Take a look at our January newsletter!
For The Ambitious Advocate BRIEF RECESS
JANUARY 2024
FROM THE LAW OFFICES OF J. PRICE MCNAMARA
2024 is officially here, and as you know, every year can feel like turning a new chapter in the legal profession, and every case we take creates a 12-month story. REFLECTING ON 2023 AND WELCOMING 2024 I’ll be honest: My story for 2023 was a great one. Yes, I faced my fair share of challenges (who didn’t?), but I woke up every day, spent time with my family, laughed a lot, and helped a ton of people with their ERISA claims. And over the next 12 months, I plan to continue helping those facing challenges with ERISA claims. However, my plans for 2024 go beyond helping individual cases. I also plan to build stronger connections with my fellow attorneys to create a network of shared knowledge and resources. I’ve talked before about how powerful a group of upbeat consumer-facing lawyers can be when you’re running your own practice. For me, that group was Great Legal Marketing, but I’d like to do my part for other attorneys as well. That’s why I plan to keep sharing what I’ve learned over the years to hopefully help someone else. With that said, I would also like to thank those of you who have helped me by sending over your referrals. Your confidence in my firm is priceless, and I’m endlessly grateful. And I can help one more person receive justice against unfair denials for every referral you send. So, to all of you who entrusted me with your referrals, I want to say thank you from the bottom of my heart. Ultimately, after looking back on the amazing journey of 2023 and thinking about what 2024 has in store, I can’t help but feel grateful. Despite the inevitable challenges, I couldn’t have made it this far without the support of my family, team, clients, and colleagues, who have been the driving Cheers to a Happy New Chapter
HAVE A LAUGH!
force behind a successful year. So, here’s to another year of navigating obstacles, building relationships, and fighting for what’s right. I wish you all an amazing 2024!
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Our client Jim (not his real name), a 58-year-old family man and sole breadwinner, had been a heavy equipment operator for his whole career. But, after a heart attack, his heart disease and lack of cardio capacity caused shortness of breath, dizziness, and complete numbness in his hands. The disability insurance company agreed that Jim’s heart disease disabled him from being a Heavy Equipment Operator and paid him disability benefits of 60% of his $78,000 annual salary for 24 months. But, after paying for 24 months, they terminated Jim’s benefits. They claimed that, while he remained disabled from the required duties of a Heavy Equipment Operator, he could perform the duties of other sedentary desk jobs. The insurer based its termination of benefits on an extremely shallow vocational expert’s report that didn’t properly analyze all the duties of these desk jobs, each of which required computer skills that Jim clearly lacked. The insurer’s vocational expert never interviewed or even met with Jim. HOW WE PROVED TH The Story of Jim’s Battle Again
R ? Kupata’s
We often think dogs live the good life, as they seem to do nothing but play, eat, and sleep. Yet, some dogs are busy at work, some without being asked to do so! Take Kupata, the stray dog in Georgia, for example. This street-roaming pup takes it upon himself to guard a crosswalk all day, every day. In the town of Batumi, this stray stays by a single crosswalk and forces traffic to stop to allow pedestrians to cross the street. He’s especially protective of children! If Kupata sees a car isn’t slowing down, he’ll bark at the driver as they drive away and run to protect the person crossing the street. One local even shared that Kupata will cross the road with children and stay at the park to protect the youngsters. Road to Fame THE STRAY DOG WHO CAPTURED THE WORLD’S HEART
Does your office turn away calls about “long-term disability insurance” claim denials because you don’t handle administrative appeals or “ERISA litigation” in federal court? We want to hear from you! We happily share fees on referred ERISA long- term disability, life insurance, and accidental death insurance denial cases. Send us an email at BriefRecess@jpricemcnamara.com or call (225) 201-8311 to start the referral process! ERISA is all we do! In long-term disability policies, the definition of “disability” can vary from policy to policy. This definition drives what the claimant must prove to be considered disabled under the policy. Most policies have variations of two definitions for disability. Typically, for the first 24 months, a claimant only has to be unable to perform their “own occupation.” The definition of “own occupation” is found in the policy. WE VALUE YOUR REFERRALS!
Kupata, which in English means “sausage,” has become a staple in the community due to his hard work, and locals all pitch in to care for and feed the stray dog. His consistently round belly shows just how loved he is. You’ll even see a massive painting of the beloved animal on a nearby building. Now, after tireless days of guarding his street, Kupata has his own doghouse provided by the city with an accompanying star on
the road with his name on it. Kupata’s dedication made him go viral on social media, and now travelers from all over the world come to see Kupata. Don’t distract him, though. He’s busy at work! Sadly, even though Kupata remains cherished by his community, thousands of stray dogs in the country need shelter, food, and companionship. According to activists, around 500,000 stray dogs and cats roam the streets of Georgia. While stray animals may get a bad reputation for being dangerous or unfriendly, Kupata proves that even these furry friends deserve love and recognition.
