Day 1 - Thursday, February 22, 2018

7:00
Registration and Continental Breakfast
8:00
Co-Chairs’ Welcoming Remarks
8:30
Insights on Disability Insurance Claims: In House Counsel and Claims Professional Perspectives
9:15
Preparing For the Implementation of the New DOL Regulations on Disability Claims
10:15
Morning Refreshment Break
10:30
Strategies for Utilizing Medical Exams in Claims Evaluations: Considerations for Plaintiffs and Defendants
11:30
Establishing Venue in Favorable Jurisdictions in the Face of Statutory Language
12:15
Networking Luncheon for Speakers and Attendees
1:15
Challenges with Diagnosing Mental Disorders and Non-Visible Disorders: Establishing Objective Proof of the Subjective Disorder
2:15
Assessing the Impact of the Amendments to the Rules of Civil Procedure on Discovery and the Evolving Standard of Review in Disability Matters
3:15
Afternoon Refreshment Break
3:30
The Evolving State of New Remedies and Equitable Relief Under ERISA 502(a)(3)
4:30
Partial vs. Total Disability: Drawing the Line for Distinguishing Different Levels of Disability and Calculating Payouts
5:00
Main Conference Adjourns to Day Two

Day 2 - Friday, February 23, 2018

7:00
Continental Breakfast
8:00
Co-Chairs’ Opening Remarks and Recap of Day 1
8:15
Federal and State Judges Speak on Litigating Disability Insurance Claims
9:30
Defining “Own and Any” Occupation: Determining Occupational Demand and Suitability for Work
10:15
Morning Refreshment Break
10:30
Exploring the Emergence of RICO Allegations in Disability Claims Benefits Cases
11:30
Exploring the Numerous Limitations and Exclusions in Disability Insurance
12:15
Conference Ends; Lunch for Speakers and Attendees Registered for Post-Conference Workshop

Day 1 - Thursday, February 22, 2018

7:00
Registration and Continental Breakfast
8:00
Co-Chairs’ Welcoming Remarks

Robert K. Scott
Partner
Newmeyer & Dillion LLP (Newport Beach, CA)

Amy S. Kline
Partner
Saul Ewing Arnstein & Lehr LLP (Philadelphia, PA)

8:30
Insights on Disability Insurance Claims: In House Counsel and Claims Professional Perspectives

Nicole Guerin
Vice President Claims II
AXIS Capital

Peter M. Kelly
Deputy General Counsel & Chief Employee Benefits Counsel
Blue Cross and Blue Shield Association (Chicago, IL)

Ian Linker
Partner
Rivkin Radler LLP (Uniondale, NY)

Melissa C. Williams
Lead Counsel | Legal
CUNA Mutual Group (Madison, WI)

Moderator:

Gregory P. McMahon, Esq.
Partner
Koleos, Rosenberg & McMahon, PL (Orlando, FL)

Join us for an insider’s roundtable where in house counsel and claims professionals will provide insights for handling disability claims.

They will offer practical insights on the claims process from the initial claims filing, medical review, investigation, litigation, and appeals process.

Topics will include:

  • Assessing differences and similarities between insurance claims for ERISA and IDI cases
  • Reducing legal costs associated with discovery
  • Preparing corporate witnesses for depositions
  • Responding to appeals on denial of benefits claims
  • Managing litigation and enhancing relationship with outside counsel

9:15
Preparing For the Implementation of the New DOL Regulations on Disability Claims

Heather J. Austin
Attorney at Law
Wilson Elser Moskowitz Edelman & Dicker LLP (Philadelphia, PA)

Bryan D. Bolton
Attorney
Funk & Bolton (Baltimore, MD)

Alan Tawshunsky

Tawshunsky Law Firm PLLC (Washington, DC)

The DOL recently released its final Regulation on disability claims. This Regulation and its accompanying Rules made sweeping changes on how letters are addressed to claimants, medical information is requested, as well as altering varying other requirements for handling disability claims. The Regulation requires attention to detail and compliance is mandatory.

This session will reveal the “ins and outs” of the Regulation and help you prepare for final implementation.

Points of discussion include:

  • Analyzing the Regulation’s procedural and substantive requirements
  • Assessing how the Regulation will impact group long term disability claims
  • Evaluating how the Regulation will affect strategies for both plaintiffs and defendants
  • Determining how to change current processes to adapt to the new requirements of the Regulation
  • Addressing the impact of the DOL’s proposal to extend the applicability of the Rule to April 2018

10:15
Morning Refreshment Break
10:30
Strategies for Utilizing Medical Exams in Claims Evaluations: Considerations for Plaintiffs and Defendants

Henry Conroe, M.D.

