accessibility-1538227-1-1024x768Navigating an ERISA disability insurance claim through the courts can be a difficult task. The best ERISA disability isurance claim lawyers can help be your guide to ensure your rights are protected. The following case that arises out of the Federal Court system in New Orleans demonstrates the issues that can arise when you fail to timely provide the required documents to prove your case and your insurer denies your disability claim.

The case began when Angel Dix a two-year employee of Blue Cross Blue Shield Louisiana began experiencing back pain. Her doctors deemed her disabled for insurance purposes and she began receiving disability benefits under the company’s long-term disability program. Less than a month later, Dix was notified that she would no longer receive disability payments by her insurance company. The letter stated that the administrator found that the medical evidence “no longer supported a finding of disability.” The administrator considered medical opinions from treating and reviewing physicians, findings of an independent medical evaluation, and a vocational expert’s report. Dix appealed the decision.

During the initial review process, the administrator asked Dix whether she would like to submit additional documentation, and even gave Dix an extension on the deadline for submitting documentation. Dix failed to submit any additional information. The record was reviewed and the decision of the administrator was upheld. Then, approximately one year and three months after the administrator issued its final decision in her appeal, Dix submitted medical records, X-rays, MRIs, affidavits, and a favorable Social Security Administration decision. The affidavits were from two of her doctors stating that they do not recall speaking with the reviewing physician. The administrator declined to add the documents to the administrative record because Dix has exhausted her administrative remedies.

spinal-tap-1197804-1-768x1024Justice is often not a sprint through the courts, but a long carefully navigated journey. This is because the law is not always black and white and standards of proof may make it difficult for a Plaintiff to prove his or her case. In a lawsuit arising out of Parish of Rapides, for example, Cecilia Rachal had to navigate four separate issues through the courts to find compensation for a simple fall at work.

Alexandria’s Sam’s Club was undergoing renovations when one of its employees, Ms. Rachal, fell between a filing cabinet and a co-worker while on the job. After the accident, Ms. Rachal experienced pain in her head, neck, back, right hand and ankles. After seeing various doctors and filing a claim for workers compensation benefits, Ms. Rachal was successful in obtaining temporary disability benefits.

Under the advisement of her attorney, Ms. Rachal visited another doctor, Dr. Clark, almost a month after her accident due to the possibility of symptoms arising after the initial trauma of her injury. Ms. Rachal received a lumbar MRI scan, which helped Dr. Clark diagnose Ms. Rachal’s spinal stenosis. At the recommendation of Dr. Clark, she received injections in her lumbar and physical therapy. Ms. Rachal additionally had lumbar laminectomy surgery a few years later after the lumbar issues continued, despite conservative treatment.

law-series-3-1467437-1-1024x769When representing a client, an attorney and law firm must do their due diligence and advocate for their client in the best way possible. An excellent attorney will put in countless hours for their client and will not stop working until the job is completed. Not all attorneys do this however, and when an attorney underperforms, the client has every right to seek a different lawyer for their services.

In April 1996, Stephen Phares (“Mr. Phares”) went to the emergency room of Christus Schumpert Medical Center in Shreveport, Louisiana. Mr. Phares complained that he had back pain, and the next day had back surgery. Shortly thereafter, Mr. Phares consulted with Carl Reynolds (“Mr. Reynolds”) of the Reynolds law firm in Georgia, because he believed he had a medical malpractice claim. Seven months later on November 14, 1996, Mr. Phares and his wife signed a medical negligence employment contract and hired the Reynolds firm to represent them in their case. Because the Reynolds firm was based in Georgia, the firm needed to bring on a second firm that practiced in Louisiana. In January 1997, the Reynolds firm hired the McKeithen law firm to act as local counsel on the malpractice claim. The two firms had an oral agreement that ultimately led to a fifty-fifty arrangement regarding attorney fees.

The Phareses filed a lawsuit and a jury trial was scheduled for September 18, 2006. Before the trial, the two firms agreed to submit the malpractice claim to mediation, and as a result, a settlement was entered in which one health care provider would pay $100,000 to the Phareses and a second provider would pay $60,000. The attorney fee ended up being $72,000, however, the Reynolds firm received 60 percent and the McKeithen firm received 40 percent. Shortly after the mediation, the Phareses filed a claim against the Louisiana Patient’s Compensation Fund (PCF). The Phareses then terminated the Reynolds firm from the case and hired Martin Bohman of the McKeithen firm. A contingency fee contract between the Phareses and Mr. Bohman established that the attorney fee would be 40 percent. In August 2006, the Phareses settled their claim against the PCF for $600,000 and the McKeithen firm received $240,000 as a contingency fee.

beauty-salon-4-1570299-1024x1015When going to the nail salon, the last thing anyone thinks about is falling and getting seriously injured. Slip and fall accidents happen all the time, and it is important to gather as much evidence as possible and retain a good personal injury attorney in order to build the best possible case for yourself. The courts do not look favorably on those who make a claim and have very little evidence to back it up, as Pamela Burnett (“Ms. Burnett”) discovered when trying to win damages from the Lucky Nails salon.

