After Initially Being Denied Long Term Disability Benefits, Dell & Schaefer Gets Former Wal-Mart Employee on Claim with Liberty Mutual

A former employee of Wal-Mart contacted our firm on March 11, 2015. She informed us that she had recently been diagnosed with Multiple Sclerosis less than a month earlier. She also informed us that prior to this diagnosis she was forced to leave her occupation as a Personnel/Training Coordinator for Wal-Mart Stores, Inc. She previously had been diagnosed with small fiber peripheral neuropathy, ankylosing spondylitis and migraine headaches. Unfortunately for this very nice lady, her body left her unable to perform the material and substantial duties of her own occupation. Thankfully her employer Wal-Mart provided its employees with the Wal-Mart Stores, Inc. Associates’ Health and Welfare Plan. This plan provided a Long Term Disability (LTD) policy in case such a situation arises where a person as a result of injury or sickness is unable to continue to work. This plan would provide a percentage of her prior monthly earnings if she should qualify.

Even though her doctors had yet to fully diagnose what was occurring with her body, she figured she should surely qualify because her body left her unable to work. She timely filed an application for LTD benefits with Liberty Mutual, but this application was denied by way of a letter dated September 30, 2014.

The ERISA statutes provide that a person has a right to challenge a denial of such benefits by filing an administrative appeal. The ERISA statutes also give a 180 day deadline to file such an appeal. If an appeal is not timely filed, then the person who made the claim will lose their rights under the policy and be prevented from filing a lawsuit for this claim. In other words, filing a timely appeal is an ultimate necessity.

When this former employee of Wal-Mart contacted us on March 11, 2015, there was only 18 days remaining to file this timely appeal. Attorney Alexander Palamara quickly got involved and requested a copy of the administrative record from Liberty Mutual and also requested a 60 day extension of time to submit the appeal. Luckily, by way of a letter dated March 24, 2015, Liberty Mutual approved this request and gave us some breathing room to file the appeal. Now it must be noted that not all insurance companies will afford such an extension of time and such requests are often denied. So although this case turned out positive and Liberty Mutual gave us the requested extension, it cannot be stressed enough that no one who has been denied benefits should wait to contact our firm for representation as sufficient time is needed to draft the strongest appeal possible.

Review of the Claim and the Filing of the Administrative Appeal

In its initial denial dated September 30, 2014, Liberty Mutual relied upon a clinical review and assessment of a Board Certified Physical Medicine and Rehabilitation Physician. Based on the medical records that were previously provided by our now client, this physician opined that “physical impairment is not supported by available records…”. Unfortunately for our client, although she was suffering severely, she did not provide sufficient “proof of loss” to prove her case with Liberty Mutual.

As mentioned earlier, since the time of this initial denial letter, our now client had a new diagnosis and better understanding of why she was suffering from visual, motor and sensory problems as well as fatigue and chronic pain. Because of her diagnosis of Multiple Sclerosis and the accompanying restrictions and limitations she was suffering from, we knew that Liberty Mutual had to overturn its decision if we were able to show objectively through her medical documentation that she was unable to perform the material and substantial duties of her own occupation.

Complete medical records were ordered from all of her treating physicians. We also asked certain physicians to complete Attending Physician Statements which we drafted specifically for this client. A review of the medical records showed objectively that Liberty Mutual should be paying LTD benefits.

A timely appeal was filed May 22, 2015. This appeal provided all the compiled medical records and proved objectively that Liberty Mutual must approve this claim. Thankfully, Liberty Mutual Agreed. By way of a phone call on June 18, 2015, Liberty Mutual informed Dell & Schaefer that it was approving her claim under the “own occupation” definition of disability and that it would be paying her claim for the full year that it previously should have been paying.

Although the policy makes it more difficult to qualify for LTD benefits after the initial year (at that point, one must be unable to perform the material and substantial duties of any occupation), Dell & Schaefer will fight to prove to Liberty Mutual that our client should also qualify under the new definition of disability. Should Liberty Mutual deny her claim under this standard, Liberty Mutual knows that it will have a fight on its hand as Dell & Schaefer will continue to do whatever it takes to keep her on claim until her policy expires or until she is ready and able to return to work.

If you have been denied disability benefits by Liberty Mutual or any other disability insurance provider, please do not hesitate to contact Attorney Alexander Palamara at Dell & Schafer for a free consultation.

Read more about Liberty Mutual disability claims.

Questions About Hiring Us

Do you help Liberty Mutual claimants nationwide?

We represent Liberty Mutual 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 Liberty Mutual disability insurance policy?

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

How do you help Liberty Mutual claimants?

Our lawyers help individuals that have either purchased a Liberty Mutual 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 Liberty Mutual:

  • 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, 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.

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