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Attorneys for Prudential Disability Claims


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Our disability lawyers have thousands of hours of experience in handling Prudential disability claims on behalf of claimants. We handle everything from the initial application for disability benefits, ongoing claim management, first and second level ERISA Appeals, lawsuits in any federal court nationwide and Prudential lump-sum buyout offers.

Our experience against Prudential includes the prosecution of a nationwide disability class action, depositions of numerous Prudential employees (including the VP and Director of Claims), and hundreds of appeals and lawsuits resulting in payment of benefits to our clients. There are very few law firms, if any, that can match our nationwide experience and knowledge with regard to Prudential.

Prudential only sells group disability insurance policies, therefore more than 95% of their policies are governed by the horrific ERISA laws. We suggest you watch our numerous videos discussing ERISA disability claims.

Prudential Loves To Use Video Surveillance To Deny Claims

In more than 80% of the disability claim denials our firm has reviewed, Prudential has relied upon secretive video surveillance of a claimant in order to support their claim denial. It appears that the Prudential claims examiners have been trained to think that if a person is seen doing an activity on video for a few minutes, then that must mean they could return to work for 8 hours / 5 day a week.

Prudential claimants need to be aware that Prudential will spend thousands of dollars on video surveillance and they will often do it several times a year. We are routinely contacted by Prudential claimants that have been denied benefits after being paid for 8 years or more. We were recently contacted by a 61 year old woman that was denied after receiving payment for 18 years due to a brain disorder.

You can never let your guard down when dealing with Prudential and a claimant must always be proactive in order to protect continued payment of benefits. In addition it is common for Prudential to send misleading letters to a claimant’s treating physician which often result in a claim denial.

Free Prudential Disability Insurance Information For Claimants

Our disability attorneys believe that a claimant has a better chance of ensuring continued payment of benefits if he or she is educated about Prudential’s disability claim handling activities.

You may find it helpful and educational to watch our Prudential disability videos, read the comments and complaints posted below by Prudential claimants, review some of our resolved Prudential cases, and read our summaries of Prudential lawsuit and court decisions throughout the United States.

We hope that you find some of this information helpful and we welcome the opportunity to discuss your Prudential claim with you.

There are 44 opinions so far. Add your comment or complaint now.

Dan Trudeau:

Does Prudential LTD insurance have annual cost of living increases? SSDI benefits do. I will receive benefits from Prudential for the next 12 years, but if there are no annual increases, I will not make it financially.

Attorney Greg Dell:

Dan,

Most Prudential long term disability policies do not provide for cost of living increases. If you have a cost of living increase, then it will say so in your disability policy.

Nicole Grier:

After receiving LTD payment for over 2 years Prudential stopped payments claiming my doctor did not fill out Residual Functional capacity questionnaire. Prudential informed me of their decision 4 days prior to my normal monthly check date via telephone. Prudential claimed they did not call me in regards to incomplete paperwork because “by law” they can not make the doctor fill out the form. I hired an attorney and won at the first level of appeals. Of course attorney charged me a fee to handle case. Could I sue Prudential for the money I paid to my attorney, considering I was forced to wipe out my 401K, fell behind on rent and almost evicted as well, having to use charity care for ER visits and was unable to pay for needed medical treatment for my disability?

Attorney Greg Dell:

Nicole,

I am glad to hear that you were able to win your Appeal against Prudential. Unfortunately the law does provide for any attorney fee award at the Appeal stage. Due to the limitations of ERISA you cannot sue Prudential for any of your damages. You can only sue Prudential for disability benefits, interest and attorney fees if you were to lose your Appeal. ERISA is not a fair law. You should take a look at the numerous videos we have posted on our site discussing ERISA. You need to spread the word about how unfair ERISA is and help to make your legislator change it.

Cynthia Bushey:

I think it is terribly unfair that I have paid premiums for short and long term disability through my employer, after being in the work force for over 30 years, and Prudential demands doctors reports on a month to month, or better, basis and expects this is timely manner. Yet, they do not respond in timely manner. Not only do they not respond, but they lie, and ask for medical documentation already given to them, to just stall paying benefits. If I could work, I would, as it is better than dealing with them. I wish I was not ill and could work, in all honesty. They are overwhelming me as I am head of household and with no income, it is not easy here. Totally unprofessional, no heart, and I just do not understand how they have the right to treat me like this.

