After appeal filed by Attorney Jay Symonds, Prudential overturned its previous denial of long term disability benefits for Pennsylvania Corporate Training Coordinator

Our client, Mr. T, formerly worked as a Corporate Training Coordinator for a large consumer product corporation. In October 2015 a number chronic psychiatric conditions, including major depressive disorder, major depressive affective disorder, post traumatic stress disorder, chronic anxiety and bipolar affective disorder forced Mr. T to stop working and submit his claim for disability benefits, first under his 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 his employer’s LTD policy, he would be considered totally disabled for the first 12 months if he was unable to perform the material and substantial duties of his “regular occupation” as a Training Coordinator. After 12 months he would be considered totally disabled if he was unable to perform the duties of “any gainful occupation” for which he was qualified by education, training and experience and with additional consideration of his functional limitations and transferable skills.

After paying Mr. T for the maximum 12 month own occupation benefit period under the LTD policy Prudential denied further benefits on the basis that Mr. T allegedly no longer met the policy definition of disability. Specifically, Prudential stated that it “does not find that he has any restrictions or limitations from a psychiatric perspective… and the medical information received did not support impairment that would prevent him from performing material and substantial duties of any gainful occupation.” After receiving the denial, Mr. T contacted Dell & Schaefer and discussed his 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 Mr. T’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Prudential’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 decision to ignore the opinions of Mr. T’s highly respected treating physician, which confirmed that Mr. T suffered from significant psychiatric issues that prevent him from having the functional capabilities to perform all the essential duties of any sedentary occupation with reasonable continuity on a regular and sustainable basis, opting instead for the opinion of a highly compensated physician who, contrary to his own stated practice methodologies, conducted an incomplete paper review and offered an opinion unsupported and contradicted by all the available medical records.

Less than one month after filing the appeal, and after reviewing the appeal letter and hundreds of pages of exhibits and medical records, Prudential overturned its decision to terminate benefits reinstated Mr. T’s long-term disability benefits.

Questions About Hiring Us

Do you help Prudential claimants nationwide?

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
  • 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.

Dell & Schaefer Client Reviews   *****

Christina R.

GREGORY DELL IS THE BEST IN THE BUSINESS!

I was referred to Greg by a very well-respected attorney where I lived at the time, and he described Greg as not only one of the top attorneys in his field, but the BEST in the COUNTRY at what he does! After having interviewed other attorneys for my case that I did not quite feel right about, I contacted Greg and it was a very refreshing encounter, to say the least! He was very compassionate in regards to my health situation, and had had experience with other clients in the past who had been in the same industry as I had… and whom he had also very successfully represented. He was strong, confident and extremely intelligent.

His knowledge of the law was unsurpassed, and he had impressive Insight and expertise in dealing with insurance companies. Greg has successfully represented me now for over six years, and I honestly could not have handled the stress involved with working directly with the insurance company – in my fragile condition – without him! He and his highly-professional Staff have taken over my claim so that I can be worry-free and focus totally on my health and wellbeing. Greg is a master at what he does and I have the utmost respect for him. I have entrusted my whole livelihood in his and his capable Staff’s hands, and I feel totally confident in their ability to represent me in the best possible way, as well as to protect my very best interests. Most importantly, Greg has given me peace of mind at a very difficult time in my life. And, he has done it with kindness, compassion and honesty. His positive attitude and wonderful personality also make it a joy to work with Greg. He has been the ultimate blessing in my life since this unfortunate illness, and I sincerely feel so grateful to have found him!

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