Court Compels Metlife To Reconsider Its Decision To Terminate Claimant’s Long-Term Disability Benefits

The United States District Court for the Southern District of New York recently held that MetLife’s decision to deny benefits to a Plaintiff was unreasonable and ordered MetLife to reconsider Plaintiff’s Long Term Disability claim.

Plaintiff was 39 years old when MetLife approved his short-term disability claim due to herniated discs in his cervical and lumbar spine, scoliosis, canal stenosis, carpal tunnel syndrome, cervical radiculopathy and other medical conditions.

Plaintiff flew to Cairo, Egypt one month after being approved for Disability benefits

Approximately one month after being approved for short-term benefits, Plaintiff flew to Cairo, Egypt where his parents live. Two weeks earlier Plaintiff contacted MetLife of his plans to travel and MetLife in turn, launched an internal investigation of Plaintiff’s claim believing that his flying to Egypt was inconsistent with Plaintiff’s claim of disability.

MetLife terminates Plaintiff’s benefits after a year and nine months of approving Plaintiff’s disability claims

After paying Plaintiff benefits for the maximum period allowed under the short-term disability plan, MetLife approved Plaintiff’s claim for LTD benefits. However, in January 2009, MetLife decided to close Plaintiff’s claim after a year and nine months of approving his disability claims even though there had not been any significant change in Plaintiff’s condition.

Plaintiff submitted an ERISA Appeal and MetLife upheld the termination of benefits. As a result, Plaintiff and his New York disability attorney filed an ERISA lawsuit seeking judicial review of MetLife’s final decision.

Court concludes that MetLife’s determination was unreasonable

After reviewing the administrative record the U.S. District Court for the Southern District of New York found that MetLife’s denial of benefits was wrong. Accordingly, judgment was entered in favor of the Plaintiff.

In reaching its decision, the court explained that MetLife improperly relied on Independent Medical Reviews conducted by physicians retained by MetLife. The court pointed out that two of MetLife’s physicians did not have an opportunity to physically examine Plaintiff and their opinions were based solely on the medical records. Furthermore, one of MetLife’s doctors ignored Plaintiff’s subjective complaints of pain and had disqualified diagnostic tests because they were illegible.

The court also refused to accept one MetLife doctor’s conclusion that the Plaintiff’s ability to endure a flight to Egypt was inconsistent with his claims of disability explaining that Plaintiff’s pre-disability occupation; which required sitting, programming and typing for up to eight hours a day, five days a week was distinct from flying. Furthermore, the court explained that many people are able to travel internationally while on sedatives or other medication that would otherwise impair their job performance.

In sharp contrast to MetLife’s findings, Plaintiff had submitted substantial evidence of his conditions from six different examiners – all of which were unanimous about Plaintiff’s diagnoses – and two functional capacity evaluations. MetLife did not conduct its own functional capacity evaluation and did not request a description of Plaintiff’s job duties until four months after its initial denial of Plaintiff’s claim. The absence of a job description prior to the initial denial raised questions about whether Plaintiff’s claim was fairly and adequately reviewed.

Considering all the evidence, the Court found MetLife’s determination was unreasonable and ordered MetLife to reconsider Plaintiff’s claim in light of the Court’s findings and all the evidence submitted.

Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

View videos, articles, resolved cases and claimant reviews about your specific disability insurance company.

Leave a comment or ask us a question


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, 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.


Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us