Product Analyst, Nancy W., 49, and her Arizona disability attorney filed a complaint in the United States District Court for the District of Arizona on October 26, 2011 against her employer Intel Corporation, Aetna Life Insurance Company and Reed Group (the administrator of Intel’s Aetna Plan) to force them to provide her with her entitled disability benefits per the terms and conditions of her employee disability insurance policy.

Citing ERISA (the Employee Retirement Insurance Security Act of 1974) violations and 29 U.S.C. § 1132(a)(1)(B) provision violations that the Defendants engaged in regarding Nancy W.’s disability claim, Nancy W.’s attorney petitioned the District Court to provide Nancy W. with:

  • A judgment in her favor against the Defendants;
  • Reinstatement of Nancy W.’s short term disability benefits and her long term disability benefits;
  • Prejudgment interest on any benefits accrued prior to the date of judgment;
  • Payment of Nancy W.’s disability benefits per the terms and conditions of her plan;
  • Attorneys’ fees; and
  • Any other relief she may be entitled to.

Arizona Claimant Denied Aetna Short Term Disability Benefits in 2007

Nancy W. became disabled in 2007 and applied for her short term disability benefits through her employee disability benefits plan. Nancy W. was denied continuing short term disability benefits in November 20, 2007 at which time she appealed the termination of those benefits and after exhausting all administrative appeals, filed a Complaint on May 20, 2010. Eventually, Nancy W. and her disability attorney voluntarily dismissed the complaint after the plan administrator Reed Group agreed to conduct supplemental review of Nancy W.’s claim. Reed Group upheld the earlier decision, Nancy W.’s disability benefits remain terminated, and Nancy W. filed suit again in the United States District Court of Arizona.

Background of Aetna Claimant’s Disabling Condition

The first termination of Nancy W.’s benefits occurred when two physicians indicated that Nancy W.’s previous blood pressure condition had stabilized and stated that her medical records "failed to show that the severity of her symptoms precluded her from performing job duties." Providing the insurer with contradicting medical records, Nancy W. challenged the two doctors’ opinions to no avail. So, Nancy W. applied for her long term disability benefits. Unfortunately, since her short term disability benefits had been terminated and Nancy W. had only used 183 days of her 364 days of short term disability benefits, she was disqualified from being eligible for long term disability benefits.

Lawyer Backs up Client’s Claim with Ample Case Law

Citing case law to back up Nancy W.’s claim, Nancy W.’s lawyer asks the District Court to consider that Aetna might have a conflict of interest in that the insurer not only provides the claimant’s employee insurance plan but is involved in the administrative decisions determining if a claimant has a legitimate claim as well. The pair allege that Aetna deliberating or negligently refused to comply with it obligation to inform claimants of why a claim decision was made denying benefits. They accuse Reed Group as an affiliate of Aetna of being negligent as well.

In the suit, Nancy W. and her disability lawyer ask the District Court to:

  • Enter a judgment in favor of Nancy W.;
  • Reinstate Nancy W.’s short term disability benefits and long term disability benefits retroactively to November 21, 2007;
  • Order Aetna to pay prejudgment interest on all owed benefit amounts accrued prior to the date of judgment;
  • Order the insurer to continue paying Nancy W. disability benefits per the plan;
  • Award Nancy W. attorneys’ fees; and
  • Provide Nancy W. with other relief she might be entitled to pursuant to Arizona law.

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.

Disability Blog & Cases:
CIGNA faces a lawsuit by American Homecare Supply Respiratory therapist for termination of disability benefits

In a December 2, 2011 lawsuit filed in the United States District Court for the Middle District of Pennsylvania, Sharon H. and her Pennsylvania disability attorney allege that CIGNA Group Insurance unjustly terminated Sharon H.’s disability benefits.

Disability Blog & Cases:
Long time Bank of America employee sues AETNA for denial of disability benefits

Filing a lawsuit under ERISA (the Employee Retirement Insurance Security Act of 1974) against AETNA, Leslie R, and her Arizona disability lawyer accuse the insurer of operating under a conflict of interest in the denial of Leslie R.’s short term disability benefits. As the decision maker and payor of benefits, AETNA has a bias toward denying benefits. And, according to Leslie R.’s disability lawyer in such incidents like Leslie R., the insurer is inclined to deny short term disability benefits in an effort to not have to follow through with long term disability benefits payments.