Attorney Greg Dell:

Cynthia,

Disability insurance benefits are a month to month evaluation. You need to keep up with Prudential’s request or they will deny your claim. They have a right to make all of the request they are making. We represent claimants with the monthly claim handling process so that the claimant does not need to communicate with the disability insurance company. You can watch our video about monthly claim handling here.

Nicole:

Prudential hired Allsup on my behalf to file for SSD. Allsup does not charge the client any money if SSD awards retroactive benefits. After working with Allsup through 2 appeals with SSD, Prudential informed Allsup they were no longer paying for their services because Prudential did not feel I was still disabled. I hired attorney to handle my LTD denial and won. During the appeal process of LTD I decided to go with an SSD attorney from the same law firm with standard 25% fee or $6,000. Months after my LTD benefits were reinstated Allsup called me again to say NOW Prudential was willing to pay for their services again. But at that point I had already hired an SSD attorney. I am required to repay Prudential any retro pay if I win SSD? But what about the SSD attorney fee that I have to pay?

Attorney Greg Dell:

Nicole,

You are not required to pay Prudential for the $6000 SSDI attorney fee you paid.

Cheryl Stein:

I find Prudential Insurance Company to be an absolute disgrace when it comes to handling cases for their clients with disabilities. It has been my experience that they are untruthful, harassment of their clients with the with the excuse that they are not receiving the information they are requesting. Also phone calls are not returned which, in my opinion, is unacceptable and unprofessional. Dates for settlements are constantly changed, leaving their clients holding the bag with no means of support either financially of emotionally.

DeeJay:

I was denied Prudential LTD benefits after missing a reassessment hearing that was required because Prudential’s doctors did not feel I was still disabled. However, two months later Social Security granted my disability using the same medical opinions Prudential had. I was so fed up with how Prudential handled my case that I just didn’t appeal. After reading comments from others I am beginning to believe this happens all the time. My question is, can Prudential cancel or deny your claim if you are approved for social security disability benefits? Had I appealed, would I still be hostage to meeting there satisfactory guidelines for disability while receiving Social Security Disability Benefits?

Attorney Greg Dell:

DeeJay,

If the appeal deadline has not passed, then you should still appeal ASAP. Prudential is not bound to follow the SSDI guidelines and frequently an SSDI approval does not mean that the LTD carrier will pay you. Please see our video discussing your situation.

Nancy:

I have been disabled since August 3, 2009 when I had a TIA while at work. That was a Monday morning. That Friday morning I had another TIA while at home still recovering from the first one and was rushed to the hospital unresponsive. To date I have had 4 more, most recently on September 5, 2012. I have had Prudential long term disability benefits for the past 3 years since my short term disability benefits ran out. Around the same time my long term benefits started, Prudential hired Allsop to apply for Social Security Disability for me, which I was awarded on the first attempt. I have been to many different types of doctors during the first year or so as recommended by my neurologist in an attempt to diagnose or find a cause for my having the TIA’S, but none of them were successful. I have also been through months of testing for cognitive functioning ability by a neuropsychologist and I have tested extremely poor on all of the different types of tests. I also have extremely poor short term memory and I’ve lost the ability to do some things such as simple math and filling out forms.

My background is in the medical field. I was an EMT and an RN and I had to leave patient care years ago as my whole lumbar spine is injured with herniated and bulging discount and I couldn’t lift patients anymore due to the constant severe pain. I didn’t even consider disability then, but I went to work for a pharmaceutical company and I was working as a case manager in clinical trials for chemotherapy drugs and compounds.

This is what I was doing when I had the first TIA in my office in Aug 2009. At first I thought Prudential was a wonderful company and I was very grateful for having them for my long term disability benefits, but over the past year or so I honestly think they are trying to kill me. They have changed my claim manager many times and I never know who is currently managing my case. I also have been getting reviewed every couple of months where at first the reviews were twice a year. I find out that my claim was not approved by not receiving my check at the end of the month, which is extremely stressful every time this happens. My claim was again not approved in Aug 2012, and after several phone calls my current claim manager reversed that and told me that I should not have to go through this again for at least 6 months and he was going to try to get my claim permanently approved since my doctors have told them repeatedly that I am totally and permanently disabled.

On September 5, 2012, I had another TIA while sitting in the waiting room at my pain management doctor’s office and I was rushed to the hospital unresponsive again and admitted again. Prudential was notified of this and they asked for a copy of the discharge paper, and that was faxed to them and they said that they would get any other information about this from the hospital and my neurologist.

