials will actually be appealed.”

You can read more about Vermont’s efforts to gain transparency at Vermont Public Interest Research Group’s website: http://www.vpirg.org/news/pulling-back-the-curtain-on-denied-claims/ and a link to the filings of MVP and Blue Cross at http://vtdigger.org/2013/03/20/new-disclosures-show-mvp-denied-15-5-percent-of-patient-claims-in-2012-blue-cross-denied-7-6-percent/
And http://www.huffingtonpost.com/wendell-potter/the-higher-health-insurer_b_3137831.html

May 11, 2013

Congratulations to Kantor & Kantor’s Associate Brent Dorian Brehm for being named 2013 “Lawyers on the Fast Track” by the Recorder

by Kantor & Kantor LLP

Brent Dorian Brehm, a seventh year associate of Kantor & Kantor LLP, was recognized by The Recorder as part of their 2013 Lawyers on the Fast Track list - which recognizes California’s young emerging legal leaders.

Unlike many other honors in the legal field, this list considers both a lawyer’s body of significant legal achievements and their achievements in serving the larger community. As such, this award sets Mr. Brehm apart from his peers, highlighting a body of motion and trial experience few attorneys have compiled to this point in their career while recognizing the work he has performed in the greater Los Angeles community.

Mr. Brehm has spent his entire career advocating for individual’s rights to disability, life, health, and long term care insurance benefits with one of the preeminent firms in the area of ERISA (Employee Retirement Income Security Act) and bad faith insurance litigation, Kantor & Kantor, LLP. While with the firm, Mr. Brehm has resolved well over 150 disputes with insurance companies on behalf of his clients, and has made the transition to lead attorney on many of his cases. At least 13 nationally reported decisions in his client’s favor (including five cases published in the official reporter and five trial judgments in which Mr. Brehm was lead counsel) speak as testament to Mr. Brehm’s advocacy skill and experience gained through practice.

In addition to his many legal accomplishments, Mr. Brehm gives back to his community. When not practicing law, Mr. Brehm enjoys volunteering for Reading to Kids, an organization dedicated to helping inspire a love of reading in children from underserved portions of inner-city Los Angeles. Mr. Brehm was recognized by Reading to Kids when it named him as a recipient of the Distinguished Volunteer award. This effort to better serve the underprivileged members of his community has its roots in Mr. Brehm’s early volunteer activities with the Mexico Orphanage Mission and Food Not Bombs. After law school, his efforts sprouted into working to improve the quality of life for the homeless through work with the East San Gabriel Valley Coalition for the Homeless. On an international level, Mr. Brehm has paired his love of cycling with World Vision’s Bikes for Africa project: helping raise awareness for the project in addition to offering financial support.

After careful review of the professional and civic achievements from nearly 200 California attorneys in their first 10 years of practice, Mr. Brehm was selected as a top contributor to the practice of law and to his community. Mr. Brehm is honored to be recognized by The Recorder. Earlier this year Mr. Brehm was recognized by the Los Angeles and San Francisco Daily Journal, as part of their “Top 20 Under 40” list as a rising star in the California legal industry. Mr. Brehm is proud that these publications, through such awards, recognize the importance, skill, and dedication of all ERISA attorneys in protecting the rights of claimants.

See an online version of the Recorder’s announcement here: http://www.law.com/jsp/ca/PubArticleCA.jsp?id=1202596780843&Introducing_50_California_Lawyers_on_the_Fast_Track&slreturn=20130319154839. Be sure to check a special edition of The Recorder on June 24th for the full profile.

To learn more about Mr. Brehm and the firm of Kantor & Kantor see www.kantorlaw.net or call (800) 446-7529.

May 10, 2013

Your Insurance Company Pays Less Than You Think

by Kantor & Kantor LLP

If you have long term disability insurance through your employer, you probably know that you are entitled to a benefit if you ever become unable to work because of injury or sickness. The amount of the benefit varies, but it is typically 50-60% of your salary.

However, what you may not know is that most long term disability benefit plans usually don’t even pay that much. Why? Because most plans contain “offset” provisions.

What are offset provisions? Offset provisions state that if you are receiving money for your disability from other sources, the plan can reduce your benefit by that amount. Typically, benefit plans contain offsets for such things as state disability benefits, Social Security disability benefits (both SDI and SSI), and worker’s compensation benefits, among other things. Plans can even offset for income that isn’t related to your disability, like pension benefits.