Rush University Medical Center (Chicago, IL)

Alicia Paulino-Grisham
Partner
Paulino-Grisham, Smith & Chmielarz, P.A. (Juno Beach, FL)

  • Evaluating the use of IME’s, treating physician’s opinion, the FCE, and medical records to advance the best outcome for the case
  • Determining the type of test required under the policy
  • Weighing the effectiveness of direct evaluations of claimants vs. paper reviews by doctors and vocational analysts
  • Assessing whether there is a fundamental right to require IME’s or FCE’s during each stage of the case
  • Addressing the qualifications of the examiner
  • Evaluating circumstances under which the claimant refuses the examination
  • Exploring the effect of having another medical professional in the examination room and participating in the examination
  • Determining the impact of videotaping the exam
  • Comparing and evaluating the different approaches by physical therapists for the FCE
  • Taking action to establish unreliability and/or bias early on so as to preserve evidence of such for appeal

11:30
Establishing Venue in Favorable Jurisdictions in the Face of Statutory Language

Michael B. Bernacchi
Partner
Burke, Williams & Sorensen, LLP (Los Angeles, CA)

Kristina B. Pett
Partner
Edison, McDowell & Hetherington, LLP (Boca Raton, FL)

  • Determining whether plans can establish venue selection in the face of statutory language
  • Interpreting the courts’ opinion in Lorna and Mathias on venue selection
  • Factoring in statute of limitations for venue selection
  • Determining venue with plans that do not have a venue selection clause
  • Assessing how venue selection has a significant impact on participants’ abilities to find counsel to take case in jurisdiction where the case initiated
  • Evaluating the impact of venue on the standard of review
  • Strategizing and making a concerted effort to bring a case in favorable venue
  • Searching for consumer oriented federal judges as a claimant

12:15
Networking Luncheon for Speakers and Attendees
1:15
Challenges with Diagnosing Mental Disorders and Non-Visible Disorders: Establishing Objective Proof of the Subjective Disorder

James (Sandy) McCorquodale

A M Lawyers (Dallas, TX)

Leo J. Shea III, Ph.D.

Neuropsychological Evaluation & Treatment Services, P.C. (New York, NY)

  • Determining the validity of neurological testing and scoring that is utilized in the claim evaluation
  • Examining the interplay between mental illnesses and physical illnesses
  • Assessing the parameters for a bad or fake score
  • Establishing ways to test for cognitive impairment
  • Credentialing qualifications for neurologists
  • Understanding the complexities of mental illnesses and distinguishing between the physical problem in brain chemistry and a mental symptom
  • Reviewing medical records and building a record that supports your claim
  • Defining the limitations to the mental illness claims
  • Identifying the primary medical condition causing the inability to work
  • Preparing strategies to counter the challenges associated with mental/ nervous limitations
  • Evaluating challenges associated with conditions related to fibromyalgia, chronic fatigue, and chronic pain
  • Identifying the appropriate healthcare professional to properly diagnose and/or evaluate a subjective condition
  • Balancing the need for objective proof with a subjective disorder

2:15
Assessing the Impact of the Amendments to the Rules of Civil Procedure on Discovery and the Evolving Standard of Review in Disability Matters

Ronald K. Alberts
Partner
Gordon & Rees Scully Mansukhani (Los Angeles, CA)

Amy S. Kline
Partner
Saul Ewing Arnstein & Lehr LLP (Philadelphia, PA)

J. Christian Nemeth
Partner
McDermott Will & Emery LLP (Chicago, IL)

  • Understanding the increasing trend by courts to remand cases to the insurer and re-review the claim for any inadequacies
  • Evaluating the consequences of abandoning the discretionary standard of review and moving towards de novo review
  • Exploring the outcome of placing the burden of proof on the claimant to prove disability and meet the definitions outlined in the policy under the abuse of discretion standard
  • Determining whether the abuse of discretion standard requires the courts to give deference to claims decision made by the insurer
  • Assessing the amendments to the Rules of Civil Procedure on discovery
  • Allowing discovery to include relevant facts to the party’s claim or defense that is proportional to the case
  • Interpreting the amendments to the Rules of Civil Procedure on discovery and how it impacts ERISA cases under the discretionary standard of review
  • Examining how the “proportionality standard” can affect how the claim file is viewed under de novo review
  • Reviewing the impact of changing the standard from “reasonably calculated leading to admission of evidence” to “proportionality standard”
  • Evaluating the challenges of using only the administrative record vs. full discovery
  • Interpreting the Glenn and Halo case on the evolution of discovery and de novo review

