On August 24, 2011, a pre-screener for the Detroit Area Agency on Aging (DAAA) and her disability lawyer filed a lawsuit against Prudential Insurance Company of America in the United States District Court for the Western District of Wisconsin. According to their complaint, Della Davis and her Wisconsin disability lawyer allege that the insurer owes Davis:
- An acknowledgment of her disabled condition;
- Damages for losses of her benefits pursuant to her disability insurance plan with Prudential and the Employee Retirement Income Security Act of 1974 (ERISA);
- Reimbursement for costs, disbursements, prejudgment interest, actual attorney’s fees and expert witness fees incurred in the prosecution of her claim; and
- Any other relief the Court "deems just and equitable."
Claimant Designated as Disabled by SSA
An employee covered by an employee insurance policy administered by Prudential for her employer the Detroit Area Agency on Aging, Davis worked at the DAAA from 2001 through 2006 when she succumbed to her medical conditions, ceased working and applied for her Prudential disability benefits. With years of documentation of her various ailments, Davis was awarded her claim. Initially receiving her entitled disability benefits, Davis was declared disabled by the Social Security Administration and awarded Social Security Income Disability Benefits (SSDB) retroactive until September 2006. Prudential, promptly, required Davis to repay the $1,310.28 in over-payment of benefits to correlate with her SSDB, which she complied with.
Filing of Lawsuit against Prudential in United States District Court of Wisconsin
Then, shortly afterward the SSDB award and over-payment notification, Prudential scheduled Davis to participate in an Independent Medical Evaluation (IME) in which the evaluating doctor stated that "there were no objective findings to support [Davis’] inability to perform activities." With reams and reams of medical documentation, doctor’s letters, proof of surgery, and therapy, Davis found herself without disability benefits and without a premium life insurance waiver from Prudential when the insurer discontinued her disability benefits payments. Diagnosed with and treated for "cervical radiculopathjy, cervicalgia, herniated disks, degenerative disc disease, spondylosis and osteoarthritis, forminal stenosis, chronic thoracolumbar strain, degenerative changes in the lumbosacral spin, fibromyalgia, bilateral carpal tunnel syndrome (‘CTS’), right shoulder pain with impingement syndrome, deltoid atrophy, arthritis of the left knee, sleep apnea, chronic fatigue syndrome, vertigo/imbalance disorder, and thoracic outlet syndrome," Davis had no other option but to file a lawsuit against Prudential to attempt to retrieve her disability benefits.
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.