Administrative Appeal by Dell Disability Lawyers forces Principal to Reinstate ERISA Long Term Disability Claim of Former Healthways, Inc. Employee

After being forced to stop working in 2007 due to various disabling conditions, an employee of Healthways, Inc., who was employed as a Member Care Manager, filed for Long Term Disability Benefits under a policy provided by her employer that was through the Principal Life Insurance Company.

Shortly after applying for LTD benefits, by way of an approval letter dated October 23, 2007, Principal agreed that the Member Care Manager satisfied the terms of the policy and found her to be disabled. Principal commenced payment of LTD benefits effectively on October 20, 2007, after the full completion of Short Term Disability benefits, which were also approved by Principal. The Member Care Manager received LTD benefits from that time and until September 24, 2014.

Unfortunately for the former Healthways employee, such benefits were terminated as of September 24, 2014. By way of a denial letter dated September 30, 2014, Principal informed her that it had “determined that (she was) no longer eligible for (LTD) benefits.” In support of its determination, Principal relied upon an Independent Medical Examination it had commissioned and performed on August 27, 2014. Principal also relied upon Attending Physician Forms completed by her own treating physicians. Principal used this information and concluded that the “restrictions provided by (her doctors) and the IME physician would allow you to perform a sedentary level occupation.” Principal also stated that the “IME did not provide any restrictions for fine manipulation or simple grasping. It also noted that you can continuously reach below your shoulder. It goes on to state that you can occasionally keyboard and use a mouse.” Principal then concluded that with “these restrictions, you are capable of performing the Substantial and Material Duties of your Own Occupation.”

After receiving this denial letter, the former Member Care Manager for Healthways found Attorney Alexander Palamara at Dell Disability Lawyers. After listening to her and reviewing the denial letter, Attorney Palamara knew that Principal had made an incorrect decision in denying the claim of a 60 year old woman who had been on claim for the previous 7 years and who was suffering from so many serious health conditions. Her conditions included: Chronic Pain, Diffuse Arthralgias, Fibromyalgia, Chronic Fatigue, Rheumatoid Arthritis, Osteoarthritis of the Right Shoulder Joint, Neck Pain, Cervicalgia, Cervical Spine Degenerative Disc Disease, Scoliosis, Lordosis, Bilateral Shoulder Pain, Left Clavicular Joint Separation, Right Shoulder Tendonitis, Back Pain, Spinal Stenosis, Lumbar Spine Degenerative Disc Disease, Lumbago, Bilateral Knee Pain, Bilateral Hand Pain, Bilateral Hip Pain, Bilateral Paresthesia of both Upper and Lower Extremities, Bilateral Carpal Tunnel Syndrome, Left CMC Joint Effusion, Peripheral Neuropathy, Asthma, Shortness of Breath, Granulomatous Disease in the Lungs, Sinusitis, Pure Hyperglyceridemia, Migraines, Insomnia, Urinary Tract Infections, Esophageal Reflux Disease, Vitamin D Deficiency, Myopia, Anxiety and Attention Deficit Disease. Bilateral Parathesisa of both Upper and Lower Extremetries.

Review of the Claim and the Filing of the Administrative Appeal

Shortly after taking on the case, Attorney Palamara received Principal’s entire file which included the Independent Medical Examination report which Principal heavily relied upon to deny the woman’s claim. A review of this report actually showed that Principal’s hired doctor was very supportive that our now client was actually prevented from working. This doctor clearly stated such when he responded to the Principal’s question as to whether there were “any restrictions/limitations applicable which would prevent her from working currently.” The doctor simply acknowledged “Yes.” This doctor who was paid by Principal went further and stated “It is my opinion that there would be very little if any improvement in her condition and very little recovery over time. The rheumatoid arthritis and her conditions of degenerative disc noted on her lumbar x-ray perhaps maybe progressive in nature and therefore little to no improvement in her current functionality is anticipated.”

Additionally, Attorney Palamara also had a chance to review all of the updated medical records as well as those previously provided to Principal. It quickly became crystal clear that Principal’s decision was blatantly wrong and arbitrary and capricious. A timely and proper appeal was filed before the ERISA imposed 180 day deadline. This appeal showed that Principal was arbitrarily picking one liners from its IME report as well as one liners from our client’s medical records. Unfortunately for Principal, this form of review is very improper and it allowed the appeal to tear into and disprove Principal’s earlier conclusions.