3:15
Afternoon Refreshment Break
3:30
The Evolving State of New Remedies and Equitable Relief Under ERISA 502(a)(3)

Christen Archer Pierrott
Attorney at Law
Christen Archer Pierrot, Esq. (Orchard Park, NY)

Anthony F. Shelley
Member
Miller & Chevalier Chartered (Washington, DC)

Clarissa A. Kang
Director
Trucker Huss, APC (San Francisco, CA)

Plaintiffs have been utilizing ERISA 502(a)(3) to “obtain other appropriate equitable relief” for disability cases. However, it is not easy to understand what constitutes “other appropriate equitable relief”. This often debated question is one on which the industry is seeking clarity. Attendees can expect to gain a better understanding of equitable relief in this session.

Points of discussion include:

  • Interpreting the latest case law affecting the new remedies landscape
  • Examining the fallout from Rochow on recovering disgorged profits as an appropriate from of equitable relief
  • Crafting practical strategies for arguing against monetary damages as a form of equitable relief
  • Examining ways claimants can make the argument for equitable relief
  • Interpreting the McCutchen case on equitable recoupment of benefit overpayments
  • Evaluating the current state of ERISA remedies available in fiduciary breach claims
  • Addressing 502(a)(3) relief claims early in the process via procedural motions
  • Analyzing arguments for equitable relief in the context of voluntary disability when the employer pays a percentage of the premium of disability benefits earned income

4:30
Partial vs. Total Disability: Drawing the Line for Distinguishing Different Levels of Disability and Calculating Payouts

Joseph M. Hamilton
Partner
Mirick, O’Connell, DeMallie & Lougee, LLP (Worcester, MA)

  • Drawing the line when determining partial v. total disability
  • Calculating the formula used for determining payment in partial disability cases
  • Analyzing recent case law on partial vs. total disability
  • Examining the impact of claimants decision to work in partial capacity and how that impacts benefits claim
  • Defining the term “inability to perform key aspect of occupation” and how this is essential for benefits claim
  • Calculating benefits based on how much claimant made before disability and how much they are earning presently
  • Distinguishing legal and factual disability

5:00
Main Conference Adjourns to Day Two

Day 2 - Friday, February 23, 2018

7:00
Continental Breakfast
8:00
Co-Chairs’ Opening Remarks and Recap of Day 1
8:15
Federal and State Judges Speak on Litigating Disability Insurance Claims

Hon. Fernando J. Gaitan, Jr., U.S.D.J.

United States District Court, Western District of Missouri (Kansas City, MO)

Hon. Robert B. Collings, U.S.M.J.

United States District Court, District of Massachusettes (Boston, MA)

Honorable Pamela Pryor Dembe

Commonwealth of Pennsylvania Court of Common Pleas, 1st Judicial District (Philadelphia, PA)

Hon. Clifton Newman

Circuit Court of South Carolina (Columbia, SC)

Moderator:

Pamela I. Atkins

Atkins & Associates (Atlanta, GA)

In this session, prestigious federal and state judges will give valuable insight and advice on litigating disability insurance claims including discovery, amendments to the Rules of Civil Procedure, and the shifting standard of review. This session will allow attendees to learn from and ask question to jurists who have a wealth of information and experience in the disability insurance context.

9:30
Defining “Own and Any” Occupation: Determining Occupational Demand and Suitability for Work

Robert K. Scott
Partner
Newmeyer & Dillion LLP (Newport Beach, CA)

David W. Howenstine
Attorney
Lane Powell PC (Seattle, WA)

  • Evaluating the standard used to define “own occupation” and “any occupation”
  • Defining the material duties of a claimant’s occupation under an “own occupation” provision
  • Reviewing the challenges associated with defining occupation in the national economy
  • Determining the standard used to define whether the claimant can return to work
  • Proving the inability to return to work within the first two years of the disability
  • Navigating the implications and challenges associated when the definition changes from “own occupation” to “any occupation”
  • Tightening clauses in policies and defining the material duties of a claimant’s occupation
  • Examining the approaches taken by insurers in processing/evaluating vocational reports submitted by claimants
  • Evaluating challenges associated with finding qualified and newer vocational experts