I was to receive my most recent check on Friday, October 26, 2012, but when I checked my bank account I saw they did not submit the direct deposit again. I called their office in NJ which is where I live and was told that my claim was not approved after September 26th, so I was not going to get my check again. I couldn’t get anyone who could do anything to help me out on the phone and I left a couple of messages for my case manager and his supervisor but no one returned my calls. This left me with a very serious problem since Hurricane Sandy was heading up the coast and was set to make landfall in my home state of NJ. Since I did not get my check I could not get supplies before the hurricane hit and once it did I lost the electricity and I had no running water either since I have a well. I also have all my monthly bills set up with my bank’s automatic bill pay system and now I had no money, electricity, water, or supplies. Fortunately I was able to call the bank’s main office from my cell phone and they canceled all of my automatic bill payments.

Now Prudential is insisting that they have to have all these records from my neurologist and the hospital before they will review my case, and they are ignoring the fact that the doctor and hospital are in NJ, which has been hit the hardest by Hurricane Sandy and has been declared a Federal Disaster Area, and I cannot reach my doctor as I’ve been told that his office is closed indefinitely and I cannot safely drive to the hospital to get the records from them either.

I have been told by many of my claim managers that I have been declared to have a permanent brain injury as well as my other medical problems, and I have been declared to be totally and permanently disabled and I should never have to go through these reviews. But here I am, in the middle of the worst storm in my state’s history, and I have no money and no way to reach anyone who Prudential wants to hear from in order to get my claim reinstated, and since their office is located in NJ also, they know this is true.

I am totally and utterly frustrated and scared. I don’t know what to do or where to go for help. I don’t qualify for anything else because of the disability benefits, but I only get enough money to barely scrape by from month to month and I owe tens of thousands of dollars in medical bills that I cannot possibly pay. What do I do? I need food and medicine and I have to pay the normal household bills. Does Prudential ever declare anyone permanently disabled? I can’t take this stress they are causing me over and over any more. I swear they are trying to kill me.

Attorney Greg Dell:

Nancy,

It sounds ridiculous that Prudential will not release payment to you. You need to call them and demand to speak with a supervisor immediately. If you have any of your recent medical records, then you need to fax those records to Prudential ASAP. Prudential will not consider you permanently disabled, but we have many clients where Prudential has agreed to only review their files either once or twice a year. You may need to find another doctor right away if your doctor’s office will be closed indefinitely.

Anonymous for Now:

I feel that after reading all of the complaints and personally experiencing the same type of reprehensible treatment from them that there should be some way to shut these monsters down. I am in the process of preparing my own attack on them and am determined to take them to the cleaners. In the process of fighting these DNA challenged little more than monkey benign claim handlers, I originally was being paid regularly through Hartford. For the entire year of 2012, I have been fighting with them and am now in the process of an appeal while waiting on SSDI approval. During the course of this brutal battle to get any payment at all. The chronic migraines started in February 2010 and have been next to impossible to control since. I have had CAT/MRI scans, been to pysical therapy, tried several different medications and seen a neurologist.

Because of this runaround where they kept stating they were not getting paperwork from my doctor but I am positive they were, I have wiped out my 401k, am in complete financial ruin and suffered a nervous breakdown requiring me to be admitted to a mental facility right before Thanksgiving. I am now diagnosed with a new disability stemming from their appalling handling of this claim called Manic Bipolar Disorder. I do want to add that I have always worked since I was 12, have always been a positive, vivacious person. Now I am little more than a recluse. I do not trust doctors or psychiatrists anymore and the medication they prescribed during the psychiatric stay made me feel depressed while never experiencing this before. The experience has been something not dissimilar to a horror movie and a complete overhaul of my mind.

I am working through this medication free progressing on my own and feel great as long as I am alone or with my spouse devoid of any stressors. I don’t think I will ever be able to work for anyone ever again. I have some very strict, unwavering expectations of anyone who I come into contact and if I detect or hear any type of negativity or an attempt to force control over me, I won’t hesitate to point out that their actions have no effect. This can make for interesting outings and could be potentially dangerous. I now don’t even trust my employer for allowing this to continue after letting them know what was happening. I feel they also are partially responsible for this new diagnosis. I have no idea how this will affect my current claim and if this now would be considered workman’s comp or if I should hold Prudential liable and with what type of suit.

