Disability Insurance Lawsuit Stories

In Charles v. UPS National Long Term Disability Plan et al., the plaintiff, Marvin Charles, was being treated for a reoccurrence of a seizure disorder, a condition that had been dormant for about 30 years. In 2008, he had a grand mal seizure and consulted with his physician who prescribed Lacmital, a medication used for the control of seizures. He was granted 24 months of short term disability when Aetna agree...

In Hopper v. Aetna Life Insurance Company, a machinist with 11 separate medical diagnoses was initially granted short term disability benefits. When those benefits were exhausted, Aetna granted him 24 months of long term disability benefits when Aetna determined he was disabled from performing the duties of his own occupation. Due to his respiratory problems and skin rashes and visual problems, it was not diff...

In Valentine v. Aetna Life Insurance Company, the plaintiff applied for disability benefits claiming her disability began in December 2011, when she was diagnosed with trigeminal neuralgia which caused her severe facial pain. She also claimed that her pain medications had side effects that made it impossible for her to concentrate and perform her job duties. Her claim was accompanied by medical records from he...

Be Sure To Maintain a Copy of Your Original Disability PolicyIt is extremely important to make sure you maintain a copy of your disability policy once it is initially provided by your insurance company. If your policy is lost, it is possible that your insurance company may be able to provide you with a copy, but they are not obligated to do so, nor are they obligated to maintain one. In order to make sure ...

In McIlhaney v. Anthem Life Insurance Company Long Term Disability Plan, a California Federal District Court held that Anthem was "unreasonable" in its denial of long term disability benefits to its claimant when the medical records supported her claim for benefits and Anthem made a mistake in its reading of plaintiff's Activities of Daily Living (ADL) report which contributed to its denial decision.This c...

Mr. G had previously worked as a foreman for a large fertilizer company. One day at work Mr. G suffered a fall into a bin of fertilizer. Although Mr. G suffered some injuries, he soon began developing serious neurological symptoms which included parkinsonian type symptoms, seizure episodes and muscle spasms. Initially, he believed his symptoms were related to his fall into the bin of fertilizer, however, they ...

This ERISA case was not handled by our office, but we feel it can be instructive to others who may be in a similar situation as this claimant.In MacDonald v. Anthem Life Insurance Company, the plaintiff, who suffered from chronic regional pain syndrome (CRPS), alleged Anthem was arbitrary and capricious in terminating her long term disability benefits on the grounds that she could work at "any gainful occu...

The Michigan Federal Court agreed that the plaintiff had physical limitations, but none of the activities from which she was restricted were required by her sedentary occupation Plaintiff's initial claim for long term disability benefits was denied by Anthem. The denial was upheld following three administrative appeals. After reviewing her medical records, all three separate independent reviewers agreed that a...

District Court ProceedingsIn Decovich v. Anthem, a Nevada District Court granted Anthem's motion for summary judgment finding Anthem's denial of plaintiff's application for long term disability benefits was reasonable. According to the court, the "administrative record is voluminous, well-known to the parties, and its contents are not disputed." Accordingly, the court opinion provides only a brief synopsis...

The current case of Robertson v. Standard Life Insurance Company concerns the proper calculation of prejudgment interest based on the court's previous ruling that Standard had abused its discretion in terminating plaintiff's long term disability benefits. The original order was based on Standard’s denial of benefits under the "own occupation" definition of disability under its policy. To date, Standard has m...

Although this Virginia Federal ERISA long term disability case was not handled by our disability insurance lawyers, it is an example of how Anthem denies disability benefits by asserting claimants are not disabled from performing their job duties without ever determining or analyzing what those job duties are.Case HistoryIn the case of Wyant v. Anthem Life Insurance Company, Anthem denied long term dis...

The Indiana federal district court case of Kennedy v. Lilly Extended Benefit Plan is a refreshing example of how perseverance in asserting a claim for long term disability benefits after they have been terminated can pay off. The plaintiff suffered from the pain and stress of fibromyalgia as well as other medical problems which turned out not to be relevant to the court's order that Anthem reinstate her benefi...

The Federal District Court in Vermont noted that there was no question that the plaintiff suffered from "degenerative disc disease resulting in significant pain." Since the denial of long term disability benefits under the "any occupation" definition of disability was based only on a subjective conclusion without any discussion of the physical requirements of "any occupation," the case was remanded to ING / Re...

In a recent claim denial our disability law firm is handling for a physician suffering with cervical myeolopathy, Lincoln Financial stated, "A condition warranting surgery does not necessarily equal a condition qualifying an insured for Total Disability." In this claim Lincoln's own IME doctor was surprised that the claimant did not have neck surgery. Regardless of the fact that the IME doctor felt the claiman...

Mr. V had previously worked as a project manager for the YMCA until severe and chronic lower back and radiculopathic pain caused by sciatica, lumbar radiculitis, degenerative disk disease and osteoarthritis forced him to cease working and file a long-term disability claim under his employer's long-term disability insurance plan funded and administered by CIGNA.According to the National Institute of Neurolo...

After Frederick Ervin drowned in the spring of 2014, his widow, filed a claim to collect death benefits under his accidental death insurance policy carried by his employer. Her claim was denied as was her administrative appeal. She then filed this ERISA lawsuit. In Ervin v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, a federal court in Maryland agreed with National that the widow was ineligible to collect ben...

Unum is obviously scraping the bottom of the barrel and making attempts to reduce the number of claimants that are currently receiving long term disability benefits. We recently reviewed a Unum denial letter for a woman that has been deemed disabled by Unum since September 18, 1998. This woman was approved for social security disability benefits in 2000 and she has been receiving $488 a month from Unum. She is...

In Stockman v. GE Life, Disability and Medical Plan et al., the plaintiff severely injured his foot and totally lost the function of it for 12 months. He then applied for benefits under the GE Life policy claiming he suffered a "total and permanent" loss of the use of his foot. MetLife, Plan Administrator for GE, denied his claim on the grounds that the loss was not total and permanent. Both the Ohio district ...

A Pennsylvania federal court ruled in favor of a claimant who continued to suffer severe debilitating neck, shoulder and upper arm pain following a cervical fusion surgical procedure. The pain sent her into depression and she became dependent on pain killers requiring her to spend time in a drug rehabilitation program. The Life Insurance Company of North America (LINA) denied her application for long term disa...

In this video nationwide disability insurance attorney Stephen Jessup discusses a recent Sun Life long term disability claim in which the court finds that Sun Life failed to conduct a proper evaluation. The claimant that filed for long term disability benefits had a mental nervous disorder....