10:15
Morning Refreshment Break
10:30
Exploring the Emergence of RICO Allegations in Disability Claims Benefits Cases

Elizabeth G. Doolin, Esq.
Member
Chittenden, Murday & Novotny LLC (Chicago, IL)

Wm. Jere Tolton III, Esq.
Attorney
Ogden & Sullivan, P.A. (Tampa, FL)

In this session, we will explore the emerging trend of plaintiffs filing RICO cases in tandem with disability actions. In these instances, plaintiffs are alleging that insurers are violating the federal racketeering statute by defrauding the plaintiffs of their benefits. These RICO cases are difficult to prove and even more challenging to defend.

Points of discussion will include:

  • Evaluating the claims plaintiffs can bring under RICO and the viability of these claims
  • Exploring counter arguments insurers can bring under RICO cases
  • Reviewing how plaintiffs can bring RICO claims simultaneously with disability claims
  • Determining the effectiveness or ineffectiveness of RICO cases
  • Navigating aspects of RICO cases that can be effective for plaintiff

11:30
Exploring the Numerous Limitations and Exclusions in Disability Insurance

Denise M. Clark
Founding Partner
Clark Law Group (Washington, DC)

Nikole M. Crow
Counsel
Womble Carlyle Sandridge & Rice, LLP (Atlanta, GA)

  • Understanding the contractual interpretation challenges associated with limitations and exclusions in disability insurance
  • Outlining typical limitations covered under most disability insurance such as mental health coverage
  • Comparing and contrasting policies that are broad or specific to limitations and exclusions
  • Evaluating the medical conditions that can relate to or come from another medical condition
  • Reviewing the current and emerging trend of ERISA policies expanding its limitations and exclusions

12:15
Conference Ends; Lunch for Speakers and Attendees Registered for Post-Conference Workshop

Pre-Conference Workshop: Deposition Master Class: Preparing for the Corporate Witness’ Deposition-Plaintiff and Defense Perspectives

Feb 21, 2018 3:00pm - 5:00pm

$600

Speakers

Gregory P. McMahon, Esq.
Partner
Koleos, Rosenberg & McMahon, PL (Orlando, FL)

What is it about?

Oftentimes, the most important deposition in a disability case is that of an insurance professional at the administrator level, appeals committee member, or another high-level corporate executive. These depositions can be challenging as they can literally make or break a case. In this session, our workshop leaders will help you obtain the necessary skills to develop practical strategies to prepare for the corporate witness’ deposition. Panel speakers will provide tips and techniques — as well as insights on traps to avoid — in preparing for these very complex depositions from both a plaintiff’s and defense counsel’s perspective

Topics will include:

  • Identifying and choosing the appropriate executive to depose and developing strategies for qualifying this witness
  • Preparing for the corporate witness deposition in concert with the claims file
  • Ensuring the corporate witness understands the limitations of the deposition
  • Selecting and drafting the appropriate questions that falls within the subject matter of the case
  • Highlighting key aspects of the claim and drawing out the appropriate responses from the corporate witness
  • Ensuring the corporate witness stays within the subject matter and timeline of the case to ensure a successful outcome

Post-Conference Workshop: Disability Litigation Strategy Master Class: A Complete Guide for Plaintiffs and Defense Counsel for Handling a Disability Case From Start to Finish

Feb 23, 2018 1:15pm - 3:15pm

$600

Speakers

Robert K. Scott
Partner
Newmeyer & Dillion LLP (Newport Beach, CA)

What is it about?

Through a hypothetical, this comprehensive session will provide insights to plaintiffs’ and defense counsel on litigating a disability matters. Our workshop leaders will walk you through every step of a disability dispute from pleadings to discovery to trial, and final adjudication for matters of both individual disability and ERISA litigation. This workshop will provide an in-depth review from start to finish for handling disability insurance cases.

Topics include:

  • Determining whether the case falls within ERISA
  • Preparing and drafting procedural motions
  • Assessing the impact of the disability case in the litigation timeline
  • Outlining claimant side considerations
  • Strategizing counter claims for the defense
  • Conducting a thorough investigation early in the case
  • Understanding and strategically using the medical information in the case
  • Devising effective courtroom tactics and strategies