I can tell you that if I didn’t have a mental breakdown when I lost a child to SIDS about 6 years ago, then this company needs to be shut down. I have been emotionally scarred due to their ineptness and constant requests for information with absolutely nothing in return. The final straw was the 7 page interrogation request where they asked several questions I felt are an invasion of my privacy and this is to me, harassment. I really want to take down these vultures and I am considering getting a petition going, contacting the Insurance Commissioner, the Better Business Bureau as well as media involvement and letters to Senators. I am broke, nearly homeless and my children are grown. There will be no settlement because I am prepared to dig in my heels and give them everything I got and I am very angry and much stronger than I was before so this should be interesting. They might have lawyers to drag this out for years but I don’t care, it never would have come to this had they not threatened my survival.

As a SIDS parent survivor who managed to work through the grief and move on to become a successful stock broker only to be reduced to a mentally ill recipient of government assistance is an absolute atrocity and I am determined to make an example of these heartless, profit hungry, sanity thieves. I have improved but I will never be the same but I am hoping that I am able to stop them from doing this to anyone else and I have nothing to lose anymore so it is my new job now to either bankrupt or take over this company. Seems lofty, but I am going to compile all the past dirt I can find and I am thinking of starting an internet access to allow others to join. I refuse to allow them to control me and I won’t agree to be silenced. This is my story, I am going to find some closure by telling my story to anyone who will listen.

My mom always told me if I ate all my dinner, including my vegetables I would get my dessert. I liken this to me working hard all my life and following all the rules to only have my dessert stolen from me. Now I intend to take the whole pie. And I don’t even want the money anymore…

Christy:

I feel all of your pain. They do not take your word or your Doctor’s word for your claims. It’s like you’re guilty of giving false information until proven innocent. They don’t even believe the Dr.’s. To give a little insight on my claim I had to have some major work done on my right foot. I had to be completely non weight bearing for 6 weeks. 1st 3 weeks was the healing process until stitches could come out & the next 3 in a cast. When he took the cast off I had an infection that has set up in a 4″ incision in the side of my foot therefore could not walk still “just removed the cast” & couldn’t get a shoe on which my employer has a mandatory policy for no open shoes. They expected me to go right back to work on 10hr shifts right then. As someone posted earlier I went through the same thing with “The office never sent us anything” when I had just left the office & the benefits clerk showed me the confirmation page where she sent it in to them. I called these jokers just as soon as I got to my car & we argued for about 30 min. I had not received a check in over 6 weeks. We were struggling financially with a 6 & 12 yr old at home. They had my dr visit dates all wrong. Everything was a mess. I ask immediately to speak to a supervisor because the lady I was talking too was showing no effort or concern to help me though I told her it would be a different situation if the tables were turned. I also informed her this was not a fringe benefit that I paid for these benefits & I wanted my freaking money! Having to depend on them for your money was a complete & utter joke!

Cindy Johnson:

Time to vent again. I know it is too late now for any appeal, I tried that for a couple years. I begged, cried, and cried and cried. I paid for Long and Short term disability at the same company for over 30 years. After working as long as I possibly could, I was denied. I finally ,after living on and wiping out my retirement and 401k got my SSD after seeing a lawyer and a judge. I still cry sometime when I think of it and find myself in my current condition. Have had at least 2 more surgeries and take narcotic pain medication every day with very little relief. We are now living in a mobile home. Our whole lifestyle has changed. Living pay check to pay check after nursing for the same company for 30+ years just breaks my heart for my husband and I. We are just late 50’s and are dreams are gone for now. Oh how I wish I could go to work, but most days I can not go to the store. Anyway, I just can not believe that companies can actually do this to people. It could have mad such a difference in my life and Prudential would not have even felt a thing. They could have still built their stadium and every thing.

Attorney Stephen Jessup:

Cindy,

Thank you for sharing your story… I can only imagine how hard it must be. Although there is no indication that any sweeping reform is on the way that will come that will prevent the insurance industry from acting the way they do; hopefully with enough outcry things will eventually change.

Steve:

After dealing with this crooked bunch, I plan on having them submit paperwork to me so that I can decide whether or not to pay them the lump sum SSD payment I’ll receive. I may not be satisfied with what they submit, and I’ll not tell them unless they call. I usually let calls roll to voice-mail and call back at my leisure, but may follow Prudential policy of never returning calls. If I keep the lump sum payment, what can these crooks do about it?