Disability Blog & Cases:
Sedgwick continues to deny disability benefits to AT&T employee

An AT&T employee recently shared her experience about dealing with Sedgwick for a short term disability claim. This story is a routine situation for people that are forced to deal with Sedgwick for the handling of their disability insurance claim.

 Cigna again finds itself in court over termination of entitled disability benefits. In the United States District Court of the Eastern District of Pennsylvania case Gena N. v. Liberty Insurance Company of North America a/k/a Cigna, Gina N. and her Pennsylvania disability attorney have appealed to the District Court to enter a judgment against the insurer for an award of her full and complete payment of long term disability benefits from the date of the termination of her long term disability benefits moving forward per the terms of her employee CIGNA plan, reasonable attorneys’ fees, costs and "expenses as permitted under ERISA, interest and any other equitable relief" the Court deems appropriate.

Office Manager Hires Disability Attorney to File Lawsuit against Cigna

Gina N. was employed at Drexel University College of Medicine as the Office Manager until February 7, 2003 when she ceased work as the result of a serious lower back injury which she sustained when she slipped and fell on ice in a parking lot. After intensive medical treatments and failed surgeries, Gina N. was forced to stop working, applied for her Cigna disability benefits, was awarded those benefits, and was awarded Social Security Disability Benefits. Then in January of 2009, some seven years later, Cigna terminated Gina N.’s disability benefits, basing its decision on its allegation that Gina N. "was not in compliance with the policy for failure to attend a scheduled Functional Capacity Evaluation (FCE), and by February 2010, Gina N. had exhausted all her administrative appeals forcing her to seek the assistance of a disability attorney to litigate her case.

Attorney Says Cigna was Arbitrary and Capricious in Denial of Disability Benefits

Charging Cigna with arbitrarily and capriciously terminating and denying her long term disability benefits, Gina N. and her disability attorney state that Gina N. had at all times sent medical documentation to the insurer as required, verifying her disabled condition. In addition, while Gina N. did miss one FCE appointment, she did undergo an FCE on November 17, 2009 and the test revealed that Gina N. did have limited movement and did suffer from back pain; the report did not, however, evaluate whether Gina N. had the "exertional capacity to re-engage in even a sedentary level position." In fact, Gina N. provided Cigna with this FCA report in one of her appeals to no avail. Gina N. and her attorney believe, and state in her complaint, that the insurer upheld its termination of Gina N.’s disability benefits on the exclusive opinion of a doctor from MLS Group of Companies, a peer review and report ordered by Cigna.

Doctor for Cigna Passed Judgment without Examining Claimant in Person

The doctor who evaluated Gina N.’s claim did not personally interview or evaluate Gina N.’s medical condition and, in fact, used a "standard form instruction sheet that it transmits to the physicians it selects and contracts with to conduct evaluations, which form is not contained in Cigna’s claim file," but which instructs evaluating physicians to "ignore subjective complaints" and limits the scope of any investigation. Gina N.’s attorney thus alleges that Gina N.’s assessment was "intentionally constrained" and that the assessment ignored her medical records and that the evaluation of "her condition was unfair, inappropriate, misleading, and did not constitute anything remotely resembling an ‘independent medical evaluation’."

In addition, Gina N. and her attorney allege that Cigna breached its disability insurance contract with Gina N. in violation of the Employee Retirement Insurance Security Act of 1974 (ERISA) by not providing a full and fair review of Gina N.’s claim. They allege that these violations entitle Gina N. to a judgment of wrongful denial on Gina N.’s claim, and seek to reinstate her long term benefits and compensation for attorneys’ fees and other damages to be determined by the District Court.

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.

Disability Blog & Cases:
Texas claimant takes Reliastar to task for denied disability benefits

Suffering from multiple medical conditions and unable to function in a daily job, a health care professional and her Texas disability lawyer filed a lawsuit against Reliastar Life Insurance Company to force the insurer to pay disability benefits as contracted in an employee welfare benefit plan.

