Fibromyalgia Claimant Wins MetLife Disability Insurance Lawsuit

MetLife determined a disability claimant with Fibromyalgia was not disabled after two years of receiving benefits, but a California Federal Judge disagreed. Federal courts in California have stood behind employees and forced insurance companies to pay disability benefits. We want to be your California disability attorney and make the disability insurance company pay your benefits. The law governing disability insurance claims is complex and often skewed in favor of the insurance company. Let’s take a look at a court decision in which a California Federal Judge reversed a MetLife disability denial.

MetLife is Ordered to Pay Disability Insurance Benefit

In Lavino v. Metropolitan Life Insurance Company, a federal court in California found that the insurer had abused its discretion in denying long-term disability benefits under an ERISA plan. The plaintiff had been a civil project engineer for ten years. However, she sought medical leave and disability benefits in 2005 due to chronic pain and fatigue linked to fibromyalgia. After paying benefits for nearly two years, the definition of disability changed from own occupation to any occupation. The claimant was forced to return to work – even though her condition had not improved and her doctor still considered her unable to perform any work.

MetLife Denial of Long Term Disability Benefits Includes Numerous Mistakes

When the plaintiff sued to recover the disability benefits, she pointed to procedural and substantive mistakes in the way MetLife processed the claim, including:

The California federal court found that MetLife had abused its discretion in denying the benefits. The court recognized that, although the plan gave MetLife discretion, that discretion has limits. Sometimes a searching inquiry is required and this was one of those instances. MetLife decided who got benefits and Metlife was also responsible for paying those benefits. This necessarily created what the court described as a structural conflict of interest. With a financial incentive to deny coverage, the court refused to overlook the unreasonable and arbitrary manner in which MetLife denied benefits. These actions cast doubt on MetLife’s ultimate conclusion. The court’s skepticism led it to find that MetLife’s denial of long-term disability benefits could not be sustained and ordered MetLife to reinstate benefits.

Lavino v. Metropolitan Life Ins. Co., 779 F. Supp.2d 1095 (C.D. Cal. 2011).

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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   *****

Emily H. (Massachusetts)

Rachel and team were professional, knowledgeable and competent in helping me with my disability insurance claim denial. I would not have been able to do this work myself successfully.  I had an illness best known as Chronic Lyme (I have more issues than that but that’s what I understood my diagnosis to be at the time of claim denial). This is a complex illness that is plagued with faulty testing, delayed diagnosis, inconsistent prognosis/ treatment outcomes, and vague (deniable) symptoms.

Advances in the disease’s treatment have stalled for decades due to financial & reputational conflicts of interest that exist across the healthcare/ insurance / government industries. It is a major thing to go against, and a very complex & constantly evolving issue, and Rachel was very familiar with all the chronic Lyme ‘inside baseball.’ Not many people want to get involved with anything Chronic Lyme-related if they have a choice. Finding an attorney that has expertise in this area is a rare find, and I can attest to the fact that Rachel meets this hard-to-find criteria and delivered results well beyond what I could have achieved without her.

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