Monday, October 1, 2018

The Guardian Insurance Ordered to Pay RamosLaw 47K in Attorney's Fees

On September 26, 2018, United States District Court Judge Michael P. Shea ordered the The Guardian Life Insurance Company of America ("The Guardian") to pay RamosLaw, LLC a total of $47,416.35 for the attorney's fees and costs in the case of Kimberly Johnson v. The Guardian,  2018 U.S. Dist. LEXIS 165113. This order granting attorney's fees and costs comes after RamosLaw successfully challenged The Guardian's May 7, 2015 decision to terminate Ms. Johnson's long term disability benefits.

Ms. Johnson's LTD benefits were eventually re-instated as result of a Court order mandating a new evaluation of her claim.  RamosLaw waged a long battle on Ms. Johnson's behalf and was eventually able to persuade the Court that The Guardian's decision to terminate benefits "was arbitrary and capricious because Guardian had not conducted a full and fair review of Johnson's claim, and (2) procedural irregularities in the administrative process suggested that Guardian's decision was influenced by its conflict of interest as the entity that would both determine Johnson's disability status and pay disability benefits".  

The Guardian's conduct in this case was particularly reprehensible because, after paying Ms. Johnson's LTD benefits for approximately five years, it decided to stop the payments shortly before she was about to undergo a very complicated thoracic spine surgery.  Throughout the administrative process, The Guardian failed to give Ms. Johnson a fair and open minded consideration of her appeal.  The Guardian relied on the opinion of two doctors who submitted reports that contained very little or no basis to support their conclusions.   

There used to be a time when The Guardian was considered to be one of he most fair and reliable long term disability insurance companies in the Nation.  In fact, The Guardian was one of the insurance companies that professionals such as lawyers and doctors would rely on the most when looking for LTD coverage.  This is no longer true.  The actions by The Guardian in this case were just as unscrupulous as the practices of other insurers such as Cigna or Unum who have received substantial fines from insurance regulators as a result of their questionable practices.       

Individuals who have been denied LTD benefits often ask their disability lawyer whether they can obtain any punitive damages or penalties against the plan or insurance company for failing to follow the law. Unfortunately, under the law that covers most of these plans (the Employee Retirement Income Security Act of 1974 “ERISA”), these damages are not available.  Given the state of the law, there are very little consequences when a disability plan acts illegally.  The payment of the benefits owed is practically the only remedy available to plaintiffs.  However, even though there are no punitive damages, the Court may force the insurance company and/or LTD plan to pay the plaintiff’s attorney’s fees. In these instances, the imposition of attorney’s fees acts as the only penalty or punitive action that can work to deter LTD plans from violating the law.  



Monday, August 13, 2018

RamosLaw Wins at the 1st Circuit Court of Appeals!

RamosLaw just won a great victory in the First Circuit Court of Appeals against Acting Social Security Commissioner Nancy Berryhill.  On August 10, 2018, the First Circuit vacated the judgment of the Massachusetts District Court and determined that our client was "prejudiced by having his psychiatric treatment ignored by the ALJ."  Torres-Pagan v. Berryhill, 2018 U.S. App. LEXIS 22271.  

This decision shows RamosLaw's commitment to fighting and winning tough battles on behalf of persons with disabilities.  Obviously, this victory required a lot of hard work and perseverance. (The First Circuit Court of Appeals is the federal court one step removed from the United States Supreme Court.)  Very few denied disability cases ever go this far.  However, in this case, such an extraordinary amount of work was necessary in order to protect the rights of our client and create legal precedent that will also protect the rights of other disabled claimants.

In Torres-Pagan we argued that the Administrative Law Judge (ALJ) erred, --when he determined that Mr. Torres-Pagan was no longer disabled--, because the Social Security Administration (SSA) failed to obtain and consider his psychiatric records.  The First Circuit agreed with us and determined that the SSA had a heightened duty to develop the record in this case due to Mr. Torres-Pagan's mental disability.  The decision contains some very eloquent statements supporting the rights of individuals who suffer from mental illness:
[I]ndividuals with psychiatric disorders are often some of the most vulnerable in society and unlike the standard pro se claimant at an SSA hearing, those with alleged disabilities sounding in mental health may be particularly vulnerable when unrepresented by counsel. We are thus satisfied that Torres-Pagan was prejudiced by having his psychiatric treatment ignored by the ALJ.  
Torres-Pagan presented important legal and public policy issues regarding the manner in which the SSA conducts re-determination of benefits evaluations of individuals, who have previously been found to suffer from an intellectual disability, who have difficulty advocating on their own behalf and, very often are unable to obtain legal representation.  We trust that Commissioner Berryhilll will take appropriate measures within her agency to ensure that her staff and the adjudicators that she appoints comply with this decision.    



Wednesday, April 4, 2018

Washington Post Features RamosLaw in Article About Disability Hearing Backlog

Today, the Washington Post published an article that discusses the enormous backlog in the Social Security Disability hearing process. Attorney Ivan Ramos was interviewed for the article.  Here is the Washington Post piece with the comments from attorney Ramos:


Short Staffing Leads to Long Waits for Social Security Disability Hearing Decisions

By Joe Davidson

Robert Steers of Southington, Conn., was an Army captain who served in Afghanistan. He also served his country looking for contraband with the Transportation Security Administration.
Now, he’d like to get decent service from the Social Security Administration.
But, as many Americans know, this can be an exasperating experience, filled with endless waits and growing frustration. ...
Steers applied in April 2012 and was denied. To appeal, he requested a hearing with an administrative law judge (ALJ) in May 2013. It took almost two years to be denied again in March 2015. After appealing to federal court, his case was sent back to the administrative law judge in December 2016.
It is now April 2018 — six years after his initial application — and Steers is still waiting to find out if he’ll get the insurance. ...
“I think SSA does not have the staff it needs,” said Iv├ín A. Ramos, Steers’s lawyer in Hartford, Conn. “When you call a hearing office, nobody answers the phone, and when you go to the office you just stand in front of an empty window until someone finally shows up to help you. Many of my clients have trouble paying for food and shelter while they wait for their disability claims to be processed. Seeing what many of my clients and their families have to go through, just to get a hearing, has become the hardest part of my job.” ...

Staffing and service issues have plagued Social Security for years, and President Trump’s proposed budget for fiscal 2019 would make things worse. The disability hearing process can be particularly vexing because there are too few administrative law judges, who hear appeals, and they have too few support staff members. ...

For the full article visit:

https://www.washingtonpost.com/news/powerpost/wp/2018/04/03/short-staffing-leads-to-long-waits-for-social-security-disability-hearing-decisions/?utm_term=.797c84efb2dc
https://www.washingtonpost.com/news/powerpost/wp/2018/04/03/short-staffing-leads-to-long-waits-for-social-security-disability-hearing-decisions/?utm_term=.797c84efb2dc