United States District Court

Aside from the fact that many disability insurance companies already have a conflict of interest for being both the administrator of benefits and the entity that decides whether or not an employee qualifies for disability insurance, there are some cases in which it appears that insurance companies simply decide they don’t want to pay disability benefits.
Continue Reading Texas Court Reverses Hartford’s Unreasonable Denial Of Disability Benefits To A Hospital Employee

Alvin Hintz was an employee of CCL Custom Manufacturing, Inc. as Director of Information Systems for more than a decade. The company was purchased prior to Hintz’s termination, by KIK Custom Products, Inc. On August 8, 2005, Hintz was terminated along with eight other employees. In the separation agreement, there was a ‘general release of claims’ that Hintz signed. The long term disability plan was administrated by Prudential.
Continue Reading After Denial Of Long-Term Disability Benefits, Director Disabled By Heart Disease Takes Prudential To Illinois Court

Donna Blake was an employee of Express Scripts, covered under both a long term disability plan and a short term disability plan, when she applied and was denied for short term disability coverage. After internal appeals, Mrs. Blake brought her claim to the United States District Court, Missouri Eastern Division. Upon the settlement of Mrs. Blake’s claim for short term disability, she claimed that she would be prevented from filing for long term benefits, because the denial of her short term disability claim, “prevented her from applying for LTD benefits from the LTD Plan, as she was required to satisfy the applicable period of STD before becoming eligible for LTD benefits.”
Continue Reading MetLife’s Motion To Dismiss Long-Term Disability Claim For Failure to Exhaust Administrative Remedies Is Denied By Missouri Court

Walter Pettway was employed with ADP (NASDAQ: ADP), as a principal consultant, beginning in 1994. Mr. Pettway’s job required him to travel the United States helping large corporations with computer processes. In the 1970’s, Mr. Pettway had undergone a cervical fusion at the C6-7 level and at the C5-6 level in 1999. In the summer of 2002, Mr. Pettway suffered a fall which aggravated his condition, so that he experienced issues with his neck, lower back, left arm, right and left leg weakness and numbness in his fingers.
Continue Reading Mississippi Court Orders Prudential To Pay Long-Term Disability Benefits To A Computer Consultant

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.
Continue Reading Conneticut Court Rules Against Prudential After They Fail To Recognize Pain Caused By Fibromyalgia As A Long Term Disability

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.
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