AXA Equitable and DMS Approve LTD Benefits for Litigation Attorney with ADHD & Bi-Polar
Author: Attorney Gregory Dell
A successful commercial litigation and trial attorney contacted disability insurance attorney Gregory Dell to seek assistance with filing a long term disability benefit claim with AXA Equitable Life Insurance Company. Our client was in his late 40’s and he had purchased his disability insurance coverage from AXA Equitable Life more than 10 years before he became disabled. Like many business professionals, our client had been struggling for many years with his disability, yet he continued to try to work through his condition of Attention Deficit Hyperactivity Disorder (ADHD) and Bi-Polar. Prior to filing for disability he had been treating with multiple psychiatrist and psychologist on and off for approximately 4 years. Our client was earning in excess of $250,000 annually and had no interest in giving up his career as a litigation attorney. Unfortunately, as the daily errors and inability to get his daily tasks completed began to multiply, he realized that he was no longer able to perform the duties of a commercial litigation attorney.
Definition of Disability and Occupation Duties of a Litigation Attorney
Fortunately our client had purchased an own occupation disability policy that defined total disability as “your inability due to sickness or injury to engage in the substantial and material duties of your occupation“. Our client’s typical work week was 50-60 hours and his substantial and material duties included: conducting discovery, drafting pleadings and motions, attending depositions and court hearings, numerous phone conferences with clients and opposing counsel, preparing Summary Judgment and numerous other motions, trial preparation, legal research, daily travel out of the office to attend court hearings, depositions, mediations or client meetings. Our client was billing over 1,500 hours annually and was involved in multiple active lawsuits at any given time.
AXA Equitable and Disability Management Services (“DMS”) Question Client’s Disability
Disability Management Services Inc. (“DMS”) is a third party administrator that administers all aspects of AXA Equitable long term disability insurance claims. Our law firm has handled hundreds of claims that have been administered by DMS. Despite medical support from our client’s treating physicians, DMS and AXA Equitable required that our client undergo a neuropsychological evaluation and psychological evaluation in order to independently verify his restrictions and limitations. It is unusual to have an IME exam performed prior to claim approval, but DMS was questioning how our client continued to work through his years of suffering. We demanded that the IME exams be videotaped and that copies of the IME reports be sent to our client’s treating physicians for review and comment. We also clarified the scope of the testing prior to allowing our client to submit for any testing. It is unfortunate that we often see disability companies that will question the seriousness of a claimant’s disability because he or she tried to continue working with disabling condition. Disability claimants need to be careful about how long they continue to work while claiming that they are limited by a medical condition. In our client’s case the doctors hired by the insurance company actually agreed with the finding of our client’s doctors. Since our client has an own occupation disability policy he has been able to work in alternative jobs that do not require performance of the same substantial and material duties of a commercial litigation attorney. While working in alternative jobs, our client can collect his full monthly disability benefit and whatever additional income he is able to earn. We continue to monitor and manage our clients AXA disability claim on a monthly basis.