If this is all new to you, you might want to get an idea of how this offset could work for Social Security Disability Benefits. You can go to the SSA website to calculate an estimated benefit, which you can then use to estimate how the offset would reduce your long term disability benefit. Visit the SSA site here: http://www.ssa.gov/OACT/quickcalc/index.html

Because most people are entitled to at least one other form of disability benefit, this means that your employee benefit is usually not even the 50-60% amount stated in the benefit plan – it’s actually less. In fact, in some cases, your benefits from other sources can be large enough that your employee benefit is reduced to zero. Some plans will still pay a nominal minimum benefit in such cases, but some do not. In other words, even though you are disabled and eligible for an employee disability benefit, your benefit amount could be nothing at all.

Because the amount of your employee benefit is dependent on your receipt of other benefits, you must be very careful in deciding whether to apply for other benefits, and if so, how to do it. Realize however, that sometimes, you may not even have a choice as your disability plan may require you to apply for these other benefits. As employee benefit specialists, we can help if you have questions. If an insurance company is reducing your benefit because of offsets, and you think they have made a mistake, please contact us.

May 8, 2013

Kantor & Kantor proves that Unum unlawfully denied long term disability benefits to policyholder suffering from fibromyalgia

by Kantor & Kantor LLP

In January of this year, Kantor & Kantor secured a judgment against Unum Life Insurance Co. http://www.unum.com/, a Fortune 500 company and the largest group and individual disability carrier in the United States. (click here for a copy of the ruling Mondolo v. Unum Life Ins. Co. of Amer., C-11-07435 CAS (MRWx) (C.D. Cal., order filed January 16, 2013). http://www.kantorlaw.net/documents/59-Mondolo-13-01-17-Findings-of-Fact-Order.pdf

Our client, a resident of Los Angeles County, was suffering from fibromyalgia and avascular necrosis (aka bone death, believed to be a result of leukemia treatment). She had been treating for these conditions at U.S.C.’s Keck School of Medicine and had been on disability since July 2009. After paying long term disability benefits for over a year, Unum terminated our client’s disability benefits. Unum’s Gilberto Del Real determined that our client was not disabled because she was capable of working in a sedentary occupation. After our client appealed, Unum’s Stephanie LeSieur also erroneously concluded that our client was capable of sedentary work.

“Like so many group disability insurers, Unum labored under a structural conflict of interest because Unum has both the duty to determine whether claimants qualified for benefits and the responsibility for paying those benefits,” said Kantor & Kantor partner Alan E. Kassan
, who assisted associate Brent Dorian Brehm on the case. “Unum’s bias led the court to review Unum’s decision regarding our client’s benefits with enhanced skepticism and the denial could not withstand scrutiny.”

Kantor & Kantor was able to prove that Unum’s structural conflict of interest had contributed to its decision to terminate his client’s disability insurance benefits. In reaching its decision, the court noted Unum’s history of biased claims administration and case specific facts that the Kantor lawyers argued aggravated Unum’s conflict of interest. The court found the following:

•Unum failed to properly investigate the client’s claim, neglecting to determine how much sitting she could tolerate without significant pain.
•Unum did not investigate whether the alternative jobs it claimed our client could perform were appropriate for her limited ability.
•Unum and its reviewing physicians failed to consider psychological evidence, even though the policy expressly stated that such evidence must be considered.

In addition, attorneys Kassan and Brehm argued that Unum’s conclusions were unreasonable. For example, Unum insisted our client could sit between one-third and two-thirds of a work day. The Kantor attorneys proved even if Unum’s supposition was accurate, our client was still not able to meet the requirements of, or perform the sedentary work for which Unum argued she was capable.

Click here http://www.kantorlaw.net/Cases_Resources/Document_Library.aspx to learn more about this case.

At Kantor & Kantor, we spend every working day doing one thing: helping people resolve disputes with their insurance companies. Life is difficult enough for people living with chronic illness, and we understand that being denied disability coverage by your insurance company or employer only exacerbates the situation. If you are in need of the services we provide, please call us at (800) 446-7529 for a no-cost consultation or go to www.kantorlaw.net for more information.