Attorney Stephen Jessup:

Steve,

If you are on claim, they can withhold your benefit check in satisfaction of the over-payment; or Prudential can send you to collections, and in some instances file civil suit to collect the money (although the latter is not a common occurrence).

Danny Lee White:

I had an accident policy through Prudential that should have paid me $298,750 and it was denied. Walgreens had me on 100% disability but I had 6 months to try to come back as a pharmacy manager which I had been for 15 years. I also had an additional policy called Income Protection Plan for Pharmacists and Nurses which should have paid me $7,000 a month for life. I was in an automobile accident that a lady ran a stop sign and ran her Oldsmobile through my windshield and caused the Mercury Mountaineer, 23 foot bass boat and trailer to roll on top of my entire left arm crushing it and impaling it into the metal of the door with shoulder, arm elbow, and entire hand showing 10 fingers. I had to have a Medtronic Neurostimulator placed along my spinal cord with lithium battery to allow electrical stimulation of the entire left arm. I worked for 5 months and was denied both payments even though I was within the six months they said it was a new claim even though the booklet says any new claim will be considered the same claim if within the 6 month period. I am totally disabled and on disability which should entitle me to both claims.

Nikki:

I have been on LTD through Prudential since August of 2012 and have been approved to August of 2014. I just received my approval from SSDI after my 3rd appeal. No award letter yet but, I will get back pay to August 2012. I hired my own attorney. I was never offered the service from Prudential or even knew they worked with attorneys and offer a credit for those fees if awarded back pay. When I informed my case manager that I would be receiving back pay and that they are required to credit my attorneys fees he didn’t know anything about that. I, of course, have asked for a written estimate of what is being taken out of my back pay bit, how do I ensure they give me that credit? I’m afraid they are going to charge me for those fees and in that case I will owe them more than my backpay. I also asked about COLA and he said that would be taken out as well. I thought they could not do that. I feel like I know more than he does about this!

Attorney Stephen Jessup:

Nikki,

When you receive the Award Letter from the SSA send it to Prudential. The claims person seems ignorant to your question or has misunderstood it. Prudential’s right to repayment of any overpayment will only be based on the base monthly benefit amount received (before any applicable COLA increases) minus any fee awarded to your attorney. You should not be required to payback the money awarded to your attorney, or any increase amount on account of COLA.

Linda Harrelson:

I need help. I have worked all of my life, I was making 20 dollars an hour at my job of 13 years. I had to go out because of my back. I went through pure hell to get approved, I got one little check and now they are bugging me for more information from my Dr. I don’t even have health insurance yet, this is something I paid for through my company, my nerves are shot.

Attorney Stephen Jessup:

Linda,

Please feel free to contact our office to determine how we might be able to assist you. As disability benefits are reviewed on a month to month basis, please be advised that you have an ongoing duty to provide Prudential with information as often as monthly.

Michelle:

Wow, I am so sorry to ALL of you for your situations and have said a prayer for all. Apparently, the boat we’re in is rather large. I’m no different than some of y’all, purely broke and thankful to friends and family who have helped us however they can; blessed to have a husband who can carry our health insurance and at least make a teacher’s salary which is better than nothing!

I was a med-surg nurse until Oct 2010 when my body just exploded. My primary doc gave up on me cause he couldn’t figure it out, so I left his practice and did most of the researching myself, using my neurologist at the time to order the tests and prescribe meds. I’m STILL peeling back the layers now in Nov. of 2013 of the constant struggle to get well enough to be there for my 10 and 12 y/o daughters, plus I’m only 38 and I’m not giving up.

At this point I’ve ended up with fusions of my neck and low back, C4-5-6 and L5-S1, and artificial disc at C6-7. Hysterectomy and breast mass (benign) removal, three rounds of physical therapy, did massage weekly for about a year, and acupuncture. I already had Celiac disease and found out that I have to keep casein out of my diet as well. I have 4 autoimmune diseases, and starting a workup for two more. Found I’ve had narcolepsy my whole life, but with all this going on plus the pain meds and muscle antispasmodics needed, sometimes I sleep a day or two straight. The excessive daytime sleepiness, memory, and thinking is helped a little by Adderall XR, but I can still fall asleep on it and I didn’t tolerate any of the other meds.

