ERISA disablity insurance claim: pre-existing condition denial overturned for executive

Our client suffered from Post Traumatic Stress Disorder and applied for long-term disability insurance benefits under the terms of his group disability policy. His insurance carrier denied his claim, asserting that because he took anti-depressant medication and was also diagnosed with a personality disorder within the three months prior to obtaining insurance coverage, his condition was pre-existing.

After researching his psychological documentation, our firm determined that his prior condition, for which the medication was prescribed, was separate and distinguishable for his current disability. Our firm submitted a lengthy appeal, citing applicable case law and providing significant psychological documentation. Based on this, our client’s insurance carrier reversed its denial of benefits. Our client remains on claim today.

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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.

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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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Dell & Schaefer Client Reviews   *****

Diana B. (Indiana)

Alex was very compassionate and professional in handling my case. Losing my disability caused extreme financial hardship and took a toll on my emotional health. Struggling with MS every day is a challenge, but Alex helped me greatly and was able to get my benefits reinstated as well as later he was able to get a lump sum settlement.

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