May 8, 2013

Obtaining insurance coverage for human growth hormone treatment for Idiopathic Short Stature (ISS)

by Kantor & Kantor LLP

In 2003, the Food and Drug Administration approved the use of growth hormone (GH) for the long-term treatment of idiopathic short stature (ISS), which refers to extreme short stature that does not have a diagnostic explanation, such as GH deficiency. Unfortunately, GH treatment is expensive and, as a result, insurance companies often resist paying for it.

Follow this link to an article we have prepared which discusses how ISS is defined, how it is diagnosed, how insurance companies try to avoid payment for it and how we respond to the insurance companies’ arguments: http://www.kantorlaw.net/documents/Article-on-HGH-treatment-DJO-4-5-13-pdf.pdf

April 22, 2013

Disability is Real: Correcting distorted perceptions around diagnosis, symptoms, and life with a disability

by Kantor & Kantor LLP

In August 2012, Kantor & Kantor posted this blog on the unfounded assertion that receiving disability insurance is a positive substitute for gainful employment: http://www.californiainsurancelawyerblog.com/2012/08/ridiculous_to_claim_disability.html

More recently, we encountered NPR’s week long series titled, “Unfit for Work: The Startling Rise of Disability in America." This series advanced a number of misleading thoughts about living and working with a disability. These include:

1. The implication that people with disabilities are either taking advantage of government assistance or being victimized by it.
2. The failure to explain why people might have the same diagnosis, yet experience symptoms that differ in severity and impact on daily living.
3. A false impression expressed about how disability is actually determined, suggesting that one’s personal physician can make this claim without the involvement of insurance investigations, background checks, medical examinations, medical/employment/financial records, interviews by insurance companies, etc.

As attorneys who represent clients with various types of chronic illnesses, we have come to appreciate the devastating and painful effects of life with a disability. Those who disparage the necessity of Social Security Disability Insurance (SSDI) and disability insurance, which our clients depend on, have probably never suffered from a chronic disabling condition nor had a loved one disabled by disease. Beyond the physical impact, our society has a long history in which many people acquire a sense of identity and purpose from their occupation. This is lost when they become disabled. Additionally, this is a space where many social relationships are formed as a result of job-related interactions. When illness forces you to prematurely leave your occupation, this experience can be just as painful and isolating as being diagnosed with a debilitating illness.

Before assuming that disability has become “a de facto welfare program for people without a lot of education or job skills,” it is important to consider the reasons for the rise in disability claims. Firstly, baby-boomers are aging, and with age comes a host of disabling conditions. Also, during the past 40 years, more and more women have entered the workforce. Although medicine can’t explain why, women tend to be impacted more than men by some severely disabling conditions. Both of these factors will drive up the number of disability claims.

Charles Martin and Debra Shifrin from the National Organization of Social Security Claimants' Representatives (NOSSCR) have said that “Disability benefits protect the most vulnerable members of our society, who have no other options.” We couldn’t agree more.

If your long term disability claim has been denied, contact Kantor & Kantor for a no-cost consultation at (800) 446-7529. We understand, and we can help.

April 19, 2013

Information Processing Impairments in Chronic Fatigue Syndrome

by Kantor & Kantor LLP

Chronic fatigue syndrome (CFS) is a long-term and debilitating condition that affects at least one million Americans. The symptoms are complex, often including intense physical and mental fatigue (usually made worse by exertion), muscle and joint pain, disturbed sleep, and both concentration and memory problems.

Chronic fatigue syndrome derives its name from its dominant symptom – fatigue. However, CFS has eight other official symptoms:
• Loss of memory or concentration
• Sore throat
• Enlarged lymph nodes in your neck or armpits
• Unexplained muscle pain
• Pain that moves from one joint to another without swelling or redness
• Headache of a new type, pattern or severity
• Unrefreshing sleep
• Extreme exhaustion lasting more than 24 hours after physical or mental exercise

Those who suffer from CFS can experience debilitating cognitive dysfunction and mental fatigue. This is commonly referred to as “brain fog.” A recent research study found that the main cognitive disruption in those living with CFS was attributed to slow information processing. After comparing several types of cognitive dysfunction between control subjects and those with CFS, they found information processing speed and reaction time to be impaired in those with CFS.
Interesting to note, researchers discovered that information processing problems did not seem to be a consequence of psychiatric status, depression, anxiety, the number or severity of CFS symptoms, fatigue, sleep quality, or everyday functioning. While the CFS group showed impaired reaction time, they displayed comparable performance on attention, memory, motor function, verbal ability, and spatial ability (even though these remain commonly reported problems in CFS) to the control subjects. The significance of these findings is unclear, but prompts us to consider the relationship between the cognitive symptoms of CFS and information processing difficulties.

