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.

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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
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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.

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.

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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.

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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   *****

Jim F.

My employer offered both Short Term Disability and Long Term Disability insurance as optional benefits among others. The premiums were significant, but since they could be payroll deducted I felt they could be reasonably managed and the security of continued income in the event of a medical disability was well worth the investment. As with the purchase of a first aid kit, most would prefer never having to use it.

I have been very fortunate to have had few illnesses or injuries throughout my life and more specifically my 45 year career as a healthcare professional. It wasn’t until early in 2012 that I was diagnosed with a chronic, progressive disease of the eye. Symptoms were minimal at that time, though regular visits to a retinal specialist, including regular therapy by ocular injection, were necessary to slow its progression, the symptoms did not appreciably interfere with my work. In spite of my treatments the condition continued to progress. In early 2014 the symptoms began to interfere dramatically with my day to day duties. My job required significant computer use and the reading of copious amounts of medical documentation. It became evident to me that I could no longer meet the expectation of my management and clinical position without working frighteningly long hours and enduring the relentless eye strain and other symptoms related to the illness.

Though I had always planned for eventual retirement from my full-time position, like most professionals I had hoped to be able to continue to practice my profession on a part-time basis throughout my retirement as long as I remained competent and able. That was not to be. Thankfully, I had the foresight to elect the disability benefit options offered by my company and have the premiums payroll deducted for many years. I notified my supervisor and HR representative that I had to stop working due to my condition and proceed with the disability application process.

All went very well and after using up my accrued vacation and sick time, my short-term disability benefits commenced. Since my condition is progressive and incurable I felt secure in knowing that once my short-term benefits were exhausted my benefits would continue under the long-term policy. However, much to my surprise, after receiving about a month of benefits I received notification from the insurance company that a decision had been made to terminate my benefits due to lack of objective medical evidence to support my claim, though significant documentation had been provided by my retinal specialist.

I was bewildered and unsure of how to proceed with an appeal of that decision. Since I had 180 days to do so, I decided to research the matter thoroughly. In spite of my being a veteran healthcare professional everything I had been reading on the subject cautioned about attempting to proceed with an appeal on my own. Legal representation was highly recommended.

I then began a review of local attorneys, hoping to find one that provided enough documentation on their website that indicated experience with non-social security disability related cases. I was also interested in seeing evidence of some experience with disability cases related to diseases of the eye and resultant vision impairment. I was unsuccessful.

So I expanded my search to include national law firms. It was then that I discovered Dell & Schaefer. After thoroughly reviewing their website, watching many of the video discussions, noting experience with vision related cases, particular documentation related to the insurance company that handled and then eventually denied my benefits, and reading a significant number of testimonials, I decided to request a free consultation as advertised. It was one of the best decisions I have ever made.

After that consultation, I was very confident that I was in very skilled hands which alone reduced my anxiety level immensely. Attorney Alexander Palamara and his Legal Assistant, Kathleen Bordes, immediately began managing my case, their professional expertise clearly evident.

They worked closely with my retinal specialist, my optometrist and the insurance company in compiling the medical documentation necessary for a successful appeal in an amazingly short period of time, keeping me fully informed all along the way. Shortly after being notified by the insurance company that my benefits would be reinstated and paid through the full term of my short-term policy I received a lump-sum payment.

Once the short-term disability appeal was successfully completed, Alex and Kathy immediately addressed the long-term policy benefits. Again in a remarkably short period of time I was granted those benefits, receiving a lump-sum payment for benefits to date and will receive a payment monthly going forward per the terms of my LTD policy.

I am extremely pleased with how my case was handled and the very favorable outcome. Alex and Kathy were a delight to work with and extremely professional in every way. Incidentally, the fee I paid to Dell and Schaefer for their incredible representation was very reasonable and very well earned.

I highly recommend the services of Dell & Schaefer to anyone who may find themselves in a similar disability-related situation.

***** 5 stars based on 165 reviews

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