Within 60 days of the filing of the administrative appeal, Principal contacted our office and informed us that it was reinstating our client’s claim for disability benefits. It has since paid all back benefits owed and is continuing to pay all monthly benefits timely. We do not foresee Principal denying this claim yet again and we foresee our client receiving full benefits until the policy ends at age 66, her normal social security retirement age.

It is unfortunate that our client had to suffer months without her rightfully owed benefits. However, we are pleased to have taken on her fight and gotten her back on claim. Our client rests assured that Principal will not again play games with her claim as they know that we continue to represent her and will do whatever it takes to keep her on claim.

If you have been denied disability benefits by Principal Life or any other disability insurance provider, please do not hesitate to contact Attorney Alexander Palamara at Dell Disability Lawyers for a free consultation.


Did you find this helpful?
Unhelpful (0)

Resources to Help You Win Disability Benefits

Disability Benefit Denial Options
Submit a Strong Appeal Package

We work with you, your doctors, and other experts to submit a very strong appeal.

Learn more

Sue Your Disability Insurance Company

We have filed thousands of disability denial lawsuits in federal Courts nationwide.

Learn more

Protect Your Benefits
Get Your Disability Application Approved
We help claimants throughout the entire application process.

Learn more

Prevent a Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.

Learn more

Negotiate a Lump-Sum Settlement

Our goal is to negotiate the highest possible buyout of your long-term disability policy.

Learn more

Principal Reviews
(642)

Policy Holder Rating

1.6 out of 5
Read 16 reviews
0%would recommend
5
0%
4
0%
3
0%
2
56%
1
43%
Timely Payments
2.3out of 5
Handling Claim
1.8out of 5
Customer Service
1.8out of 5
Dependable
2.0out of 5
Value
2.0out of 5
Showing 8 of 642 Reviews
Principal

Sorry, Principal. My residual and renewal commissions aren't "earned"

Reviewed by Ron on August 24th 2020   Verified Policyholder
(CAPS are added by me for emphasis:) I am a self-employed insurance broker working only on commissions. I was disabled due to surgeries and received some income replacemen... read more >
Reply
Sent on August 24th 2020 by Attorney Rachel Alters

Ron: You certainly can challenge Principal’s interpretation of the various provisions at issue through an appeal, if you have not already.

Principal

Principal will do anything not to pay

Reviewed by George on October 7th 2018   Verified Policyholder
Hello, I’m writing this on behalf of my wife. Her vision has degraded to the point that she no longer is able to see a pc screen without extreme headaches within a few m... read more >
Reply
Sent on October 7th 2018 by Attorney Gregory Dell

George, it sounds like your wife is a victim to the very common 24-month denial. It is unfortunate that Principal will not accept the opinions of the numerous doctors w... read more >

Principal

Principal is absolutely ridiculous. I'm in financial harship after not receibing my full pay from work and exhausting my long term sick

Reviewed by Michelle P. on December 19th 2017   Verified Policyholder
I was placed on medical leave after suffering from vertigo and later diagnosed with Meniere’s Disease. I was put on Meclizine and Klonopin and Prednisone. During these e... read more >
Reply
Sent on December 19th 2017 by Attorney Stephen Jessup

Michelle, will your ENT complete the applicable Attending Physician’s Statement? The APS will allow the doctor to place all restrictions and limitations he/she is imp... read more >

Principal

Principal owes me 60k

Reviewed by Daniel S. on March 15th 2017   Verified Policyholder
I had a lawyer for my long term disability claim but they wouldn’t sue them for me because the company I worked for sent them a letter saying I didn’t work but 3 hrs a... read more >
Reply
Sent on March 15th 2017 by Attorney Stephen Jessup

Daniel, we would need to see copies off your denial letters and your policy to determine how we may be able to assist you.