While parts of CFS and its relationship with its symptoms are not yet fully understood by the scientific community, studies continue to show that the symptoms and life altering effects are real. Many of our clients have been deeply impacted and disabled by the cognitive and physical symptoms of CFS. Their complaints of extreme fatigue, pain, and cognitive impairment are often dismissed by insurance companies in deciding claims. Often this is because there is no single diagnostic test to confirm the illness.

If your CFS has adversely affected your ability to work, contact Kantor & Kantor for a no-cost consultation. We can help. Find us at www.kantorlaw.net or call (800) 446-7529.

April 18, 2013

Kantor & Kantor Supports Parkinson’s Disease Awareness Month

by Kantor & Kantor LLP

On March 29, 2012, the United States Senate officially declared April as Parkinson's Disease (PD) Awareness Month. With many clients who suffer from Parkinson’s Disease, Kantor & Kantor recognizes the magnitude of this illness and the importance of dedicating this month to research, promoting awareness, and spreading information about the disease.

The Parkinson’s Disease Foundation (PDF) is an organization with the mission to find a cure, to advance research, to increase knowledge, to empower the community and to ensure that those living with the disease enjoy the best quality of life possible. See http://www.pdf.org/en/mission

This organization offers valuable information for our clients and their families on topics that include: understanding the illness, coping with a recent diagnosis, managing PD and support for care partners and family. These are just a few examples of the many resources available on the PDF’s website. See http://www.pdf.org/.

In addition to providing assistance with coping with PD, the website can also serve as a valuable resource for those who choose to make a disability claim. If you have been diagnosed with PD, and the symptoms of the disease and side effects of treating medications becomes disabling, you might want to consider submitting a claim for disability benefits through your private or employer-provided disability plan.

Unfortunately, insurance companies don’t always understand how devastating and life changing this illness can be. If your Long Term Disability claim is denied, The Parkinson’s Disease Foundation can be used as a valuable resource when researching how to prove to your insurance company that your condition and its symptoms are disabling. One requirement of most disability policies is that the claimant be undergoing ongoing treatment for the disabling condition. This website provides information that helps you to understand exactly what type of care that is.

If you get your insurance coverage through your employer, as most people do, you fall under the umbrella of ERISA (Employee Retirement Income Security Act). Under the Employee Retirement Income Security Act, you have a legal right to appeal the denial of disability benefits. The burden and responsibility of proving your claim becomes yours. It is crucial for you to create a record of documented evidence during the appeal in case litigation becomes necessary in the future. Do NOT rely on your insurance company to help you.

Managing an appeal on your own can be risky if you are not physically or mentally capable. If the case becomes too complicated to handle on your own, you may want to seek out advice from a professional. Kantor & Kantor has a team of experts that work on a on a contingency fee basis, which means you only pay if we obtain a benefit for you. We understand the struggle of living with a chronic disease, and we are here to help. For questions about your long term disability claim, call (800) 446-7529.

March 14, 2013

Kantor & Kantor Associate Named one of “Five Associates to Watch” by the Daily Journal

by Kantor & Kantor LLP

Brent Dorian Brehm, a seventh year associate of Kantor & Kantor LLP, was recognized by the Los Angeles and San Francisco Daily Journal, as part of their “Top 20 Under 40” list of California’s emerging legal leaders, as a rising star in the California legal industry. Mr. Brehm has spent his entire career advocating for individual’s rights to disability, life, health, and long term care insurance benefits.