Prudential finally gave me LTD after an appeal, but pulled their sneaky trick by sending that Capacity Questionnaire to my neurosurgeon. His nurse filled it out not knowing much about me at all and stuck it under his nose to sign. Said I was ready for duty 40hrs per week with all the usual joys of nursing, even though the PA in that office had just sent me to another Ortho to check out my clavicles that partially dislocate 24/7. Seriously. So the big P received that June 13 and cancelled my benefits that very day. Imagine my surprise when I had pretty much no money in my account on payday and FINALLY received a letter telling me what happened on JULY 1st GRRRR. They didn’t even type up the letter until June 24th. So, no steak for us :(

I sent my appeal with 7 pages typed by me (took two weeks to do that with my thinking problems and sleepiness) and the rest COMPLETELY UP-TO-DATE notes, tests, etc. 108 page fax. And of course the guy assigned to me called me a week later to ask all the dumb questions that were in my letter and documents. So we played the game of “we need more information” until about two weeks ago.

At that point is when I asked him when were we going to stop chasing the ball and actually consider the appeal, because as YOU ALL know, that ball never stops. There’s ALWAYS more doctor visits.

Then I started calling him daily, sometimes several times per day, to ask if he received my fax, or blah blah blah, I just made up dumb reasons to call. Finally by this past Tuesday, Nov 5th, he got enough of me, asked me to fax what I had to him from my sleep doc – which was previously not acceptable to him for whatever reason (stalling) – and he would turn it in that day for consideration.

He called yesterday, the 6th, to say they have to use the extension period (45 days) because there is no way they can consider all of it by the 17th of this month. Humph.

My ALJ hearing is soon for SSD! Apparently Florida is a very backed-up state, so my hearing is via video with the Santa Fe office, and I do have Allsup representing me. My rep says the decision period is usually 60-90 days, but may be longer due to the domestic dispute in Wash. D.C.

Is anyone able to tell me that it might come sooner?

Anyone ever heard or noticed that if a person is approved for SSD already, that P is more likely to give approval to an appeal?

Thanks and PBTG!
Michelle

Attorney Stephen Jessup:

Michelle,

I cannot speak as to the timing of any ALJ hearing with the SSA, but I can tell you that receipt of Social Security benefits contemporaneous to a claim denial and resultant appeal does increase your odds of being approved on appeal. As SSDI approval occurring during the 180 day administrative appeal process is additional evidence of disability that will be hard for Prudential to ignore when reviewing your appeal. That being said, it is still no guarantee Prudential will overturn any prior denial.

Jennifer:

My boyfriend is permanently disabled thanks to medical malpractice. He applied for Prudential long term disability and was denied. He appealed, submitting 500 pages of medical records including X-rays, MRIs, etc., two independent medical exam reports, and a list of 18 doctors. Prudential has surpassed the 45 days to respond and has sent more forms to be filled out. Are they ever going to pay him? He is housebound, cannot work per doctor’s orders, and has no income. He worked for the same employer for 18 years and has an exemplary work record. Unfortunately, that employer is also a sovereign nation, so he can’t get the records for worker’s compensation either. Prudential is basically waiting for him to die.

Attorney Stephen Jessup:

Jennifer,

If they have not requested their legally allotted extension beyond the 45th day, and there has been no tolling of time, then the case could be ripe for a lawsuit now. Please feel free to have your boyfriend contact our office to discuss how we may be able to assist him.

C. Murphy:

I am currently out on STD in New Jersey, after hurting my knee. My company offers supplemental STD payments through Prudential. The day following my injury, I went to my primary care Dr, who wrote me out of work and sent me to the specialist. The specialist confirmed I require knee surgery. The soonest surgery date available is 6 weeks from the date I was written out of work from my primary care Dr. After jumping through a bunch of hoops with Prudential claim filing requirements, they confirmed the STD supplement is approved and told me check is in the mail. I’ve been looking on their website, and it shows my claim is approved, how many hours of time are approved, that nothing is needed from me, but the section that is supposed to show payments they mailed, is still blank. I get a call from my primary care Dr today who tells me Prudential called them, said they audited them, and they want to know why my primary care Dr has not sent them weekly updates to confirm I am still temporaily disabled. Prudential told my primary care that they will not pay me until I go see my primary care Dr once a week for them to send a factual update of my condition to Prudential, until I return to work. What kind of craziness is that? I see a lot of people on this site are saying Prudential wants monthly updates, and although that seems dumb too, especially when the anticipated return to work date is given to them at the start of a STD, wanting weekly updates seems more like a way to deter me further from pursuing thier pittance of a supplemental payment. It would cost me more in gas and co-pays than what they are saying they will pay as a supplement per week. And that’s another thing, I max out on what the State will give me. One would think ‘supplemental’ would mean it will make up the difference between what the State will pay me and what I make while I’m working, but according to Pruduential the amount of ‘supplement’ I [have to fight to] receive will equal about $9.00/wk! I thought ‘that cannot be right’ but no, they insisted it’s only $9.00.

