Dell & Schaefer Successfully Appeals Metlife Denial of Benefits to Veteran

Mr. A contacted our firm after being denied benefits by his employer’s group disability carrier, MetLife. He had been working as a supervisor for a large manufacturer of heavy duty automotive components. His job required him to perform prolonged physical activities like climbing, kneeling, standing, pulling grasping, lifting and working with various tools.

He was suffering from a long list of medical conditions including both physical conditions and mental health conditions and having served in the military for some time many of his conditions were service connected.
Over time, his conditions greatly diminished his capacity to perform his occupation effectively and he was forced to file for disability benefits.

The Veterans Administration approved his disability claim for service connected conditions and the SSA immediately approved his disability claim. However, when he applied for benefits with his employer’s group disability carrier, MetLife, he encountered some trouble.

During the initial application, Mr. A included all of his medical conditions including PTSD, back injuries, knee injuries, carpal tunnel and several other conditions.

After filing his claim, MetLife concluded that his medical records did not support a functional impairment that would prevent him from working in his own occupation from any employer in his local economy.

Before finding us, our now client retained an attorney from another law firm to handle the appeal on his claim. Unfortunately, MetLife denied the appeal but this time finding that there was support for functional impairment but that an exclusion in the policy applied to his claim. Since his psychiatric conditions were service connected, a war exclusion applied and no benefits were payable.

At that point, his attorney washed his hands of the claim which led our now client to find another attorney.

Given that they had issued a denial for a different reason than the first denial MetLife allowed another appeal but with the caveat that the appeal review would be limited to reviewing the psychiatric conditions that were denied under the war exclusion.

Despite the difficulty in the claim we took on his case.

After reviewing the claim file and medical records it became apparent that MetLife’s decision was wrong. While MetLife had classified his mental health conditions as the primary disabling conditions there was a substantial amount of information supporting disability from a physical standpoint.

During his service in both Iraq and Afghanistan, he suffered several injuries and the appeal became a matter of combing through the medical records to determine which medical conditions would fall outside the scope of the war exclusion.

We also set our client up to undergo an FCE to ensure that MetLife would not fall back on their common argument that there was no objective medical evidence.

After submitting the appeal, MetLife agreed to review all the information we submitted. Not long after, we received a letter overturning the denial.

Attorney Peña continues to represent Mr. A to best ensure that MetLife will not terminate his benefits. Feel free to call our disability attorneys for a free consultation if you have a similar claim or with questions on any matter relevant to your disability claim.

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FAQ

Do you help MetLife claimants nationwide?

We represent MetLife 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 MetLife disability insurance policy?

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

How do you help MetLife claimants?

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

  • 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   *****

Russel H. (Texas)

My experience is as such. I suffer from a variety of mental health issues the biggest being severe PTSD. When I had lost all hope the Good Lord guided me to Attorneys Dell & Schaefer. My assigned lawyer, Stephen Jessup, was the most understanding and compassionate human being I had come across since my breakdown. He not only guided me legally, but his kind words and understanding helped me spiritually as well. His co-worker, Sonia, was a heaven-send as well. Her kind words and prompt responses were amazing. Both Stephen and Sonia will never understand how blessed I am that they came in to my life at my darkest hour. Their work ethic and rigorous efforts towards my case gave me not only a win but it gave me justice and at the end of the day that’s all I wanted. I went in to this case with legal counsel and I left this with great friends. I was always informed, spoken to with the utmost respect and sincere compassion.

Stephen and Sonia, y’all are my silver lining in humanity. I’m a better person today having met you both even if only by phone and email.

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