Mr. Brehm has spent his career with one of the preeminent firms in the area of ERISA (Employee Retirement Income Security Act) and bad faith insurance litigation, Kantor & Kantor, LLP. While with the firm, Mr. Brehm has resolved well over 150 disputes with insurance companies on behalf of his clients. As a litigation associate, Mr. Brehm has developed a body of motion and trial experience few attorneys have compiled to this point in their career.
At least 13 nationally reported decisions in his client’s favor (including five cases published in the official reporter and five trial judgments in which Mr. Brehm was lead counsel) speak as testament to Mr. Brehm’s advocacy skill and experience gained through practice.

Having established a track record of success early in his career, Mr. Brehm has made the transition to lead attorney on most of his cases. In one such case litigated in San Francisco, Mr. Brehm secured the first trial judgment in the nation on behalf of a plan participant against AT&T’s long term disability plan in the hotly contested case of Peterson v. AT&T Umbrella Ben. Plan No. 1, 2011 WL 5882877 (N.D. Cal. 2011). Last month, in a case tried in Los Angeles, Mr. Brehm received another favorable trial judgment, this time against Unum Life Insurance Company – the largest group disability insurer in the United States. (Mondolo v. Unum, 2013 WL 179711 (C.D. Cal. 2013)).

To learn more about Mr. Brehm and the firm of Kantor & Kantor see www.kantorlaw.net or call (800) 446-7529.

March 12, 2013

Kantor & Kantor Recognizes the Challenges of Multiple Sclerosis: MS Awareness Month 2013

by Kantor & Kantor LLP

In 2006, March was designated MS (Multiple Sclerosis) Awareness Month. This year, the National Multiple Sclerosis Society spreads awareness by emphasizing the impact of connection. While MS destroys the connection between the body and mind, and between people, advocates can strengthen and encourage connections through sharing knowledge and information.

According to the National MS Society:
• There are currently 2.1 million people living with MS.
• Every hour of every day someone in the U.S. is diagnosed with MS.
• Most people are diagnosed in their 20’s or 30’s…but it lasts a lifetime.
• There is no cure.

What is MS?

MS is a chronic disease that strikes the central nervous system (CNS). The immune system attacks the CNS leading to damaged nerve fibers. This damage creates scar tissue (sclerosis), and distorts the nerve impulses traveling to and from the brain and spinal cord. The flow of information between the brain and body is interrupted. The symptoms can be disabling- affecting the brain, spinal cord, and optic nerves. MS presents itself differently for each individual, and its severity and symptoms are difficult to predict.

Each year at this time, advocates come together to spread awareness, raise funds for research, and offer support and connections within the MS community. At Kantor & Kantor, many of our clients suffer from MS, and seek our assistance when their disability benefits have been unfairly denied. We understand that living with MS can be painful, difficult, and challenging. Being denied benefits by your insurance company only aggravates an already complicated condition. Contact our office at (800) 446-7529 or on www.kantorlaw.net if your claim has been denied. We can help.


March 12, 2013

Kantor & Kantor Recognizes the Challenges of Multiple Sclerosis: MS Awareness Month 2013

by Kantor & Kantor LLP

In 2006, March was designated MS (Multiple Sclerosis) Awareness Month. This year, the National Multiple Sclerosis Society spreads awareness by emphasizing the impact of connection. While MS destroys the connection between the body and mind, and between people, advocates can strengthen and encourage connections through sharing knowledge and information.

According to the National MS Society:
• There are currently 2.1 million people living with MS.
• Every hour of every day someone in the U.S. is diagnosed with MS.
• Most people are diagnosed in their 20’s or 30’s…but it lasts a lifetime.
• There is no cure.

What is MS?

MS is a chronic disease that strikes the central nervous system (CNS). The immune system attacks the CNS leading to damaged nerve fibers. This damage creates scar tissue (sclerosis), and distorts the nerve impulses traveling to and from the brain and spinal cord. The flow of information between the brain and body is interrupted. The symptoms can be disabling- affecting the brain, spinal cord, and optic nerves. MS presents itself differently for each individual, and its severity and symptoms are difficult to predict.

Each year at this time, advocates come together to spread awareness, raise funds for research, and offer support and connections within the MS community. At Kantor & Kantor, many of our clients suffer from MS, and seek our assistance when their disability benefits have been unfairly denied. We understand that living with MS can be painful, difficult, and challenging. Being denied benefits by your insurance company only aggravates an already complicated condition. Contact our office at (800) 446-7529 or on www.kantorlaw.net if your claim has been denied. We can help.