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

After receiving disability benefits for more than 10 years, the Reliance Standard denied disability benefits. After a 4 year legal battle, the Arizona district court determined that Melisa Gemmel was disabled by fibromyalgia. Melissa Gemmel was employed at Systemhouse, Inc. and covered under her employer’s long-term disability plan, issued by Reliance Standard (NYSE:DFG). In 1989, it was discovered that Gemmel suffered from osteophytes in the neural canal at C5-6, a posterior osteophyte at C5-6, and a C7-T1 abnormality.

→ Click here to continue reading Arizona Court Reverses Reliance Standard And Awards Disability Benefits to Woman Suffering From Fibromyalgia

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When Vickie Costello left work on May 19, 2006, after a stressful encounter with one of her co-workers, she had no idea that her problems were going to get even worse. In order to return to her job at Logan Aluminum, Inc., her employer required her to sign a “last chance agreement.” Already suffering from debilitating pain for which she had been under a physician’s care since 1999, Ms. Costello felt that this event marked the time to claim disability through her employer’s long-term disability plan with Sun Life Assurance Company.

Sun Life’s policy stated that if Costello became disabled and could not perform the “material and substantial duties of her occupation” that she would be entitled to disability benefits for 24 months. At the end of 24 months, she would have to prove that she was “unable to perform the material and substantial duties of ‘any gainful occupation” in order to remain eligible for disability benefits.

→ Click here to continue reading Sun Life Ordered To Re-Evaluate Long-Term Disability Benefit Denial By Federal Judge

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Mrs. Pettigrew was an employee of Pioneer Automotive Technologies, Inc from December 8, 2003 until May 15, 2006. Her most recent position was that of a senior engineer. Mrs. Pettigrew had been experiencing increasing pain and symptoms of Chronic Fatigue Syndrome (CFS), Fibromyalgia and Radiculopathy. Because of the increasing problems Mrs. Pettigrew was facing, she was finally forced to stop working. On May 25, 2006 Mrs. Pettigrew submitted a claim for short-term disability benefits, claiming that she was unable to work due to fatigue, severe pain causing lack of concentration, difficulty sitting as well as standing.

→ Click here to continue reading Prudential Ordered To Re-evaluate Long-Term Disability Claim of Engineer Suffering From Chronic Fatigue Syndrome and Fibromyalgia By Court

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Annette Engel was employed with Harborcreek Youth Services as a Clinical Director, where she performed duties such as providing leadership and vision, developing proposals, overseeing interviews and recruits of other clinicians, consultation and more. On September 5, 2007, Mrs. Engel applied for long term disability benefits under her employer’s plan with Jefferson Pilot (aka Lincoln National), claiming fibromyalgia, chronic fatigue, stress, and depression resulting from working long hours.

→ Click here to continue reading Disability Benefits Ordered To Paid By Jefferson Pilot To A Clinical Director Suffering From Fibromyalgia, Chronic Fatigue And Depression

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Mrs. Rebecca Duperry worked as payroll benefits HR administrator for Railroad Friction Products Corporation (RFPC) until April 7, 2006. Mrs. Duperry suffered from rheumatism, and stopped working in April pursuant to the advice of her rheumatologist. The rheumatologist told Duperry to ‘slow her work down’ and that cutting hours was a good idea, although working from home would be an even better idea.

October 16, 2006, Duperry claimed disability from three conditions,  rheumatoid arthritis, osteoarthritis and fibromyalgia. Among the documents Mrs. Duperry submitted to CIGNA Life Insurance Company of North America were two attending physician statements completed by Duperry’s primary care physicians, Dr. Glenn Harris, and her rheumatologist, Dr. Supen Patel. In his statement, Dr. Harris stated that “plaintiff was limited to zero hours per day of climbing, balancing, stooping, kneeling, crouching, crawling, reaching, walking, sitting, or standing, and that plaintiff would "never" be able to return to work.” A statement was made also by Dr. Patel that Duperry was ‘permanently disabled’ and therefore could not return to work.

→ Click here to continue reading Disability Benefits Ordered To Be Paid By CIGNA To HR Administrator Diagnosed Fibromyalgia

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In February of 2006, Mrs. Lanoue was a table games floor person for the Mohegan Tribal Gaming Authority and had been since October of 1997. She was covered under the long-term disability plan issued and funded by Prudential Insurance Company of America (NYSE:PRU). In April of 2006, Mrs. Lanoue filed for long-term disability, claiming to have chronic pain, fatigue and fibromyalgia. Her claim included an employee statement and an attending physician’s statement (APS) from rheumatologist, Dr. Sandeep Varma.

→ Click here to continue reading Conneticut Court Rules Against Prudential After They Fail To Recognize Pain Caused By Fibromyalgia As A Long Term Disability

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Our client, a pharmaceutical sales representative, was recently denied benefits by her carrier, Cigna, despite clear medical documentation of several severe medical problems that prevent her from performing the duties of her occupation.

→ Click here to continue reading Attorneys Dell & Schaefer Files Lawsuit Against Cigna In Hawaii On Behalf Of Pharmaceutical Sales Representative

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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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The Client, a South Florida podiatrist, retained the law firm of Attorneys Dell & Schaefer in December 2007 due to the denial of disability benefits by one of her two long-term disability insurance carriers. Beginning in 1999 the client began suffering complications from fibromyalgia, sjogren’s syndrome, carpal tunnel syndrome and chronic fatigue syndrome.

Determined to continue the practice of podiatry and not allow her disabling conditions to destroy the practice she had worked so hard to build, the client continued to treat patients, perform surgeries and work a full time work week. However, it was not long before our client was forced to reduce her working hours and as a result experienced decreased revenues, less patients and canceled appointments.

→ Click here to continue reading Podiatrist Receives Lump-Sum Buyout at Pre-Suit Mediation With Long-Term Disability Insurer

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Our client was an executive assistant for a leasing company who became disabled after developing fibromyalgia. In April 2007, she filed a claim with USAA Life, with whom she had taken out a personal long-term disability policy in 1995.

→ Click here to continue reading Executive Assistant Recieves Confidential Settlement From USAA Life For Long-Term Disability Policy

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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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