Attorneys Dell & Schaefer win long term disability insurance appeal against MetLife on behalf of engineer suffering from Parkinson’s

Our client, who suffers from Parkinson’s, was a highly skilled engineer and operations manager for an international corporation before his illness rendered him unable to perform the duties of his occupation. Diagnosed with Parkinson’s years before filing for long term disability benefits under his company’s disability plan, he did everything in his power to work at a job he enjoyed and excelled at. However, the nature of his illness began to take a heavy toll, as symptoms relating to his cognitive functioning began to worsen. Left with little choice, he applied for disability benefits under his company’s short term disability policy in March of 2008. He was approved for short term benefits under the disability policy. However, in October of 2008, when the short term disability benefits were exhausted, MetLife denied his claim for long term disability benefits.

He then contacted Attorneys Dell and Schaefer to appeal MetLife’s denial. From the start, MetLife was uncooperative in requests for information made by Dell and Schaefer. Persistent in our representation we finally secured all of the documentation requested. Review of the MetLife claim file immediately identified how MetLife wrongfully denied our client’s claim. The most glaring injustice was that in denying his claim, MetLife relied upon the opinion of a licensed social worker and a registered nurse. MetLife had a duty to our client to give his claim for long term disability income benefits a full and fair review, and failed to do so when they decided to not hire appropriately qualified medical providers in the area of Parkinson’s to render opinions as to our client’s functional capabilities. In addition to this, the individual’s hired by MetLife to review our client’s medical records did not contact our client’s treating physicians to gain any insight into his condition, nor did they draft any reports documenting their findings and opinions. Moreover, MetLife relied on the report of a vocational rehabilitation specialist, who completely failed to identify the duties of our client’s occupation. Instead, the specialist concentrated on the most insignificant of job duties in rendering her opinion our client could perform his occupation.

Attorney’s Dell and Schaefer helped to guide our client to proper treating physicians for his condition, as well as tests to be performed that would counter MetLife’s reasons for denying his claims for long term disability benefits. To develop a better understanding of our client’s pre-disability occupational duties and his difficulty performing those duties, Dell and Schaefer contacted past co-workers for further insight, and to help present a complete picture of the battle our client endured with Parkinson’s. Armed with objective testing to prove cognitive dysfunctions and an understanding of the true nature of our client’s occupation, Dell and Schaefer filed an extensive appeal with MetLife to overturn the wrongful denial of long-term disability benefits. MetLife had 45 days under ERISA in which to review the appeal, however, presented with overwhelming evidence and arguments as to the mishandling of the claim, MetLife overturned its denial in less than one month.

This case was handled by attorneys Gregory Dell and Stephen Jessup.

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There are 2 comments

  • Jim,

    It is all too common that the most difficult obstacle in a claim for disability benefits is a lack of support from a treating physician. It goes without saying that if your doctor won’t support the disability then the carrier would be justified in denying a claim by relying on your doctor’s opinions. It is incredibly important to stress to a doctor the demands of your occupation and to point out that a claim for “disability” does not mean you cannot do anything, but rather you cannot perform the duties required of your occupation. More than likely you policy is governed by the federal law ERISA, and as such your doctor would never be subject to providing deposition or having to testify in Court as ERISA does not allow for either. Sometimes this fact helps soften a doctor’s stance as they realize that supporting the disability will not get them wrapped up in lengthy legal proceedings. Please feel free to contact our office to discuss your options in applying for benefits.

    Stephen JessupFeb 18, 2014  #2

  • I am 58 year old pharmacist diagnosed 10 years with parkinsons by neurologist. My appointments are every 3 months and symptoms well documented. Recently I took the battery of neuropsyche tests that revealed some cognitive slowing but they believe I am still of ability to work. I trust the psychologist but the tests are certainly not sensitive to the extraordinary fast pace and work requirements required daily. The liability to myself and company would appear very high. My home life is simply rest before and after work just to get by each day. I additionally have most of the typical symptoms of parkinsons. My superiors have treated me beyond what any employee could ask. They also provide me with both std and ltd. When mentioning to my neurologist that I am ready for disability his mood changed and I am not certain if he supports total disability. Could you please advise me on how other patients have dealt with this delicate topic.

    Jim TottonFeb 17, 2014  #1

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