Disability Blog & Cases:
Wells Fargo disability claimants in Alabama and Florida file lawsuits against Liberty Life Assurance Company of Boston for unpaid long term disability benefits

Wells Fargo disability claimants in Alabama and Florida file lawsuits against Liberty Life Assurance Company of Boston for unpaid long term disability benefits

Recently, two Wells Fargo employees were forced to file Federal Lawsuist against Liberty Life after being denied disability benefits. Utilizing the services of an Alabama Disability Attorney and a Florida Disability Lawyer, the two lawsuits are currently pending. Let’s take a closer look at both cases:

Disability Blog & Cases:
Tempur employee suffering from chronic fatigue syndrome sues Union Central Life for denial of disability benefits

A federal lawsuit was recently filed in the U.S. District Court in Pennsylvania against the Union Central Life Insurance Company (Union) by a Pennsylvania disability attorney. The Plaintiff, Janet G., worked as a Direct Sales Supervisor for Tempur World, Inc. (Tempur). Due to her employment at Tempur, Janet was provided long-term disability insurance with Union Central.

An Alabama Claimant and her Alabama disability attorney filed suit against Liberty Life Assurance in the United States District Court for the Northern District of Alabama Northeastern Division. A former DIRECTV Group, Inc. employee, Juarlesa W. worked as a customer service representative and was fully vested in her company’s Liberty Life Insurance Plan when she became disabled in January 2010.

Suffering from the "combined effects of several impairments, including cervical/lumbar degenerative disc disease, lumbar/cervical radiculitis, osteoarthritis, fibromyalgia, degenerative joint disease of the right shoulder, chronic pain syndrome, post-op knee arthropathy, hypertension, GERD, migraines, restless leg syndrome, and insomnia," Juarlesa W. and her disability attorney filed suit against the insurer on November 7, 2011 for denial of Juarlesa W.’s long term disability benefits.

Background of Alabama Claimant’s Suit against Liberty Life

Approved for her short term disability benefits by Liberty Life, Juarlesa W. has an issue with only the denial of her long term disability benefits. After her short-term disability benefits expired, Liberty life began paying Juarlesa W. her long-term disability payments, but arbitrarily decided to terminate those payments in September 2010. The insurer asked for further information from Juarlesa W.’ treating physician to further evaluate her disability claim. In response, Juarlesa W.’s treating physician submitted a letter in November 2010, confirming that Juarlesa W.’s condition remained the same, meaning the same as when Liberty Life approved Juarlesa W.’s disability claim and paid her disability benefits.

Ignoring Juarlesa W.’s physician’s opinion as well as the insurer’s own physician consultant, Liberty Life continues to stand by their opinion that Juarlesa W.’s is not disabled and denies her further disability benefits. According to the complaint filed by Juarlesa W.’s disability attorney, "Liberty Life redid its prior decision concluding that [Juarlesa W.] was no longer disabled for the very same reasons it previously approved her claim." In addition, the insurer has not provided any other evidence that would indicate that Juarlesa W. is not disabled. After appealing and losing all administrative challenges to Liberty Life’s decision to terminate her long term disability benefits, Juarlesa W. hired a disability attorney to litigate her claim in District Court.

Disability Attorney States Case against Liberty Life

Offering up Juarlesa W.’s lengthy medical history as well as the opinions of her treating physician and Liberty Life’s own evaluating physician, Juarlesa W.’s attorney claims that Liberty Life wrongfully terminated Juarlesa W.’s disability benefits in violation of the Employee Retirement Insurance Security Act of 1974 (ERISA) as well as in violation of Liberty Life’s own policies. Consequently, Juarlesa W. and her disability attorney ask the District Court to:

  • Review her disability benefits claim with Liberty Life;
  • Award her all past due long-term disability benefits to which she is entitled;
  • Reinstate Juarlesa W.’s claim to all present and future long-term disability benefits under her plan;
  • Award her attorney’s fees;
  • Award Juarlesa W. interest on all past due disability benefits; and
  • Further relief as is proper and just.

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.

Disability Blog & Cases:
At least five lawsuits were recently filed in Florida District Courts against Prudential for non-payment of disability benefits to deserving claimants

With at least five suits filed against them in July for denying disability benefits, Prudential Insurance Company of America has a lot of unhappy claimants in Florida.

Disability Blog & Cases:
California Consultant sues Northwestern Life Insurance Company for unpaid disability benefits

Northwestern Insurance beneficiary Todd W. and his California disability attorney‘s complaint against the insurer accuses Northwestern of breach of the Duty of Good Faith and Fair Dealing and Breach of Contract in response to its denial of Todd W.’s disability benefits.