Attorney Stephen Jessup:

C. Murphy,

The reason why Prudential is requesting weekly updates (as opposed to monthly) is most likely due to the fact you are paid the benefit (no matter how small) on a weekly basis. As such, they review entitlement to continued benefits each week and can therefore request weekly updates (with long term, it’s usually a monthly evaluation, thus requesting once a month). The amount of your benefit is most likely due to an offset created for your receipt of NJ state disability benefits.

RA Mom:

Can Prudential discontinue benefits for not receiving information from the treating physician in a timely manner? I’ve been receiving LTD for 4 years from Prudential. They review my claim 1-2 times per year. I always send all requested information immediately, and I haven’t really had a problem with them. I received a call from the claim manager last week informing me that, unbeknownst to me, they have been trying to get transcribed progress reports from my doctor for the past two months. I asked her to please copy me on any correspondence because my doc’s front office is very small and they get backed up with these types of requests. She then told me the doc has 5 days to get the info to them or they will deny my claim. They have the records, they just can’t read his handwriting. Can they discontinue benefits because my doctor hasn’t responded fast enough? And if so, how do I proceed?

Attorney Stephen Jessup:

RA Mom,

Unfortunately, Prudential could deny the claim for lack of medical information to support ongoing disability. I would recommend you contact your doctor’s office to follow up with them about sending it, or in the alternative, secure a copy of the records yourself and forward them to Prudential.

Wanda joseph:

I was diagnosticed with fibromyalgia, degenerative disk, sjogren ‘s syndrome. These symptoms cause me so many problems, that I can hardly function in a good day. I am appealing my denial. Should I hire a attorney now or wait until after my appeal is answered. I am waiting on the paperwork from Prudential.

Attorney Stephen Jessup:

Wanda,

It would be in your best interest to consult with an attorney before filing an appeal.

Terri:

I have been on STD since Oct. 25, 2013. I pay for my Prudential LTD, not my employer. Prudential sent me a denial letter, which seems to be the standard practice. They claim the Dr’s statements/diagnosis, do not match up with my own statements of my diagnosis. I know what the Dr’s have been treating me for. I know what is wrong with me. I take daily meds for my disability. They made several incorrect statements in the denial letter. They don’t mention half of what I told them. I need to appeal. I am not able to sit or stand or walk without having pain and I am disgusted that I paid for 6 yrs for LTD and they turn around and deny me stating basically I am depressed and don’t suffer from Degenerative Disc Disease. That my Sciatic Nerve doesn’t cause me a great deal of pain. They do have at one of my MRI’s ( I have had 2) and the one CAT scan I had on my spine.

What steps do I take next?

Attorney Stephen Jessup:

Terri,

More than likely you will have to go through the Administrative Appeal process. Please feel free to contact our office to discuss how we may be able to assist you with same.

Jenny Green:

Hi, my claim with Prudential is currently pending an appeal made on June 1 2014. I know they have 45 days to make a decision. They denied my claim due there being no objective evidence. I worked for 5 years at previous job, have been on fmla since december 9 2013. They paid short disability till May 12th. I have COPD, fibromyalgia, major depression with bipolar tendencies, painful degenerative disc disease. I cannot work the previous job due to pain, inability to sit/stand/walk for extended periods, light/sound/noice effect my fibromyalgia and causes major stress triggering my fibro and bipolar. For last 5 years I have taken FMLA for 3-6 minth per year and Prudential paid STD each time. Each leave was approved by the same doctor now they don’t want to honor long term claim which is for the same reason of all my other leaves. Since each attempt resulted in the same routine, work till couldn’t take it no more, take short term leave try work again and so on; Dr. agrees it is time for disability now have to bicker with Prudential.

If this appeal is denied I will get a lawyer, but I don’t understand why an insurance company would be allowed to operated like they do?

Attorney Stephen Jessup:

Jenny,

What you are experiencing is not uncommon. Typically, short term disability benefits are administered by an insurance company, but paid out of the assets of your employer. When a claim transitions into long term disability the benefits are more often than not paid by the insurance company. As such, the carrier has a financial interest in your claim and more of an incentive to deny it. Please feel free to contact our office to discuss how we may be able to assist you should your appeal be denied.

