Corporate executive working in the banking industry was denied benefits by MassMutual for nearly two years. He suffered from multiple orthopedic conditions in addition to chronic pain. After hiring a national law firm, the other firm was unsuccessful in obtaining disability benefits over the course of a year and a half. Afterwards, he hired us and was paid over $800K in back benefits with total benefits paid in the amount of nearly $3M.
Account manager for a major accounting firm suffered from a failed back syndrome causing chronic pain. Metlife refused to pay her disability benefits. Her benefits were reinstated in full with over $200K in a settlement of back benefits paid with current full disability payments continuing thereafter.
A radio frequency engineer for a communications company was denied benefits although he suffered from a bad back. Unum utilized mischaracterized videosurveillance and phony in-house medical reviews to deny the disability benefits claim. The client let his claim be denied and took no action. We were able to re-open his claim as part of the Multistate Settlement against Unum and he was paid nearly $200K in back benefits with continuing benefits paid thereafter.
A nurse suffered from obesity and underwent gastric bypass (bariatric) surgery which resulted in an overtightening of her stomach causing her to slowly starve to death. She was insured by Aetna for accidental death benefits. Aetna refused to pay stating that the victim had died over a year after the surgery which was the initiating incident. This case resulted in a lawsuit with the court finding that the continuing malpractice by the treating physician in failing to act to repair the botched surgery were additional acts and resulted in payment of the claim.
A stock broker suffering from fibromyalgia and orthostatic hypotension was denied disability benefits by MassMutual on multiple occasions and even recruitment of a reknown neuropsychologist to accuse the client of malingering. The expert was throughly debunked by his own test results and comments made in his own medical articles. The case was paid in full with the claimant to receive in excess of $2M.
A thirty-two year old man suffered from a very serious heart condition including a recent heart attack. Unum denied the claim by mischaracterizing test results and misclassifying his occupation which was much higher in exertion than the insurer claimed. Benefits were resinstated in full.
A forty year old computer analyst who suffers from adult sickle cell anemia was denied disability benefits by Metlife who ignored the findings of the treating physician. After demonstrating disability via a series of tests and medical literature supporting the symptoms suffered, the insurer relented and paid full benefits.
A forty year old nurse coordinator suffering from fibromyalgia was denied disability benefits by Sun Life who attempted to discount her condition and mischaracterize her work activities. Corrective evidence and new testing resulted in a payment of benefits.
A forty-two year old managing editor at a university became disabled due to chronic fatigue syndrome and fibromyalgia. Liberty Life denied her claim by discounting her medical conditions and inventing functional capacities of which she was not capable. This matter was appealed and resulted in full payment of disability benefits.
A corporate reorganization specialist with a chronic low back condition with multiple disc herniations was denied benefits by Unum who enlisted the support of its in-house medical reviewers to create medical and functional capacity evidence on which to base a denial of claims. This matter required a large scale effort to “debunk” the insurer’s efforts, ultimately resulting in a large settlement of the claim.
A young attorney with multiple cervical and lumbar disc conditions with surgery was denied disability benefits by The Hartford. The denial failed to recognize the nature of her chronic pain condition and the combined effect of Ehlers-Danlos Syndrome on her conditions and the consequential reduction in functional capacity. Following the administrative appeal, full benefits were paid.
A computer store manager suffered a stroke and was denied disability benefits by Prudential. The insurer went so far as to characterize the client’s remaining ability to operate a motor vehicle as evidence that he could perform work despite serious cognitive deficits and residual physical weakness from the stroke. Full benefits were paid on this claim.
A fifty-nine year old podiatric surgeon with a well-documented heart condition was denied disability benefits by Unum. By conducting functional testing and undertaking thorough medical research, the appeal was successful in obtaining his benefits.
A former auditor became disabled as a result of a severe stroke which incapacitated her both mentally and physically. Rather then deny the claim on the basis that her condition did not impair the client substantially, the insurer, GE Capital, chose to deny the disability claim on the basis of a preexisting condition; namely, high blood pressure. Additional information was submitted demonstrating the high blood pressure had been under control for a number of years and there were dozens of other causes for a stroke. GE Capital did not relent until a lawsuit was filed and settled favorably.
A psychologist was denied benefits by Unum as it discounted the effects of his post-polio syndrome. Following successful appeal, Unum offered a very favorable buy out the entire policy.
A information security system specialist became disabled due to the effects of post-polio syndrome. CNA (now part of The Hartford) denied benefits relying on a poorly developed claim file. Extensive medical reporting and literature were gathered in addition to functional capacity evidence which resulted in payment of the disability claim in full.
A thirty-two year old with polyglandular autoimmune syndrome and carnitine deficiency was denied disability benefits by The Hartford. The medical reviewers showed no understanding of the severity of the client’s condition. Even worse, the claims analyst attempted to coerce the treating physicians to make findings against the client. None of this was successful with disability benefits paid in full.
A computer systems engineer was denied disability benefits by Aetna for failing to demonstrate disability due to his medical condition. This client suffers from Glanzmann’s thrombocytopenia and chronic ankle malalignment, both of which were ignored by the insurer until better brought to their attention. The insurer denied the claim a second time which another successful appeal made with continuing benefits paid.
A pharmacist suffering from the effects of a liver transplant including fatigue, chronic pain and diarrhea in addition to the avascular necrosis of the hip was denied disability benefits by Cigna. Even after the profound cognitive effects of Claimant’s medication regimen and physical functioning deficits were brought to light, the insurer would not relent. A lawsuit was filed with a favorable settlement for the client.
A former salesman was denied disability benefits by Cigna on multiple occasions although he was afflicted with a serious low back condition. Cigna would initially relented in its denial following evidence of bladder incontinence and use of many household assistive devices. After some time, Cigna denied the case again which required a lawsuit in order to arrive at a favorable settlement.