Disability Blog & Cases:
Duke University Doctor sues UNUM Life Insurance Company for long term disability benefits

Dr. Karen M. and her North Carolina disability attorney filed a lawsuit against UNUM in the United Stated District Court for the Eastern District of North Carolina to acquire her long term disability benefits. The beneficiary of disability benefits under a plan provided through her employer Private Diagnostic Clinic PLLC at Duke University Medical Center, Dr. Karen ceased working as a general practitioner on February 23, 2007.

Wanda N. and her North Carolina disability attorney filed a lawsuit in the United States District Court for the Eastern District of North Carolina Western Division, claiming that Liberty Life wrongfully terminated Wanda N.’s long term disability benefits in violation of the Employee Retirement Insurance Security Act of 1974 (ERISA) and other federal statutes.

In the suit, Wanda N.’s disability attorney petitions the District Court to rule in favor of Wanda N. by:

  • Passing judgment against Liberty Life and obligating the insurer to pay Wanda N. her entitled disability income benefits from December 30, 2010 through the date of the judgment, plus pre-judgment interest;
  • Passing judgment against Liberty Life and obligating the insurer to fulfill its future obligations to pay Wanda N. her monthly disability income benefits as long as she is eligible to receive them under the terms of her policy;
  • Awarding Wanda N. attorney’s fees and court costs at the discretion of the court; and
  • Providing Wanda N. with any other "relief as the Court deems just and proper."

Claimant’s Disability Benefits are Terminated by Liberty Life in Violation of ERISA

As an employee at Kidde Aerospace & Defense, a subsidiary of United Technologies Corporation, Wanda N. was enrolled in her employer’s insurance policy benefit plan when she became disabled due to back pain in February of 2010. After receiving her short term disability benefits for six months and being approved for her long-term disability benefits in August 2010, Wanda N. discovered that her disability benefits would be terminated in December 2010. Apparently, the insurer concluded that Wanda N. was no longer disabled and believed that the previous evidence it had of Wanda N.’s disabled condition "no longer supported [Wanda N.’s] claim." On appeal of this decision, Wanda N. was denied.

Disability Attorney Presents Claimant’s Case in Their Complaint

A Floater at Kidde Aerospace, Wanda N. "performed various jobs when co-workers were absent from work or when additional workers were required for a particular job." Prior to her work stoppage, Wanda N. had a two-year history of "lower back pain radiating into her buttocks and legs, with numbness and tingling in her buttocks and thighs." Wanda N. underwent surgery in an effort to relief her back problem in March 2010, with some improvement of her condition, but no complete resolution. On various medication and attending to her healing process through physical therapy, Wanda N. received short-term disability benefits from Liberty life through August of 2010. Still recuperating, Wanda N. then applied for long term disability benefits, provided the insurer with her a completed Physical Job Evaluation Form, and Liberty Life approved her long term disability claim with plans to re-evaluate her situation in November 2010.

In November, a Liberty Life physician, in dispute with Wanda N.’s treating physician, determined that Wanda N. could perform light-duty work. Unfortunately, the Liberty life physician ignored Wanda N.’s medical records, which explicitly described how much pain Wanda N. was in and that her activity level potential was far short of the requirements of her position at Kidde Aerospace. In response Wanda N. "submitted a one-page appeal to Liberty Life in January 2011" and "advised Liberty Life that she could not sit up straight in a chair, could not sit for more than 15 minutes at a time without pain, could not stand for more than 10 minutes without pain, could not bend over, she laid down in the afternoons with a heating pad to help with the pain, she was currently on Zanaflex, Vicodin, Neurontin and Mobic, she was not allowed to drive a car due to the medication she was taking, and she remained under the care of" two doctors.

After another Liberty Life physician concluded that Wanda N. could work, Liberty Life again denied Wanda N.’s appeals resulting in Wanda N. hiring a disability lawyer to fight for her disability benefits in District Court. 

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.

Disability Blog & Cases:
Question writer for Jeopardy/Sony Pictures files suit against Prudential

A California disability attorney and his client filed suit against The Prudential Insurance Company of America (Prudential) in the United States District Court Central District of California on October 28, 2011 for unpaid long term disability payments due per the terms of an employee disability insurance plan.