On August 20, 2012, Ms. Burnett went to the Lucky Nails salon in Baton Rouge, Louisiana to get a standard nail polish change. All was going well at the salon, but as she was walking toward the pedicure chairs after choosing a polish color, she slipped and hit her head on the foot rest of one of the chairs. Ms. Burnett filed a lawsuit against the nail salon and its insurer, State Farm Insurance Company. Ms. Burnett alleged that the nail salon was negligent in maintaining the property and the floor of the salon. The defendants filed a motion for summary judgment because Ms. Burnett could not prove that there was a foreign substance or hazardous condition on the floor, that the nail salon created or had actual or constructive notice of the hazard, and that the salon failed to exercise reasonable care. The Trial Court found the evidence did not demonstrate that there was anything obvious on the floor. Ms. Burnett testified that the floor felt slippery, but was unable to identify what kind of substance was on the floor. The Trial Court granted the defendants’ motion for summary judgment on September 9, 2014, and dismissed the suit with prejudice. Ms. Burnett appealed this decision to the Louisiana First Circuit Court of Appeal.

On appeal, the First Circuit addressed Ms. Burnett’s argument that the Trial Court failed to look at the most critical evidence of the case. This evidence was a video recording of Ms. Burnett’s fall at the nail salon. The Trial Court stated that they were unable to see the video, however, they had plenty of still photographs taken directly from the video recording. The photographs clearly depicted the floor of the salon and they showed no substance or liquid on the floor. The First Circuit was able to view the video but found that it did not matter that the Trial Court was unable to view it because it did not present any new conclusions to reverse the summary judgment decision.

hotel-hilton-santo-domingo-1222125-1024x768Securing a loan with collateral might seem like a simple and everyday task, but even the smallest of mistakes in the process can carry severe consequences. Brent Kovach (Mr. Kovach), a shareholder in a few New Orleans French Quarter hotels, experienced the repercussions of a simple oversight when one paragraph in his collateral assignment nearly offset his entire life insurance policy. The following case delves into just how critical hiring an excellent attorney might be when interpreting seemingly straightforward contracts and when those contract disputes turn to a lawsuit.

Mr. Kovach was a shareholder of St. Peter Inc.’s Hotel and a member of A Creole House, LLC, which managed a French Quarter hotel. In the wake of Hurricane Katrina, these hotels required refinancing and in order to secure the necessary loans, Mr. Kovach personally guaranteed them with his life insurance policy as collateral. Mr. Kovach and his wife, Ellen Kovach (Mrs. Kovach), acquired the one million dollar life insurance policy on Mr. Kovach in 1995 from New England Mutual Life Insurance Company.

After receiving the refinancing, the hotels failed to make loan payments and in May 2010 the bank requested a cash surrender of the value of the policy from New England Mutual Life Insurance Company. The life insurance company paid the value of the policy, $52,316.33, to the bank based upon the terms of the assignment and canceled Mr. Kovach’s life insurance plan without any notification to him.

tax-1501475-1024x768In Louisiana, a failure to pay your property taxes can result in your property being subject to a tax sale. This can cause a tremendous headache. Though the Louisiana Constitution and Revised Statutes provide that the government’s right to proceed to a tax sale expires three years after the last day of the year in which the taxes were due, one New Orleans property owner was sent a tax bill including unpaid taxes which seemingly should have been expired.

In 2006, Kathleen Bilbe purchased a piece of real estate located at 1722 Lark Street in New Orleans. The property was subject to ad velorem taxes. Ms. Bilbe failed to pay her property taxes in 2007, which accumulated interest, penalties, and costs. The New Orleans Department of Finance sent Ms. Bilbe a tax bill for 2007 reflecting the real estate taxes she owed for 2010, neighborhood fees for 2010, and the unpaid taxes from 2007. Ms. Bilbe made a partial payment towards the unpaid 2007 taxes in February 2010 but the entire balance of the 2010 bill remained.

The Department of Finance sent a notice to Ms. Bilbe that her property could be subject to a tax sale due to her unpaid taxes in July of 2011. That same month she paid the entire balance and her property was spared from the tax sale. Though the Louisiana Revised Statutes allow an opportunity to dispute the amount assessed by the tax collector, Ms. Bilbe did not indicate that she was making the payment in protest. La. R.S. 47:2314.

trailerpark-1-1559039-1024x820In any personal injury lawsuit, it is absolutely critical that the plaintiff documents his or her injuries and gather evidence in support of legal claims. In addition to establishing that the defendant breached a duty of care, personal injury plaintiffs must also prove – through medical testimony and documentation – that it was more probable than not that the accident at issue caused their injuries. See Maranto v. Goodyear Tire & Rubber Co., 650 So.2d 757 (La. 1995). This is particularly complicated when the plaintiff is already receiving care for preexisting injuries, as the law holds that defendants are not liable for damages caused by separate, independent, or intervening causes or injury. A recent case of the Louisiana First Circuit Court of Appeal is revealing.  In this case, the Court of Appeal upheld a jury’s finding of no causation despite unconverted testimony by two expert witnesses.