Principal

I lost everything when Principal terminated my benefits without calling or emailing me

Reviewed by Ray T. on September 22nd 2016   Verified Policyholder
I went on short term disability August 1st of 2013 I had to get my left thumb total reconstructed. After 6 months of short-term I went on long-term. My company told me I h... read more >
Reply
Sent on September 22nd 2016 by Attorney Stephen Jessup

Ray, have you received a formal denial letter denying the benefit? If the initial denial occurred in October 2015, there are concerns as to time expiring to file an adm... read more >

Principal

I cant but feel I am being starved out and given the runaround.

Reviewed by Christopher on June 7th 2016   Verified Policyholder
I went off of work may 29, 2015, with a blood clot in my leg. I have had vein surgeries in the past to alleviate pain and discomfort, all of which I took vacation on a Fri... read more >
Reply
Sent on June 7th 2016 by Attorney Stephen Jessup

Christopher, I am not sure the reason for the proof of good health- was this from a different department? If the claim is already in appeal review then there would be l... read more >

Principal

Principal owes me 4k

Reviewed by Louann W. on April 28th 2016   Verified Policyholder
Purchased short term disability through my employer with this group. I’ve been out of work since 2/29/16. Haven’t received the first pay. Contract is I’m supposed to... read more >
Reply
Sent on April 28th 2016 by Attorney Stephen Jessup

Louann, if they uphold the denial of your claim on appeal please feel free to contact our office to discuss what your rights/next steps are. Hopefully they will not nee... read more >

Principal

I've never worked with people that are so obviously stalling before. Bunch of crooks

Reviewed by Mike on March 2nd 2016   Verified Policyholder
I have been disabled for over 10 weeks and Principle kept saying the forms incomplete so they needed all the medical records from my doctor, including office notes. After ... read more >
Reply
Sent on March 2nd 2016 by Attorney Rachel Alters

Mike, is this a policy you purchased on your own? From what you’re saying it seems that they are investigating to determine whether or not there are grounds to rescin... read more >

Answered Questions by Our Lawyers
(25)
Showing 8 of 25 Answered Questions

Q: Can Principal deduct my social security payment from my monthly Principal disability benefit payment?

Answered on March 30th 2023 by Attorney Gregory Dell
A: Does you disability policy say social security retirement is deductible? If it does then they are allowed to d... Read More >

Q: Why did Principal not back me when Social Security did?

Answered on August 21st 2020 by Attorney Alex Palamara
A: Durron, I am sorry to hear that your LTD claim was denied. While there are different standards for approving L... Read More >

Q: What is the difference between time period of the claim while approved and the time period of the claim while denied?

Answered on August 14th 2020 by Attorney Alex Palamara
A: Mark, please gather all the correspondence concerning your claim and please contact us for a free consultation... Read More >

Q: Will Principal harass me if I don't accept their buyout? And, is it standard for a buyout to be lower than the full benefit paid over time?

Answered on July 17th 2018 by Attorney Stephen Jessup
A: Jan, I have not experienced retaliatory actions form Principal for refusing a buyout offer. As to your second ... Read More >

Q: Can Principal's independent physician determine what I can and cannot do?

Answered on April 30th 2019 by Attorney Cesar Gavidia
A: APC, it is difficult to know what they courts would do or how they would weigh the opinion of Principal’s co... Read More >

Q: Do I have to pay Principal back once I receive back pay from SSA?

Answered on October 5th 2017 by Attorney Stephen Jessup
A: Toni, if your policy was an employer provided policy then almost certainly the policy would contain language t... Read More >

Q: Can Principal take away my deceased husband's 3 month survivor benefit? They justified it saying he was eligible for SSDI when he didn't even apply.

Answered on June 1st 2017 by Attorney Stephen Jessup
A: Michele, I am sorry to hear of your loss. We would need to see a copy of the disability policy to determine an... Read More >
Helpful Videos
(875)
Showing 12 of 875 Videos
Disability Benefit Tips
(330)
Showing 8 of 330 Benefit Tips

Principal Disability Benefit Denial Options

If you've recently received a disability insurance denial letter from Principal Disability or are worried that your claim for long term disabi... Read More >

Stephen Jessup and Gregory Dell discuss their experience in handling claims with Principal Financial

Principal Financial is one of the more interesting disability insurance companies to deal wit... Read More >

Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak

If you're seeking long term disability benefits from an insurance company, you may be concern... Read More >

Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company

When you're seeking disability benefits under a long term disability policy, your medical rec... Read More >

Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

One thing many long term disability claimants don't know about (or expect) from the claims re... Read More >

How Do You Fight a Long-Term Disability Denial?