Disability Blog & Cases:
CIGNA under fire in Minnesota Federal Court for termination of claimant’s disability benefits

Beverly S. and her Minnesota disability attorney filed a lawsuit against CIGNA in the United States District Court for the District of Minnesota in an effort to procure her entitled disability benefits.

Disability Blog & Cases:
Electrical assembly worker for Northrop Grumman files a complaint against UNUM for denial of long term disability benefits

Fifty-nine-year old, former Northrop Grumman Corporation employee Rita L. and her Utah disability lawyer filed suit against UNUM Life Insurance Company and her employer in Federal Court in Utah. Claiming that the UNUM Plan Administrator erroneously denied Rita her disability benefits, the complaint asks the District Court to right this wrong.

On November 10, 2011, Liberty Life Assurance Company of Boston claimant, Dana E., and his California disability lawyer filed a complaint against the insurer in the United States District Court for the Northern District of California under the Employee Retirement Income Security Act of 1974 (ERISA) and 29 USC § 1132(a)(1)(B) in an effort to force the insurer to release his entitled disability benefits.

Dana E., age 55, was a Senior Local Sales Account Executive for Comcast, when he ceased working in compliance with his doctor’s recommendation on July 25, 2009. At the time, Dana E. was suffering from fatigue, joint pain, skin lesions and photosensitivity caused by Lupus. Lupus, a chronic inflammatory disease, causes its victims immune system to attack healthy tissue that results in multiple debilitating symptoms.

Claimant and Disability Attorney File Complaint in California District Court after Denial of Disability Benefits on Appeal

As confirmed by his treating rheumatologists, Dana E. was disabled from performing the duties of his occupation in August 2009. Needing periodic rest due to fatigue and pain management, Dana E. became extremely limited in his daily activities and was unable to work the long hours of sitting at a desk that his Comcast position required. A Liberty life employee policy holder, Dana E. applied for longer term disability benefits, providing the insurer with sufficient medical corroboration of his disabled condition in addition to the recommendations from his treating physicians of his disabled condition. Dana E. received long term disability benefits until July 2011, at which time Liberty Life denied him further benefits. On appeal, the insurer continues to deny Dana E.’s claim, leading to the hiring by Dana E. of a disability lawyer to claim his entitled Liberty Life disability benefits.

Liberty Life Accused of Breach of Its Obligation to California Claimant

In the complaint, Dana E.’s disability lawyer alleges that Liberty life "breached its obligation under the long term disability plan by denying coverage for [Dana E.’s] disability payments" when he clearly meet s the requirements of eligibility. In the complaint, it is asserted that Liberty Life "arbitrarily and unreasonable relied on retained consultants” opinions as opposed to [Dana E.’s] own treating doctors" when deciding to discontinue Dana E.’s disability benefits. Forced to retain the services of a disability lawyer to protect his rights, Dana E. and his attorney petition the District Court to rule against Liberty Life and provide compensatory damages, costs of suit, reasonable attorney fees, prejudgment interest on all back benefits, and "such other and further relief as the court may deem 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.

Disability Blog & Cases:
Office Depot employee files suit against employer and Aetna for unpaid disability benefits

An Office Depot employee and her Georgia disability attorney filed suit against her employer and Aetna Life Insurance for unpaid disability benefits on November 3, 2011 in the United States District Court for the Northern District of Georgia Atlanta Division.

Disability Blog & Cases:
New Jersey BankUnited employee files suit against Lincoln National

Robert B. and his New Jersey disability lawyer go to battle against The Lincoln National Life Insurance Company to retrieve Robert B.’s entitled disability benefits as promised in his employee disability benefits plan.

Disability Blog & Cases:
New Jersey claimant files suit against New York Life, Unum and Paul Revere for miscalculated disability benefits

William M. never suspected that should he need to make use of his disability insurance policy (which he had faithfully paid premiums on for years) that the promised disability benefits would be denied him when he needed them most.

A sales representative for Long Forms, Inc., President and part owner of Advanced Transportation Systems, Inc. and The Institute of Logistical Management as well as an hourly employee of Temple University as a Criminal Justice instructor, William was diagnosed with Hodgkin’s’ Lymphoma in 1997. Between January 1997 and February 1998, William underwent surgeries, biopsies, chemotherapy, and radiation to combat the progression of the disease.