The plaintiff Laura Schlitt worked as a Regional Marketing Director for Camden Property Trust. She was a participant to a group Prudential disability insurance policy which was fully insured and administered by Prudential by virtue of her employment with Camden Property Trust.
Disability Benefits Application with Prudential
On January 8th 2010, the plaintiff became disabled under the term of the policy and was unable to perform the duties required of her occupation. According to the lawsuit, the plaintiff applied for short term disability benefits which were paid in full. Upon the expiry of her short term disability benefits, the plaintiff applied for long term disability benefits and was notified by Prudential on June 14th 2010 that she was approved for long term disability benefits for the period of April 9, 2010 through May 31, 2010.
Prudential Denies Long Term Disability Benefits and Arizona Attorney Files Suit
In the June 14th 2010 letter, the plaintiff was also informed that Prudential was terminating her disability benefits beyond June 1st 2010 as there was a lack of medical documentation supporting her inability to return to her regular occupation. In response, the plaintiff appealed the decision to deny her claim for long term disability benefits on July 25th 2010. To support her appeal, she submitted additional medical evidence to Prudential.
During the ERISA appeal, Prudential had a review done on the plaintiff’s medical record by a consulting physician from MES Solution. According to the lawsuit, the plaintiff stated that the review done was based on selective review of the evidence and ignored evidence in order to provide opinions or reports which supported the denial of claim. Hence, on August 27th 2010, Prudential informed the plaintiff that it was upholding its prior decision to terminate the plaintiff’s disability benefits beyond June 1st 2010.
The plaintiff made a second appeal to Prudential on February 18th 2011. Again, to support her appeal, the plaintiff submitted additional medical evidence including a Functional Capacity Evaluation (FCE) that indicated "inability to perform tasks, even at the sedentary work level, due to her restrictions and limitations".
Another "paper review" was done by Prudential and the plaintiff was notified by Prudential on May 13th 2011 that it was denying her appeal. At the same time, Prudential also informed the plaintiff that she had exhausted her administrative appeals and could file a civil action lawsuit in federal court pursuant to ERISA.
Arizona Disability Lawyer Files Lawsuit Against Prudential
In the case of Laura Schlitt vs. Prudential Insurance Company of America, Camden Property Trust, Camden Property Trust Employee Disability Plan filed at the District Court for the District of Arizona, the plaintiff alleged that the Prudential Insurance Company of America (Prudential) was denied her claim for long term disability benefits in order to save itself money in the long run.
The plaintiff alleged in the lawsuit that:
- Prudential failed to adequately investigate the Plaintiff’s case and failed to engage the Plaintiff and her treating physician in a dialogue during the appeal of her claim with regard to what evidence was necessary so the Plaintiff could perfect her appeal and claim.
- Prudential denied the Plaintiff a lawful, full and fair review pursuant to ERISA for various reasons by:
- Failing to consider all evidence submitted by Plaintiff or de-emphasizing the medical evidence supporting Plaintiff’s disability.
- Disregarding Plaintiff’s self-reported symptoms.
- Failing to consider all the diagnoses and limitations set forth in her medical evidence as well as the combination of those diagnoses and impairments.
- Failing to obtain an Independent Medical Examination when the policy allowed for one.
- Failing to engage Plaintiff in a dialogue so she could submit the necessary evidence to perfect her claim.
- Failing to consider the impact the side effects from Plaintiff’s medications would have on her ability to engage in any occupation.
Relief Sought By The Plaintiff
In the lawsuit, the plaintiff stated that she is seeking from the Court the following relief:
- An Order requiring Prudential to pay the plaintiff disability benefits and any other employee benefits she may be entitled to as a result of being found disabled pursuant to the policy or Plan retrospectively.
- A finding that the plaintiff meets the definition of disability set forth in the relevant Prudential policy and directing Prudential to continue paying the Plaintiff the disability benefits until such time she meets the conditions for termination of the benefits.
- An award for attorney’s fees and costs.
- An award for such other and further relief as the Court deems just and proper.
About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.