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.

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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.

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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
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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.

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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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BK. K.

After my claim was denied I was at a standstill. Not knowing what to do next, I happened upon Dell & Schaefer on an Internet search… skeptically I investigated and did due diligence. After initial contact, I firmly realized it was in my best interest to have Dell & Schaefer represent me. Throughout the appeal process, my emails were answered, my phone calls were returned and there was no such thing as a stupid question. It was a complicated case and my confidence was positive throughout the appeal experience. After several months I was put back on claim and there is no question I could not have done this without Dell & Schaefer’s excellent and fair representation.

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