After Two Appeals The Standard Insurance Approves Short & Long Term Disability Benefits for Nurse

Prior to filing for disability, our client was a Registered Nurse employed as a Senior Case Manager for United Healthcare. Our client was a dedicated employee who enjoyed her work until chronic pain, frequent headaches, and resulting cognitive dysfunction forced her to stop working in July of 2018. Fortunately, her employer provided disability insurance coverage under two policies: UnitedHealth Group’s self-funded Short Term Disability Policy and a Group LTD Policy which was administered and insured by The Standard Insurance Co. Initially, our client was found to be totally disabled under the terms of the STD policy but not for the maximum benefit period. Following the filing of an appeal by Attorney Palamara, her benefits for short term disability were reinstated and paid through the maximum benefit period which ended in January  of 2019.

While her STD appeal was pending, our client filed for LTD benefits under the governing LTD Policy with the Standard. Unfortunately, despite being awarded her maximum Short Term benefits following the STD appeal by Attorney Palamara, The Standard denied her claim for long term disability benefits. In the LTD denial letter, The Standard claimed her illnesses did not preclude her from performing her nursing duties, and as a result, the Standard felt that she did not meet the Definition of Disability.

The Standard’s decision to deny benefits rested almost exclusively on a paper review and opinion by a physician consultant, who never examined or met with our client. The physician consultant noted inconsistencies regarding our client’s functional abilities and disregarded much of the relevant medical information concerning her multiple chronic impairments. Citing the physician consultant’s review, Standard concluded that the medical evidence did not contain any objective findings to support restriction and limitations and that our client could return to her past work as a Nurse Case Manager.

Appeal by Attorney Palamara

After receiving the denial letter for the long term disability claim, Attorney Palamara quickly reviewed the denial letter and knew that Standard did an improper job of reviewing her claim. After ordering the claim file and all medical records from the treating providers, it was quickly seen that Standard and its reviewing consultant overlooked ample objective evidence of her chronic pain and disabling conditions.

First and foremost, Standard and its physician consultant did not examine our client to have an opportunity to observe her decreased sensation, as well as her impaired grip and motor strength. It also did not interview our client to ascertain or quantify the extent of her chronic pain complaints. Attorney Palamara also highlighted a multitude of additional functional restrictions that were supported by the medical records but not considered by Standard.

LTD Claim Approval

On July 24, 2020, we received word from Standard that it was approving our client’s Long Term Disability Claim. In its correspondence, The Standard advised that its Administrative Review Unit completed its review of the claim and determined that it was reasonable to conclude that our client continues to satisfy the applicable definition of disability. Shortly thereafter, our client received a sizable benefit check for nearly a year and a half of benefits and remains on claim at the present time. Although our client is relieved to be finally on claim, she knows that the fight will continue as her policy’s definition of disability changes after 24 months of benefits. At that point, we will have to prove to Standard that she is “unable to perform with reasonably continuity the Material Duties of Any Occupation.” Thus, Attorney Palamara will continue to work on this claim to continue to prove to Standard that our client remains disabled and satisfies the requirements of the policy.

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

Questions About Hiring Us

Do you help Sedgwick claimants nationwide?

We represent Sedgwick 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 Sedgwick disability insurance policy?

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

How do you help Sedgwick claimants?

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

  • 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   *****

Michelle (California)

Jay Symonds,

I just wanted to send you a formal Thank You for your time and support.

I hope you received my email that I have been assigned a new case manager. Since I haven’t received a denial letter, I’m assuming I’m back on the yearly audit schedule. If anything changes in the status of my claim, I will contact you to handle my case. Thank you again for the time you gave me. Very Much Appreciated!

***** 5 stars based on 202 reviews

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