After appeal filed by Attorney Jay Symonds, Prudential overturned its previous denial of long term disability benefits for New York Financial Control Officer

Our client, Ms. L, formerly worked as a Control Officer for a large financial services institution. In May 2016 a number of medical issues, including Lyme Disease, babesiosis, Fibromyalgia, CFS, vertigo, vestibular dysfunction migraine headaches forced Ms. L 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. Both benefits were funded and administered by Prudential. Under her employer’s LTD policy, she would be considered totally disabled if she was unable to perform the main duties of her “own occupation” as a Control Officer.

After paying Ms. L for the maximum benefit period under the STD policy, which relied on a definition of total disability nearly identical to that in the LTD policy, Prudential denied LTD benefits on the basis that she allegedly no longer met the policy definition of disability. Specifically, Prudential stated that her “claimed conditions… are not supported by the medical evidence available…[and] no restrictions and/or limitations are supported by the physical/neurological examinations performed, on the imaging studies, on physiological studies or on the laboratory testing provided.” After receiving the denial, Ms. L contacted Dell & Schaefer and discussed her case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Prudential’s denial letter and in the evidence it relied on and agreed to prepare and submit Ms. L’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Sun Life’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of Prudential’s denial and significant inconsistencies with Prudential’s medical reviewer’s findings. In particular, the appeal addressed Prudential’s unilateral dismissal of the opinions of Ms. L’s highly respected neurologist and infectious disease specialist and its incorrect suggestions that Ms. L’s clinical course was “atypical” and that her constellation of symptoms were “inconsistent” with her documented diagnosis. The appeal also focused on Prudential’s overly restrictive assessment and failure to address whether, regardless of cause, the medical records and treating physician’s medical records support the fact that Ms. L does suffer from debilitating symptoms that prevented her from working, which they clearly did.

Less than one month after filing the appeal, and after reviewing the appeal and hundreds of pages of exhibits and medical records, Prudential overturned its decision to terminate benefits reinstated Ms. L’s long-term disability benefits.

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We represent Prudential 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 Prudential disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Prudential. 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 Prudential.

How do you help Prudential claimants?

Our lawyers help individuals that have either purchased a Prudential 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 Prudential:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
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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.

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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.

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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.

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