• Boston Mutual Life Insurance Company Disability Claim TipsBoston Mutual Life Insurance Company Disability Claim Tips

Claimant Unsuccessful in Disability Insurance Lawsuit against Boston Mutual Life Insurance Company in a Louisiana Lawsuit

A recent ruling by a Louisiana Federal Judge illustrates the importance for a long term disability claimant to be represented by an experienced ERISA attorney throughout each and every phase of a claim for benefits. In this ruling, the Court notes that it found no evidence to contradict the insurance companies “independent” reviewers’ opinions that the claimant could return to work. As such, the Court’s decision leaves this claimant with no benefits and no avenue to get back on claim. Due to the extreme lack of medical support it does not make sense that a lawyer would actually file this lawsuit. This claimant appears to have had some medical conditions, but the claimant and his treating doctor disagreed about the extent of the claimant’s physical limitations.

Medical History and the LTD Claim Against Boston Mutual

Previously employed by Southside Machine Works, Inc. as a Machinist, the claimant was forced to leave work on June 23, 2005 due to degenerative back problems. Shortly thereafter he applied for disability benefits from Boston Mutual Life Insurance. Relying on the support of his neighbor who was also a physician who diagnosed him with severe degenerative joint disease/spinal stenosis-lumbar spine, along with the medical records of another treating physician, the claimant felt confident in his filing for benefits.

Upon receiving the claim for benefits, Boston Mutual thoroughly reviewed his claim in an effort to determine its veracity. The first thing Boston Mutual noted was that the neighbor/physician stated that his treatment of the claimant was “off the record”. The neighbor/physician was however supportive when he informed the insurance company that the claimant was “in a bad way” and “would not be able to work in a machine shop.” When Boston Mutual spoke with the other physician who had treated the claimant, they found a doctor who was not as enthusiastic of stating that the claimant was disabled. In fact, this physician told Boston Mutual that the claimant was “much improved” after taking just 3 pain pills over a month. This physician also would not provide any restrictions or limitations and stated that the claimant could return to work when he felt like it. This is a fact that essentially made it impossible for the claimant to prevail on his claim for benefits.

Boston Mutual then had a Registered Nurse look at this case. This Nurse noted that the claimant’s job as a machinist provided that he would have to lift 50 pounds and be able to use a significant amount of torque to tighten machinery. The Nurse again contacted the claimant’s treating physician to determine if he would be able to perform this occupation. The treating physician would again not put any restrictions or limitations on the claimant. Boston Mutual therefore decided to deny the claim.

The claimant appealed. With his appeal the claimant noted that he was scheduled for surgery in the upcoming months. However, medical records and surgical records were provided with his ERISA appeal. Boston Mutual ordered these records and the records from a prior recent medial branch block procedure. Boston Mutual had these new records reviewed by an outside orthopedic physician. This reviewing physician also spoke with the claimant’s treating physician. The treating physician informed the reviewing physician that he felt that the claimant could return to work at this time. The reviewing physician therefore concluded that he found “no documentation of symptoms, physical findings, or other documentation that would support R & Ls…”. Boston Mutual again denied the claim but gave the claimant an option to file an additional appeal.

ERISA Lawsuit Against Boston Mutual

Instead of filing an additional appeal where the claimant could have sent in updated medical records including updated MRI’s and the newest surgical records, the claimant decided to file this lawsuit instead. This decision to go forward with such a lack of medical support appears to have been an incorrect decision. Boston Mutual filed a motion for summary judgment whereby it asked the Judge to rule in its favor prior to trial because its findings were so overwhelmingly supported by each of the reviews it conducted and the opinion of the claimant’s own treating physician. The claimant’s attorney failed to file any response to Boston Mutual’s Motion. The Court therefore found that were no medical records in the Administrative Record contradicting Boston Mutual’s findings, and thus the Court held that Boston Mutual did not violate its discretion and upheld its decision to deny the claim.

It appears that many different avenues could have been taken to have given this claimant a better shot at receiving disability benefits. Whether it would be getting more supportive objective evidence prior to filing the first appeal, filing a second appeal to make the administrative record as strong as possible, or filing an answer to the insurance company’s motion for summary judgment, this case is illustrative why an individual needs an experience ERISA disability attorney handling the claim at all times.

It must be noted that our firm DID NOT handle this case, however, we handle many like it throughout the country. Please contact us for a free consultation and to discuss your disability claim.

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FAQ

Do you help Boston Mutual claimants nationwide?

We represent Boston 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 Boston Mutual disability insurance policy?

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

How do you help Boston Mutual claimants?

Our lawyers help individuals that have either purchased a Boston 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 Boston 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, 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.

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After being denied on a long-term disability claim by a private disability insurance company, while dealing with a difficult and painful case of chronic Lyme disease that has made it impossible for me to work, Alexander Palamara and the staff at Dell & Schaefer helped me to get a fair settlement that will help me financially. Dell & Schaefer was incredibly easy to work with. They understood the complicated health problems that I was experiencing, which isn’t always the case in the field of Lyme disease, a field in which there are still many unknowns and many disagreements within the medical world. The staff at Dell & Schaefer made the complex legal process as clear and straightforward as possible, and I was, and remain, extremely grateful for their kindness, their assistance, and their legal expertise. I would totally recommend Dell & Schaefer to anyone needing legal help with a complicated disability claim.

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