Jenny Green:

I wrote before but since I still haven’t resolved my issue with Prudential and running out of money I probably will have to hire an attorney. Currently I am waiting on decision of appeal. I called them and e-mailed them told them I need decision by Friday. Is it best to hire an attorney first and then file a complain with Indiana Insurance License Board or do both?

How long does it usually take to resolve a case like this?

Attorney Stephen Jessup:

Jenny,

If your claim is denied a lawsuit is to be filed in Federal Court. The Indiana insurance board does not have the authority to award your benefits. In the event your claim is denied, then it would definitely be in your best interest to hire an attorney to litigate the case in Court. With respect to time frame- a trial date may not be set for 12 to 18 months. Litigation can be a lengthy process. Please feel free to contact office to discuss how we may be able to assist you.

Shanetra Ellis:

Hi. On March 5th I had a blood vessel burst in my head at work and was rushed to emergency room from there. It was labeled as a aneurism and I immediatley had three surgeries to clip and fix the issue. I was out of work until June, in which I went back due to no further funds being available. I got very sick, got consistent headaches and where the shunt was placed in my body I can’t sit up or drive for long periods if time. The jib sent me back to Dr. and I took a cat scan. Dr stated he saw no issues but it still did not explain pains and headaches plus the memory issues. They took me back out work and job stated it’s best I attempt to get LTD. But when I did that I got a call from insurance company today stating claim was denied because cat scan was clear and they see no reason I can’t do my sit down job. I work at a call center. The Dr told me the stress from a job like that is dangerous due to my issue. I take emergency calls all day. My memory comes and goes. The headaches happen frequently and my neck and back stay hurting. What should I do? My job sent me documentation stating I needed to fill out a LOA or they could terminate me.

Mike:

I was a fairly high level Sales Director who was on the fast track and making over $200k annually. This was about 10 years ago. Unfortunately, I began facing significant back issues about 15 years ago and toughed it out as long as possible. In 2001, I was traveling on a business trip and hit an animal on the highway thus totaling the rental car and seemingly leading to an acceleration of my back issues. I am told that I have severe degenerative disc disease and am not a surgical candidate due to the risk of worsening my pain. Anyway,I was being treated by a pain management physician who was attempting to preserve my job. However, in 2004/205 my boss required me to go out on disability. I resisted at first, but he was relentless. My pain doctor tried to keep me going as long as possible as I had a tremendous amount of stock that had not yet vested. Finally,he said it was necessary, as my job performance was compromised. Sometime after my disability was approved, both by Prudential and SSI,my family relocated to another state. It took me awhile to find a new pain, as several were trying to force me to either have a pain pump installed or a Deep Brain Stimulator stating that it was hard to believe that I could function on the oral meds that I was taking. I did not like those options and found a conservative pain doctor. I have been on a regimen of 80mg of Vicodin per day. I also need weekly visits to the Chiropractor as well as use of TENS units and massage therapy. We have been in maintenance mode for the past 7 years. The treatment helps me get off the couch however the side effects are bothersome, as I cannot concentrate, have sedation, memory loss, difficulty getting my thoughts across, etc. It is still better than the alternative. My dilemma is that after almost 10 years of disability, Prudential called me yesterday and closed my claim. They said that my IME states that I can sit for 6-8 hours and stand for 4-6, both are wrong. My job required extensive travel, detailed presentations, standing for long periods of time, quick thinking, budgeting, hiring and firing, sales projections, sales goals, etc. All of these are significantly hindered by my medications which is what my treating pain doctor has communicated to them. The IME doctor met with me for 45 minutes and hadn’t reviewed my file prior nor did he ask any questions about side effects nor daily activities. I’m stuck as we have depleted much of our savings and I have 2 boys who will be going to college soon. Will I even be able to pass a drug test? Won’t it create a liability if I were to drive a company vehicle while taking pain meds? I’d appreciate your thoughts.

Attorney Stephen Jessup:

Shanetra,

If you are not able to return to work your only option as it relates to your Prudential policy is to file an administrative appeal. Please feel free to contact our office to discuss same.

Attorney Stephen Jessup:

Mike,

In order to properly assess your options/rights we will need to see the policy that is governing your claim along with a copy of your denial letter when you receive it. In the meantime, please feel free to contact our office to discuss your claim in greater detail.

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