Getting a denial letter from your disability insurance company is one of the ultimate insults... Read More >

Disability Denial Reason #2 - Change of Disability Definition & Vocational Review

One of the top reasons for terminating a claimant's long term disability benefits involves th... Read More >

Disability Denial Reason #1 – Paper Review & IME

At Dell Disability Lawyers, we've seen insurance companies give countless reasons to deny lon... Read More >
Dell Disability Cases
(373)
Showing 8 of 373 Dell Disability Cases

After Principal Denies Continued Disability Benefits, Attorney Alexander Palamara Gets Claim Reinstated for a Vienna Beef Employee

Our new client was a dedicate employee of Vienna Beef who worked as a Customer Service Representative (a sedentary occupation) since August 20... Read More >

Principal reinstates benefits of Orthopedic Surgeon unable to work full-time after Attorney Rachel Alters submits Appeal

Dr. S is 47-year-old left hand dominant Orthopedic Surgeon who was forced to stop working full-time effective May 2, 2016, due to progressivel... Read More >

Dell Disability Lawyers Successfully Appeals Denial Of Benefits To Claimant With Trigeminal Neuralgia

Ms. R contacted our firm after her claim for Long Term Disability (“LTD”) benefits was denied by Principal Life Insurance Company.Befo... Read More >

Administrative Appeal by Dell Disability Lawyers forces Principal to Reinstate ERISA Long Term Disability Claim of Former Healthways, Inc. Employee

After being forced to stop working in 2007 due to various disabling conditions, an employee of Healthways, Inc., who was employed as a Member ... Read More >

Principal Approves Long Term Disability Benefits for Surgeon

Our client was a highly successful Podiatric Surgeon who was suffering from severe neck pain due to two crushed cervical facet joints with res... Read More >

Transportation Manager with Brain Injury Wins Unum Disability Benefit Appeal

Unum unjustly terminated our client’s long term disability claim after it had approved and... Read More >
Disability Lawsuit Stories
(765)
Showing 8 of 765 Lawsuit Stories

Court Orders Principal Life to Pay Long-Term Disability Benefits to Plaintiff

In Craig Robertson v. Principal Life Insurance Company, Plaintiff, a National Account Sales Manager with XPO Logistics in Phoenix, A... Read More >

Court Orders Principal Life to Reinstate Long Term Disability Benefits

Flaaen v. Principal Life Insurance Company, is a win for the claimant who suffered a severe back injury in August 2005 in his job as a truck d... Read More >

Principal Life Disability Denial of Truck Driver Reversed by Washington Federal Judge

This is an interesting long term disability benefit case that was litigated in the Washington... Read More >

Court Upholds Principal Life's Denial of Extended Disability Benefits

In Peterson v. Principal Financial Group, plaintiff injured her back in a car accident and subsequently underwent a spinal fusion. She was awa... Read More >

Court Agrees: Principal Life Correctly Terminated Disability Benefits

In Winkler v. Principal Life Insurance Company, Thomas Winkler, a financial planner, collected 24 months of disability benefits when he was un... Read More >

Federal Court Orders Principal Life Insurance Company to Pay Disability Benefits

In Zorn v. Principal Life Insurance Company, the plaintiff, a member of the National Association of Professional Insurance Agents, obtained in... Read More >

Objective versus Subjective: Evidence Requirements in ERISA Disability Lawsuits

It is common when dealing with claims for short and long term disability benefits to have the disability insurance company request "objective ... Read More >

Principal Life denies disability benefits to a physician and then seeks attorney fees after physician's disability denial is affirmed by Texas Judge

Dr. Bruce Leipzig had been denied long-term disability benefits by Principal Life Insurance Company, and brought his ERISA case before the Dis... Read More >

Reviews from Our Clients

Request a Free Consultation

Our Lawyers Respond Same Day

5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our lawyers for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability lawyers have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance lawyers that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our lawyers have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We welcome you to contact any of our attorneys for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 700 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our lawyers help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, GoToMeeting sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.