Peter Casciano recently settled a Long-Term Disability client’s claim as a result of successful mediation with a major insurance carrier. Although the client had been restricted from working his physically demanding job by his medical providers, the insurance carrier denied his initial application for LTD benefits. This case involved a complicated back-and-forth with the insurance carrier during the administrative appeal stage. Andalman & Flynn built the record by providing carrier with objective medical evidence and supportive documentation from the client’s treatment providers. After filing an appeal in Federal Court, at mediation the carrier agreed to a substantial lump sum payment so. The client agreed and can now focus on his health and wellbeing without the pressure of future interactions with the insurance carrier.
Successful Long Term Disability Claim for Client with Mental Impairment
Like most LTD policies, our client’s policy had a two year limit on benefits paid for disabilities caused or contributed to by a mental impairment. This client came to us after their benefits were terminated based on the mental impairment limitation. However, this client had severe pain as a result of a back injury as well as a mental impairment. We appealed the termination and collected documentation to establish that the physical disability was disabling regardless of the client’s mental impairments. Our appeal was successful and our client remains in pay status to date.
A 55-year-old woman retained our services to prosecute an application for Long Term Disability (LTD) benefits. The client was presenting symptoms of severe arthritis in both knees causing her to limp significantly, along with major back problems including degenerative disc disease with disc bulges. Complicating matters for our client was her inability to tolerate major pain medicines such as oxycodone and tramadol. Our client held a physically taxing job at a local airport where she was charged with lifting, pushing, and carrying heavy items. Attorney Peter Casciano was able to secure the full payment of Short Term Disability (STD) benefits for the client and then was able to ensure her successful transition to pay status for LTD benefits.
Attorney Peter Casciano successfully appealed CIGNA’s 2018 decision to terminate his client’s long-term disability benefits, which she received due to post-fusion surgeries, migraines, and fibromyalgia. After unfairly receiving a denial on the initial administrative appeal, we did not give up and crafted a compelling second-level appeal, which resulted in CIGNA’s reversal of their denial and reinstatement of his client’s benefits retroactive to July 2018. Also, the claimant was awarded ongoing disability benefits so long as she remains disabled in accordance with the LTD policy’s definition of disability.
This client retained our services to appeal a denial of insurance coverage for a psychiatric hospitalization. Blue Cross Blue Shield (BCBS) claimed that the hospitalization, which was for over two months, was not considered medically necessary. We obtained the entire medical record from the hospitalization, which included extensive documentation that the hospitalization was indeed medically necessary, and convinced BCBS in an ERISA administrative appeal to pay the claim. We also helped the client work out a settlement payment plan on the remaining balance owed. Additionally, we successfully had removed from client’s credit report an additional disputed hospital bill.
Peter Casciano had just settled a Long Term Disability (LTD) client’s claim in full for total settlement of over $800,000.00! This was a significant win for the client for several reasons. First, the client’s claim was denied on initial application. Mr. Casciano was able to successfully appeal this denial and produced medical and vocational evidence that convinced the insurance company to place the client back in pay status. Then after less than two years in pay status, client’s the carrier terminated client’s benefits after surveillance was conducted on the claimant and the Carrier found out that the claimant had traveled out of the country. Again, Mr. Casciano appealed that decision, submitted updated medical and vocational evidence, and the client was placed back into pay status. Shortly after that, the insurance company offered our client a lump sum settlement amount in lieu of any future LTD payments. The client was open to settling the claim in order to avoid future reviews and surveillance and to have control of this substantial resource. After significant negotiations, the parties reached agreement on a lump sum settlement.
Client retained our services for claim for Long Term Disability (LTD) and Social Security Disability (SSD) benefits. Claimant has had both hips replaced and has low back pain, and osteoarthritis. The claim for LTD benefits was awarded on initial application, but with initially three month reviews. Subsequently we have also won three reviews of the client’s LTD claim, and the client remains in pay status. The client also won SSD benefits on initial application.
This client retained our services to appeal a denial of Long Term Disability (LTD) benefits. Basis of disability is profound fatigue. The carrier claimed that records did not include specific restrictions and limitations on why the client could not work nor were diagnostic tests provided. Benefits were awarded after additional medical records and reports were obtained that rebutted the denial decision. Diagnostic test results were provided as well as clear delineation of restrictions and limitations on activities.
A client retained our services to appeal termination from Long Term Disability (LTD) benefits. Basis of disability is lupus. Benefits were terminated because the client’s treating doctor reported that her condition had stabilized and also based on the client’s ability to travel to visit her sick parent and to move out of the country because of her husband’s employment. The client had not gotten well enough to resume working. Benefits were reinstated after supporting statements and medical records were submitted by the current treating physician out of the country as well as additional information from her prior treating physician in the U.S.
The client retained our services to appeal a denial of Long Term Disability (LTD) benefits. Basis of disability is osteoarthritis of the right knee for which client underwent a total knee arthroplasty. A significant hurdle in this claim was that the benefits manager at the client’s company never properly filed the initial application with the carrier and the client was no longer eligible to apply for benefits. We were able to prove that the client had filed the application timely, and provided sufficient evidence to have the claim awarded.
Casciano Law Group | All Rights Reserved | © 2025 | Design & Marketing by Blittzed!