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After 24 months, a claimant must prove that he or she cannot perform “any occupation.” Usually, the definition includes “any occupation” that the claimant can perform based on his or her education, background, and skills. The “any occupation” standard often includes a salary percentage component. This provision means the company cannot deny benefits because the claimant can perform the duties of any job at any wage. Instead, to support a denial, the insurance company must identify occupations that usually pay the claimant at least 80 percent (typically) of their pre-disability income. In many cases, the disability insurance company will pay benefits for the first 24-month “own occupation” period, then terminate benefits under the “any occupation” provision. This triggers the start of the administrative appeal process, the same as an initial claim denial. Jim helped us develop a detailed educational and work-experience background, with special attention to his lack of computer experience. We also got vocational expert input of our own to prove that, although physically capable, Jim did not have the skill set to perform all the duties of the alternative occupations the insurance company had identified. HE INSURER WRONG! nst Unjust Benefit Termination
THE ORIGINS OF LOUISIANA’S KING CAKE TRADITION As January rolls around, many Americans commit to healthy diets and lifestyle changes for the New Year. However, in places like Louisiana, people celebrate the start of the new year with a special pastry called a king cake! This popular treat is typically sold in bakeries from January to early spring and is associated with celebrations like Mardi Gras or Epiphany.
But the question is, how did the king cake tradition in Louisiana start?
Back to the Beginning The origin of a popular sweet treat can be traced back to ancient European celebrations that took place before the spread of Christianity. These celebrations included a ritual sacrifice, where a man was chosen to be the “sacred king” and was treated like a king for a year. At the end of the year, he was sacrificed to ensure a good harvest. To determine “the king,” some communities followed a tradition where townspeople would gather and eat cake with a coin or bean hidden inside. The person who finds the coin or bean is considered the “winner.” The King Cake Comes to Louisiana As Christianity spread across different parts of the world, it replaced many other religions, and during this time, the tradition of king cake was also adopted by Christians. However, instead of a sacrifice, the cake was mainly used to honor the three wise men mentioned in the Bible who traveled to Bethlehem to visit the newborn Jesus. So, when the French traveled to Louisiana in the 1700s, they brought many of their customs with them. One of those customs was the king cake, traditionally eaten during a special event called Epiphany, a Christian feast day. However, in the 1800s, Mardi Gras became a more popular celebration than Epiphany, and the king cake became linked with this holiday instead. The King Cake We Know Today The king cake we know today is usually a twisted ring of sweet bread-like dough covered with icing or sugar in the colors of Mardi Gras — green, gold, and purple. However, some people like to make the cake even more delicious by deep-frying it and filling it with cream cheese and praline. Often, a small trinket, usually a baby (said to be baby Jesus), is hidden inside the cake, and whoever finds it is believed to have good luck for the rest of the year!
With this additional evidence added to the record in our appeal, the insurance company’s vocational expert agreed that Jim remained disabled. He was awarded all back pay owed and will receive benefits going forward to age 67! • 1 tsp vanilla extract • 1/2 cup all-purpose flour • 1/4 tsp baking powder • 1/4 tsp salt • 1/2 cup chopped nuts (optional) World’s Best Brownies Directions 1. Preheat oven to 350 F and grease an 8-inch square baking pan. 2. Melt butter and chocolate in a saucepan over low heat, stirring constantly, then remove from heat and let cool slightly. 3. In a large bowl, beat together sugar, eggs, and vanilla, then add melted chocolate mixture and blend well. 4. In a separate bowl, stir together flour, baking powder, and salt. 5. Gradually add flour mixture to chocolate mixture, stirring until blended, then stir in nuts if desired. 6. Pour batter into prepared pan and spread evenly. 7. Bake for 25–30 minutes or until a toothpick inserted in the center comes out clean. Ingredients • 2/3 cup butter • 2 oz unsweetened chocolate • 1 cup granulated sugar • 2 large eggs
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PRST STD US POSTAGE PAID BOISE, ID PERMIT 411
ERISA INSURANCE J. PRICE MCNAMARA Claim Attorney
10455 Jefferson Hwy. Suite 130 Baton Rouge, LA 70809 (225) 201-8311 WinMyBenefits.com
INSIDE THIS ISSUE
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A Year of Shared Success!
Meet Kupata, Georgia’s Street-Roaming Pup Hero
Jim’s Journey From Benefit Termination to Full Compensation
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The Fascinating History of Louisiana’s King Cake
World’s Best Brownies
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Why Eating Together Matters More Than You Think
FOOD FOR THOUGHT THE BENEFITS OF EATING AS A FAMILY
Weight Management Eating together also helps in controlling weight more effectively. Home-prepared meals usually contain healthier ingredients and allow for better portion control. Mealtime structure also supports better eating habits, which can be a crucial factor in weight management for both adults and children. Positive Effects on Child Development Research suggests that eating dinner together positively affects child development. Children interact with adults and siblings, and conversations help them learn social skills, table manners, family values, and culture. Emotional Well-Being Family meals are not just about the food but also about spending quality time together.
Enjoying a meal with loved ones allows family bonding and may even improve mental health. It contributes to fewer emotional problems and helps children feel loved, safe, and secure. Educational Benefits Mealtime conversations can be educational. Parents can discuss various topics, helping children expand their knowledge, vocabulary, and critical thinking skills. This intellectual stimulation can be particularly beneficial for school-aged children. Sharing meals with family or friends is not just a social custom but a healthful practice with numerous benefits. The advantages are numerous, especially for children. So, make it a point to gather around the table for a meal at least three times a week. Your body, mind, and soul will thank you.
In today’s fast-paced world, it’s easy to overlook the simple yet profound act of sharing a meal with family or friends. However, research suggests that eating together at least three times a week can significantly benefit overall health, particularly for children. Let’s delve into why this age-old tradition is more important than ever. Promotes Healthy Eating Habits One of the most immediate benefits of family meals is you generally eat better. Families sitting down to eat together are more likely to consume a balanced homemade meal rich in essential nutrients like calcium and fiber. This is especially beneficial for children in their formative years who need these nutrients for growth and development.
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