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Court upholds Standard Insurance Company’s denial of disability benefits, despite claimant’s approval of social security disability benefits

For several years, Elizabeth Black was the executive director of Milwaukee World Festival, Inc. (MWF), the organization that governs Summerfest, a music festival in Milwaukee.  Black was covered under the company’s disability insurance plan, underwritten and administered by Standard Insurance Company.  Black was diagnosed with multiple aortic aneurysms, bulging and weak areas in the aorta.  In 2001, Black had surgery to repair the aneurysms and was recommended by her doctor to medically manage a third aneurysm in the descending aorta.

After surgery and recuperation, Black went back to work in the summer of 2001 being monitored closely by her doctor, Dr. Brian Griffin, as well as her cardiologist, Dr. David Slosky for hypertension.  At the end of 2002, Black was in contract negotiations, trying to land another five year contract with MWF, but at the same, time her relationship with co-workers was strained to the point that she was experiencing harassment.  In a letter sent to the counsel for MWF, Black complained about her co-workers, the harassment and her desire for a new contract.  She sent letters from her two doctors as well as her neurologist Dr. Griffin explained that Black, “has significant hypertensive problems… it is vital that her blood pressure be well controlled. Stress, particularly in the form of verbal abuse, is very deleterious for her blood pressure control”

Dr. Slosky wrote that Black, “has significant hypertension…  her blood pressure is quite labile and reactive to stressful conditions. It is particularly sensitive to acute and direct confrontation… The patient should not be subject to harassment of this kind.” And the neurologist, Dr. Eric Maas, wrote, “any undue stress should be minimized given Black’s medical history particularly with regard to hypertension and her vascular disease,” and that “had been undergoing a great deal of stress stemming from her responsibilities as Director of Summerfest in Milwaukee and her contract negotiations,” and he requested “that these factors be taken into account in planning these negotiations with Elizabeth.”

In July 2003, the committee voted not to renew Black’s contract.  On August 6, 2003, Mrs. Black filed a disability claim with Standard Insurance Company. Black sent a letter to the board of directors, stating that she was unable to perform her duties and that doctors had advised her that she could no longer work that her condition had been worsened by her job activities and stress.

Standard reviewed medical records from Dr. Griffin and Dr. Slosky and Dr. Michael Deeken, Black’s psychiatrist. They also received an ‘attending physician statement’ from Dr. Griffin, stating that he had advised her to stop working as of 2003, and that she is unable to control her blood pressure.  On visits to Dr. Slosky on August 2001, July 2002, and July 2003, records revealed that Black’s health was stable, with the exception of poorly controlled hypertension.

Dr. Slosky wrote a letter to the Standard  Insurance Company, stating that that Black should cease working due to poor blood pressure control and the “potential for aneurysm enlargement/dissection.” Her psychologist, Dr. Deeken also submitted a statement that Mrs. Black had a diagnosis of depressive disorder and anxiety disorder.  Adding more evidence to her case, Mrs. Black submitted a copy of the Social Security Administration’s approval of her disability benefits.  She had been considered disabled due to aortic disorders and anxiety disorders by the SSA, and was considered disabled by another disability insurance company, from which she had additional coverage.

Standard denied Mrs. Black’s claim for disability benefits, stating there was not enough evidence to consider her disabled under the plan.  However, she appealed the denial, including additional letters from her doctors, who stated that Black had experienced fatigue and concentration problems.  She also submitted letters from friends and family that had witnessed her concentration and memory problems.  Standard then consulted four physicians, who took a look at Black’s medical records and evidence.  Each of them concluded that Black was not disabled, while Dr. Fraback (one of the reviewing doctors) suggested Standard consult a cardiologist, which they did.

Two cardiologists, Drs. Kent Williamson and Storm Floten reviewed the charts.  Dr. Williamson noted that while stress may reduce the risk of an aneurysm rupture, that Black’s condition could be managed with medication and that since her scans had not shown any significant change, there was no solid evidence that she was unable to work.  Dr. Floten gave his opinion that Black’s aneurysm had not been affected by her job and that the “descending aorta has not enlarged significantly in the last three years.”

Both had concluded that she was not disabled.  Dr. Gwinnell, a psychiatrist was consulted by Standard, who reviewed Black’s claim and stated that her complaints of fatigue and cognitive difficulties was not supported by her medical records.  On January 2005, Black took the case to the district court, where she was ruled against.  She appealed again to the United States Court of Appeals to the Seventh Circuit.

Black’s case was reviewed; specifically the fact that Standard denied Black while the SSA approved her.  It was found that the medical information given to the SSA was not the same information given to Standard, and therefore, that Standard was not opposing the SSA, but that the cases were completely different.  The court also found that the physician’s reports were conflicting and shifted to support Black’s disability claim. The court therefore supported the district court’s decision to rule for Standard.

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Questions About Hiring Us

Do you help Standard claimants nationwide?

We represent Standard 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 Standard disability insurance policy?

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

How do you help Standard claimants?

Our lawyers help individuals that have either purchased a Standard 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 Standard:

  • 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.

Dell & Schaefer Client Reviews   *****

Craig (California)

Cesar and Michal helped me through my case against Prudential. That only touches the surface. I suffered a bad injury which made me a challenge as I often didn’t recall what was said and to whom.

Cesar took the leap of faith to help me but he didn’t treat me like a client but more as if I was part of your family. I don’t know how you were able to get transform the team to have such a great attitude but by far I must say I am treated well from the moment I called, retained your firm it helped me through the minute I faced IME’s. Cesar demonstrates empathy and cares for his clients. I know that I made the right decision to select your firm and am fortunate that firms such as yours are around to help go up against big companies.

I truly am happy to send you a note to advise of my complete satisfaction.

The first and most important matter you have at hand is to take care of your health and let your retained lawyers handle the information needed to not only be approved for long term disability but also to make sure that your claim is managed for the duration of your disability. The disability is a matter that may last a lifetime.

A thorough online yelp review was held prior to conversations with Cesar Gavidia Esq. and Michal Mizrahi from the firm of Dell & Schaefer. I decided to retain them to handle my disability claim. The law-firm has an elaborate web page that demonstrates their ability to go up against all the largest insurance with a stellar track record.

The ERISA law is complex and if you decide to battle the insurance company without representation the odds will be stacked against you. An insurance company has one goal alone and that is to generate profits. The representation of Cesar Gavidia Esq. and Michal Mizrahi were responsible for the successful appeal and approval of my case.

An insurance company typically will deny or delay the claim as the penalty for denial or delay is non-existent. In my case, I was prepared with retained council Cesar Gavidia Esq and Michal Mizrahi who prepared and submitted the ERISA appeal. The document was complete and included information to demonstrate that I was disabled and overturned a previous denial from Prudential.

I’m not only happy to say that I picked the right firm but that I have developed a trusting relationship with combination of Cesar Gavidia Esq. and Michal Mizrahi from the firm of Dell & Schaefer.

Cesar Gavidia Esq. or Michal Mizrahi will pick up calls and take the time to explain what is being done by the insurance company or return the call in a timely basis if they were busy. This was after I had signed to be represented.

I never met Cesar Gavidia Esq. or Michal Mizrahi in person but I consider them my friends versus just attorneys that have been hired.

***** 5 stars based on 202 reviews

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