Disability Benefit Claims Law Blog : Disability Benefits Lawyer & Attorney : Dell & Schaefer : Disability Insurance Claims Law Blog

The case of Mary Midgett v. Washington Group International Long Term Disability Plan, 561 F.3d 887 (8th Cir. 2009) is a reminder that there are discrepancies in how Federal courts apply the law with regard to the weight of credibility to give to an insured’s treating physicians versus the opinions of doctors hired by the insurance carrier to conduct reviews of medical records only.

Mary Midgett was a contract manager for Washington Group International, and was insured under Washington’s group short term and long term disability policies. The policies were originally administered by Broadspire, and then by Aetna. Ms. Midgett filed for benefits under Washington’s short term disability policy due to a myriad of conditions including degenerative arthritis, fibromyalgia and cervical degenerative disc disease, and osteoporosis.

→ Click here to continue reading Broadspire And Aetna Deny Long-Term Disability Benefits To Manager Suffering From Fibromyalgia, Arthritis And Cervical Disc Disease

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In, Lona v. Prudential, 2009 WL 801868 (S.D. Cal)., the Court determined that the opinions of three doctors hired by the insurance carrier to review the insured’s medical records did not carry as much weight as the opinions of three other doctors that physically examined the insured. This case shows that Prudential will continue to hire doctors to review a claimant’s disability file, until they have found the right doctor to provide the opinion they are looking for.

→ Click here to continue reading Judge Orders Prudential To Pay Account Manager $90,416 In Long-Term Disability Benefits

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Prior to becoming disabled, Mrs. C was an eighth grade English literature teacher in southern California. In 1996, Mrs. C began experiencing pain in her muscles and joints as well as fatigue and disturbed sleep. Her physicians soon diagnosed her with various connective tissue disorders, including: Sjogren’s syndrome, rheumatoid arthritis, atypical lupus , Raynaud’s phenomenon, fibromyalgia and muti-nodular goiter. She was experiencing pain in a number of small joints in her upper extremities, as well as her knees, ankles and hands. The stress and emotional toll was even causing her to experience hair loss. In 2002, Mrs. C was forced to stop working and file a claim for disability benefits under her long-term disability policy provided through her teacher’s association. After reviewing her claim and giving careful consideration to the medical evidence, the disability insurer approved Mrs. C’s claim and began paying total disability benefits.

→ Click here to continue reading Teacher Suffering From Sjorgen's Syndrome, Fibromyalgia And Other Conditions Receives Lump-Sum Buyout Following Denial Of Long-Term Disability Benefits

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Cigna attempted to deny lifetime disability benefits for a claimant suffering from a psychiatric organic brain disorder, but the district court of Colorado disagreed. Following a remand from the court of appeals, which ruled the district court had erred by considering evidence outside the “administrative record,” the district court nonetheless reaffirmed its ruling in plaintiff’s favor after carefully considering all of the evidence in the record and analyzing each of the medical opinions presented.

→ Click here to continue reading CIGNA'S Attempt To Limit Claimant To A Maximum Of  2 Years Of  Long-Term Disability Benefits Limitation For An Organic Brain Disorder Such As Bi-Polar Is Reversed  By The District Court

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Our client, a breast cancer survivor, was a senior property manager for a large property management company for nearly fifteen years. As a senior property manager, our client was responsible for planning, controlling and directing the day to day operation of multiple properties. Year after year she received numerous recognitions for the quality of her work.

Like many breast cancer survivors, our client experienced cognitive difficulties, commonly referred to as “chemo-brain,” following treatment with chemotherapy and the medication, Tamoxifen. She experienced problems remembering things, focusing, multi-tasking, as well as problems with being able to analyze information in a logical manner. These deficits in her thinking made it impossible for her to continue to perform her job, and in turn she filed for long term disability income benefits with Prudential.

→ Click here to continue reading Prudential Denies Long-Term Disability Benefits To A Breast Cancer Survivor And Attorneys Dell & Schaefer Submit An Appeal

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Dr. C, a dentist, came to Attorneys Dell & Schaefer in 2006 seeking assistance in submitting applications for long-term disability benefits. In 1999, Dr. C began noticing a slight tremor in his right hand while writing and at times while holding a dental instrument. He immediately sought care from a neurologist, who after examining Dr. C, determined that the tremor was likely stress and anxiety related. Dr. C continued working and operating his dental practice with the hopes that his slight tremor would resolve.

→ Click here to continue reading Dentist With Hand Tremor Files Suit And Receives Confidential Settlement For Past Due And Future Long-Term Disability Benefits

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Attorneys Dell & Schaefer has filed a long-term disability breach of contract lawsuit in federal court against Conneticut General Life Insurance Company (“Connecticut General”) seeking lifetime disability benefits. Our client, a former floor trader on the American Stock Exchange, was disabled due to bipolar disorder, a sickness, from March 1995 until April 2006. In 2004, while our client was totally disabled due to his bipolar disorder, he suffered a hernia injury while carrying a television to his car. Our client ‘s disability policy has been administered by MetLife insurance company, which means that MetLife made the decision to deny his benefits as of age 65.

→ Click here to continue reading Former Financial Trader Files Lawsuit Against Connecticut General Life Insurance (Metlife) Seeking Lifetime Long-Term Disability Benefits

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Our client, a Texas resident, contacted Attorneys Dell & Schaefer following her initial application denial and first appeal of her disability denial by a prior law firm. This woman, suffering from chronic neck and back problems, a stroke, depression, headaches, and memory loss, had been a quality control manager for a large corporation. The client was unable to perform an work and was seeking total disability benefits.

→ Click here to continue reading Jefferson Pilot's Denial of Long-Term Disability Benefits To A Quality Control Manager Is Reversed

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A federal jury in Boston found that Unum, the nation’s largest disability insurer, had committed fraud in some cases by requiring customers to apply for Social Security benefits even though it knew they were not eligible.

But the verdict, based on a sample of six claims, contained enough ambiguity to leave both sides declaring victory in the case, filed on behalf of the Social Security Administration. In a verdict returned Wednesday, the jury found that two of the disability claims had been fraudulent and two others had showed no evidence of fraud. The jury was unable to reach a decision on the other two cases.

→ Click here to continue reading Unum Found Guilty Of Social Security Disability Fraud By A Federal Jury

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Robin Doyle was a registered nurse working for ChoicePoint Services, and filed a claim for short-term disability benefits on January 30, 2004. She based her disability on a number of conditions, including anal fissure, enlarged internal hemorrhoids, and external anal skin tags. She underwent surgery on February 10, 2004, in an effort to solve these health problems.

→ Click here to continue reading Nurse Wins Opportunity For Reassessment Of Claim With Liberty Life For Long-term Disability Benefits Based On Her Fibromyalgia

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Medical Condition and Occupational Duties

Our Client, an OBGYN (hereinafter referred to as “Dr. OBGYN”), was employed by a hospital when he began to experience anxiety and depression following the filing of a malpractice lawsuit. Our client began drinking alcohol on a daily basis and was subsequently hospitalized for three months as a result of alcoholism, anxiety, depression and suicidal thoughts. Prior to claiming disability Dr. OBGYN’s substantial and material duties involved the delivery of babies, gynecological surgeries and on-call requirements.

→ Click here to continue reading Prudential Reverses Denial on Second Appeal & Pays $260,000 In Past Due Disability Benefits To OBGYN

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