Dell & Schaefer Successfully Appeals Denial of Benefits to Former Inventory Control Specialist

Pre-disability and initial disability claim

Our client contacted us for assistance with her claim against Liberty Mutual after receiving a denial of her Long Term Disability (“LTD”) benefits. Ms. M had been working as an inventory control specialist with her employer until June 2014 when her doctor advised her to stop working due to various medical conditions including pseudoarthrosis, post-laminectomy syndrome, chronic low back pain, chronic pain syndrome, peripheral neuropathy, bilateral SI joint pain, general osteoarthrosis, and fibromyalgia. Ms. M received short term disability benefits until January 2015 at which point she became eligible to receive long term disability benefits. Unfortunately, in February 2015, Ms. M received a letter from Liberty Mutual denying LTD benefits and stating that Ms. M was not disabled and could return to work.

According to Liberty Life’s denial letter, the decision to deny Ms. M’s claim for LTD benefits was based primarily on the peer review performed by Liberty Life’s physician consultant, Dr. Mark Kaplan. Based on his review of only the paper medical records, Dr. Kaplan opined that Ms. M would be capable of sitting for 30 minutes continuously for up to 8 hours per day, standing for 10 minutes continuously up to 30 minutes per day, walking for 10 minutes continuously up to 30 minutes per day, lifting and carrying up to 10 pounds occasionally, pushing and pulling up to 10 pounds occasionally, and driving a car for 30 minutes continuously up to 1 hour per day. Dr. Kaplan restricted Ms. M from total balancing, climbing ladders, working at unprotected heights, total kneeling and pedaling. He indicated she was restricted to performing repetitive bending, twisting or squatting up to 4 times per hour, and lifting or reaching above shoulder level and below waist level up to 4 times per hour.

Based on the opinion of Dr. Kaplan, Liberty Life concluded that Ms. M had full time sedentary work capacity and, therefore, could perform the material and substantial duties of her own occupation.

Ms. M. Contacts Attorneys Dell & Schaefer

Unsure what to do, Ms. M contacted our firm for help fighting Liberty Life. We reviewed Ms. M’s denial letter and discussed her claim with her. Our team immediately began working on Ms. M’s appeal and requested a complete copy of the claim file from Liberty Life. Upon review of the claim file it became apparent that Liberty Life did not understand the nature of Ms. M’s condition and the effect of her conditions on her ability to work.

Appeal by Dell & Schaefer

The appeal prepared by Dell & Schaefer appeals team pointed out the errors in Liberty’s review. Liberty Life had overlooked or completely ignored all of the objective and diagnostic evidence found in the medical records and relied solely on the single contrary opinion of Dr. Kaplan, which interestingly did not seem to support the purported “sedentary” work capacity Liberty Life states Ms. M had the ability to perform.

The great weight of the medical evidence in fact supported that Ms. M has less the sedentary work capacity and, therefore, is unable to perform the material and substantial duties of her own occupation.

To provide additional objective evidence corroborating Ms. M’s disability, we had Ms. M undergo a Functional Capacity Evaluation (“FCE”). As suspected, the report revealed that Ms. M’s ability to engage in competitive employment is unlikely.

Liberty Life’s review of the appeal and decision to overturn its denial

The appeal was submitted to Liberty Life by letter dated August 24, 2015. By September 3, 2015, less than 2 weeks later, Liberty Life notified our office that the denial had been overturned and a check for back benefits would be issued.

We will continue handling Ms. M’s claim against Liberty Life.

Questions About Hiring Us

Do you help Liberty Mutual claimants nationwide?

We represent Liberty 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 Liberty Mutual disability insurance policy?

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

How do you help Liberty Mutual claimants?

Our lawyers help individuals that have either purchased a Liberty 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 Liberty 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, 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   *****

Eric S. (Ohio)

Cesar and his paralegal Vanessa were always engaged and went above and beyond taking a case I had trouble finding help with until I met them! After the lengthy appeal failed Cesar continued to work hard and he won a very satisfying settlement for me!

It’s a shame that we consumers look to insurance companies to provide for us in our time of need, yet they consistently do just the opposite when counting their premiums and holding on to them just as long as possible. The fact they reward their claim specialists with variable bonuses each year instead of paying them a straight salary tells the story most effectively. Of course those bonuses rise when beneficiaries lose. So sad. Thanks to Cesar’s negotiating skills it wasn’t as painful as the insurance company would have preferred…

***** 5 stars based on 202 reviews

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