Court Upholds Principal Life’s Denial of Extended Disability Benefits

In Peterson v. Principal Financial Group, plaintiff injured her back in a car accident and subsequently underwent a spinal fusion. She was awarded 24 months of disability when she was unable to return to her own occupation as a Target employee. After 24 months, the definition of disability changed to requiring her to be disabled from any job “that provides 128% or more of the disability benefit.” Principal refers to these as “extended disability.” After evaluating her medical and other records, Principal denied her application for extended disability.

After exhausting her administrative appeals, Peterson filed this ERISA lawsuit. The court upheld Principal’s denial of extended benefits concluding that, “Principal’s determination that Plaintiff was not entitled to extended disability benefits was based on substantial evidence and is therefore reasonable.” She raised several issues in the lawsuit, all of which the court determined had no merit. Two of them required a deeper analysis.

There Was Substantial Evidence to Show Peterson Could Work at a Sedentary Level

The Colorado federal district court evaluated all the evidence presented to Principal which resulted in its denial including:

The court found Principal acted reasonably in denying the application for benefits, noting, “The relevant inquiry is not whether Principal’s conclusion was the best one, but rather whether Principal’s conclusion was a reasonable one—even if on the low end of reasonableness.”

There Was Substantial Evidence That Jobs Were Available That Paid 128% of Peterson’s Disability Benefit.

Following Principal’s determination that Peterson qualified for sedentary work, the burden shifted to her to prove no such work existed for which she was “reasonably fitted by education training or experience” that would pay her $24,222.72 per year. Principal suggest four different jobs available to her that, according to the requirements of the plan, she “could become qualified ‘by education, training, or experience.'”

Since Principal’s determination that she could qualify for these jobs, the court held that she Principal’s determination that she was “not entitled to extended disability benefits was based on substantial evidence and is therefore reasonable.”

This case was not handled by our office, but we think it can be instructive to those struggling to obtain disability benefits when required to prove their inability to work in “any occupation.” For information about disability benefits, call one of our lawyers for a free evaluation.

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Our lawyers help individuals that have either purchased a Principal long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

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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.

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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.

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Celestine D.

I am a 61 year old Senior Business Analyst. I had been working at a health insurance company for approximately 11 years when I became disabled and have had numerous, bulging disks, nerves that were severely impinged, and active arthritis and degenerative disk disease throughout my spine. I underwent back surgery for L1 thru L5 infusion which included insertion of 2 titanium rods and 6 pins. I continue to undergo physical therapy 3 xs per week. Not to mention the surgery left me worse than before the surgery considered a FAILED BACK SURGERY. I’m unable to sit or stand for more than 2 hours with getting up. I am unable to walk for more than 1 city block. I also have many other medical conditions. After collecting LTD from Lincoln Financial for about 3 years, the harassment began. They decided that I was no longer disabled. In short they felt I was capable of returning back to the work force. (Social Security Disability deemed me permanently disabled)

After fighting with Lincoln and exhausting my appeals I decided to research and hire an attorney. I selected Dell & Schaefer based on their website, case success statistics, and the speed at which they returned my calls and emails.

Let me tell you, my experience in working with Rachel Alters and her assistant Michal Mizrahi is nothing short of outstanding. They responded quickly to phone calls and emails and were mindful of my concerns and information needs. Talking with the both of them made me feel confident and assured they were doing the best for me. I cannot say enough good things about Michal. She anticipated my needs and was proactive in keeping me informed as my case progressed. What a TEAM they make. Any time I reached out with questions or concerns they were very responsive and always left me feeling satisfied that I had the best in my corner. Rachel is an angel. She is so down to earth compassionate, professional and trustworthy attorney. Rachel was there to guide me from the start and helped me get through this stressful and lengthy process.

While attempting to handle it on my own, my long-term-disability claim had been denied two previous times. With the help of Rachel Alters and her team, I was able to obtain a settlement I never would have been able to get without their assistance. Rachel and her team far exceeded my expectations in every capacity. She was focused, clear, responsive, efficient and above all exceedingly knowledgeable.

***** 5 stars based on 202 reviews

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