On July 18, 2011, Wendy Richardson was returning to her home in Powers Trailer Park in Ascension Parish, Louisiana when her vehicle’s right rear tire fell into a hole. The hole developed suddenly in the gravel lining the entrance to the trailer park from Airline Highway. Ms. Richardson filed a lawsuit against the owner of the trailer park, Homewood Holdings, L.L.C. and its insurer, Scottsdale Insurance Company. Ms. Richardson argued that the hole caused her vehicle to unexpectedly stop, causing her serious injuries that necessitated undergoing spinal surgery.

At trial, Ms. Richardson presented the testimony of two treating physicians in addition to her own testimony. Ms. Richardson testified that she did not immediately seek medical attention for her injuries because she was already being administered a narcotic for serious injuries suffered in a domestic violence incident, and her contract prohibited her from receiving medication from any other source. She waited until her next scheduled appointment with her pain management specialist, Dr. Thomas Cockerham.

the-old-red-barn-1233750-1024x736In litigating claims, parties (particularly the attorneys) must exercise diligence. This means being timely when it comes to gathering evidence, complying with a court order, or filing a pleading, motion, appeal etc. In its Commentary to the Model Rules of Professional Responsibility, the American Bar Association specifically warns that procrastination can seriously harm a client’s cause. Good attorneys heed this warning. Procrastination can and will often prompt the court to dismiss a litigant’s claims or objections. Illustrative is a recent case from the U.S. Fifth Circuit Court of Appeal.

In 2011, Red Barn Motors, Inc. entered into a financing agreement with Dealer Services Corporation (“DSC”). Under the financing agreement, DSC would finance Red Barn’s purchase of vehicles at auction. But soon, things went sour. In March of 2013, Red Barn stopped making payments on its line of credit with DSC and DSC began seizing some of Red Barn’s assets. The next month, Red Barn delivered several vehicles to Louisiana’s First Choice Auto Auction, L.L.C. First choice was supposed to sell the vehicles, but instead, it delivered them to DSC. Red Barn eventually declared bankruptcy. At some point, DSC was absorbed by another company, NextGear Capital Inc.

Red Barn filed a lawsuit in the U.S. District Court for the Middle District of Louisiana against NextGear and First Choice. Red Barn alleged that NextGear breached the financing agreement and benefited from unjust enrichment and that NextGear and First Choice committed conversion. According to Red Barn’s petition, sometimes six to eight weeks would pass before the auction house could transfer title to DSC, and DSC would refuse to pay the auction house until it received the title, though it would charge interest and fees starting from Red Barn’s initial purchase.

abandoned-hospital-1-1227909-1-1024x683Families depend on nursing home staff to adequately care for loved ones. When loved ones suffer due to the negligence of nursing home staff, a medical malpractice suit can arise.

Recently, in Johnson v. CLVD, Inc D/B/A Green Meadow, the beginning injury arose on November 11, 2008, when Mr. Johnson’s catheter was removed, possibly by himself. The nursing staff left the catheter out due to a hospital policy that prohibited them from replacing it. On November 15, Mr. Johnson was unresponsive and taken to the hospital, where a catheter was reinserted. As a result, Mr. Johnson had more than three times the normal amount of urine in his system causing him to develop a urinary tract infection. This infection progressed into severe sepsis, septic shock, and several secondary infections. On December 15, he was admitted to Minden Medical Center with a fever, UTI, altered mental status, and worsening renal insufficiency. His condition worsened, and he died on December 25, 2008.

Mr. Johnson’s family filed a malpractice complaint against the hospital and a medical panel of three doctors reviewed it. Two of the doctors concluded that, by failing to reinsert the catheter or consult with Mr. Johnson’s treating physician, the nursing home staff failed to provide Mr. Johnson with appropriate care. This lack of care led to a chain of events resulting in Mr. Johnson’s death.  The third-panel member disagreed based on Mr. Johnson’s age and medical problems.

portal-2-1204680-1024x680What happens when an accident happens at the workplace? Well, you would immediately head to the doctor. You would rely on your medical records to show the truth when you talk to your insurance company. However, what happens when the medical administration doesn’t agree that your medical records are demonstrative of the truth? Strengthening your case against corporations that attempt to veil the importance of your medical records requires the very best attorneys possible.

Plaintiff James Arness Thomas was a forklift operator for Marsala Beverage Company. In November 2010, Mr. Thomas fell off of his forklift when a truck driver pulled forward unexpectedly. The defendant, Marsala Beverage Company, never disputed that the accident occurred in the course of the plaintiff’s employment and that he was injured.

At the time of his injury, the plaintiff suffered damage to his neck, back, arms, and wrists. Mr. Thomas returned to work temporarily, and then stopped working. The Marsala Beverage admitted that he was temporarily disabled, and paid Mr. Thomas compensation and medical benefits. In the meantime, Mr. Thomas consulted a long line of specialists, including orthopedists and neurosurgeons.