After appeal filed by Attorney Jay Symonds, Mutual of Omaha overturned its previous denial of short term disability benefits for Colorado Senior Manager

Our client, Ms. J, formerly worked as a Senior Manager of a treatment facility. In October 2016 a number of medical issues, including fibromyalgia, chronic pain syndrome, chronic fatigue and depression forced Ms. J to stop working and submit her claim for disability benefits, first under her employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. The STD coverage was administered and funded by Mutual of Omaha. Ms. J’s occupation as Senior Manager was quite intellectually complex, detail oriented and physically demanding. Under her employer’s STD policy, she would be considered totally disabled if he was unable to perform all of the material duties of her own “regular occupation.”

After filing her claim under the STD policy, Mutual of Omaha denied STD benefits on the basis that Ms. J allegedly no longer met the policy definition of disability. Specifically, Mutual of Omaha determined that “the medical records received do not support a functional or mental impairment that prevented [her] from performing the material duties of [her] regular job after October 11, 2016.” After receiving the denial, Ms. J contacted Dell & Schaefer and discussed her case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Mutual of Omaha’s investigation of her claim and its physician consultant’s medical review, and agreed to prepare and submit Ms. J’s ERISA appeal with the assistance of his appeal team. In addition, Attorney Symonds recommended that Ms. J initiate an LTD claim simultaneous with the STD appeal.

The STD appeal addressed all of Mutual of Omaha’s short-comings and reasons for denial, with a special focus on the purported medical review conducted by Mutual of Omaha’s in-house nurse consultant and Mutual of Omaha’s assessment of the material duties of Ms. J’s regular occupation. In particular, the appeal identified several mischaracterizations and misinterpretations of Ms. J’s medical records by Mutual of Omaha’s in-house medical staff. In addition, the appeal established that Mutual of Omaha failed to consider the requirements of Ms. J’s actual regular job – as required by the STD Policy – in reaching its determination that she allegedly did not qualify for benefits.

Approximately 1 month after submitting her appeal and hundreds of pages of supporting exhibits and medical records, Mutual of Omaha overturned its decision to terminate the claim and paid Ms. J’s full short-term disability benefits through the maximum benefit period. Shortly thereafter, Ms. J’s LTD benefit claim was approved and she began receiving payments avoiding an unnecessary delay or gap in coverage and, more importantly, monthly income.

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Do you help Mutual Of Omaha claimants nationwide?

We represent Mutual Of Omaha clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Mutual Of Omaha disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Mutual Of Omaha. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Mutual Of Omaha.

How do you help Mutual Of Omaha claimants?

Our lawyers help individuals that have either purchased a Mutual Of Omaha long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Mutual Of Omaha:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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 telephone, e-mail, fax, GoToMeeting.com 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 800-682-8331 or by email. Lawyer 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.

Reviews   *****

James S. (New York)

The best place to start is a brief background. I had incurred six spine surgeries in a span of five years taking four or nine days vacation for each. These surgeries included multi level fusions, laminectomy’s, etc. I reached the point where the physicians recommended I take a period of time (six months) off to see if the injured nerves would calm down. I filed for my short term benefit (90 days) and that was approved. I filed for my long term benefit but was denied. After six months of no improvement I was deemed permanently injured, a pain management case. No other surgeries would help. This was all fully documented and supported by the surgeon. At some point in that period I realized an attorney was the only way to take on the insurance company as I was getting absolutely nowhere. I searched locally but had no luck but was recommended to Dell & Schaefer by a local attorney.

I was hesitant at first as their main office is in Florida and I am in New York but realized they had to trust me remotely also. Once they obtained all the medical records and formed the first of several appeals (at their up front cost and therefore risk) I realized they had this down and they realized I had a legit case with full physician support. The people at Dell & Schaefer were always courteous and professional. They never set any false expectations about time frame and they always kept me updated as the claim status.

Dell & Schaefer at one point had to ask my surgeon to write yet another letter on my behalf. There interaction with the very busy surgeon was polite, professional and subtle. I did not want my relationship with the doctors jeopardized by this and it never was. They also updated me with a copy of all interactions with the insurance company in a timely manner.

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