After sending claimant to a psychiatric IME, Reliance Standard realizes its decision to deny benefits was incorrect

Reliance Standard Incorrectly Denies Benefits

The claimant had been suffering from severe depression and anxiety due to many stressors in his life including a child custody battle which threw him into major depression and severe anxiety preventing him from being able to work in his occupation as an engineer. The claimant contacted the law firm of Dell & Schaefer to assist him with his appeal as he did not believe he would be able to beat Reliance Standard on his own. As his attorney, Rachel Alters worked with his physicians, reviewed his medical records and appealed his claim demonstrating how Reliance Standard was arbitrary and capricious in denying his claim. The medical records clearly supported that the claimant was unable to work due to symptoms of anxiety, depression, inattention, distractibility, disorganization, worrying and sleep disturbance that result from his preoccupation with the well-being of his children and his lack of involvement in their lives. He continued to experience chronic stressors due to his separation from his children (no visitation), his involvement in a bitter divorce, and significant financial strain due to legal bills and associated financial obligations. Until these identified stressors remit, the claimant would continue to be unable to perform his work-related responsibilities.

Since the inception of his claim for disability benefits, all of the claimant’s treating physicians consistently provided information to Reliance which documented the clinical findings on exam and supported the medical opinions that he was is incapable of performing the material duties of his regular occupation. Moreover, his treating physicians continued to provide the opinion that he was unable to work due to his disabling symptoms.

In reaching its decision to deny LTD benefits, Reliance relied on a peer review report by their hired physician. Reliance’s peer review physician noted the claimant’s symptoms of depression, anxiety, worrying, feelings of sadness and helplessness and sleep disturbances are supported by the objective findings of depressed and anxious mood. However, she disregarded his symptoms of inattention, distractibility and disorganization, despite that these symptoms were consistently reported by all of his treating physicians, due to a purported lack of objective testing.

The LTD Plan specifically provides that Reliance retains the right to have the claimant examined physically, psychologically and/or psychiatrically to determine the existence of any Total Disability which is the basis for a claim. However, Reliance failed to perform any such examination in its initial evaluation of his claim for benefits, even though a clear dispute existed between Dr. Acenas and the treating physicians regarding his symptoms of inattention, distractibility and disorganization. It is these symptoms primarily which render him unable to perform his occupation. Reliance failed to perform a full and fair review of his claim when they chose to rely solely on the paper review performed by their peer review physician instead of conducting a psychological or psychiatric examination of the claimant pursuant to the provisions of the LTD Plan.

IME Performed by Reliance Doctor Finds Claimant Disabled

After receiving the appeal from Rachel Alters of Dell & Schaefer, Reliance finally requested the claimant undergo an independent medical examination with a psychiatrist. After an extensive interview and examination, the IME physician determined that the claimant was unable to work in his occupation as his physicians stated all along. Reliance reversed its decision to deny benefits, paid the claimant his past benefits owed and put him on claim. Rachel Alters will manage the claimant’s claim until he is able to return to work.

Read more about Reliance Standard disability claims.

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FAQ

Do you help Reliance Standard claimants nationwide?

We represent Reliance Standard 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 Reliance Standard disability insurance policy?

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

How do you help Reliance Standard claimants?

Our lawyers help individuals that have either purchased a Reliance Standard 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 Reliance Standard:

  • 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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