Liberty Mutual’s denial of disability benefits to a bank employee is reversed

As an attorney for clients who go up against disability insurance companies all over the country, I can tell you that the insurance contracts are often full of legalese and gibberish that most individuals don’t understand. Unfortunately, most individuals don’t understand even the communication they receive from the disability insurance companies, such as why their claim has been denied. According to the outcome of the case below, even a judge may find communication from the insurance company difficult to understand.

Nancy Love vs. National City Corporation Welfare Benefits Plan

Nancy Love worked for National City Corporation for two decades before she was forced to stop working. When Mrs. Love began experiencing dizziness, fatigue and blurred vision, she visited the doctor and was diagnosed with multiple sclerosis. Mrs. Love applied for and received short term benefits from the National City Corporation Welfare Benefits Plan, underwritten by Liberty Mutual.  Short term disability benefits were for 18 months, and when Mrs. Love benefits expired, she applied for and received long-term disability benefits.

Mrs. Love received the disability benefits for three years before Liberty Mutual determined that she was no longer what the plan considered to be ‘disabled.’ According to the policy, an individual is considered disabled for the first two years if he or she is unable to perform their job but after the first two years, they’re only considered disabled if they’re unable to perform anyjob, including a job they could take classes and qualify for, etc.

Liberty Mutual Hired Physicians to Discredit Several of Love’s Attending Physicians

To first deny Love for any more disability benefits, Liberty Mutual relied on Doctor Jonathan Sands. Dr. Sands reviewed Love’s medical file and determined that although she most likely did have multiple sclerosis, there was no clinical attack noted, and that “no objective limitations in functional ability or capacity were noted.”

This report was sent to Love’s physician, who did not respond. Soon after, Mrs. Love’s benefits were terminated due to Dr. Sands’ assessment and Mrs. Love’s inability to provide information which supported her assertions that she was unable to perform any job due to her disability.  Mrs. Love appealed Liberty Mutual’s denial, turning over more medical records, including a functional capacity evaluation, a vocational evaluation and a physical therapy evaluation. The next physician Liberty Mutual had to examine the case was Dr. Gerald Winkler. Dr. Winkler stated, after reviewing the files, that Mrs. Love was not totally disabled and could perform certain tasks, such as answering telephones, working at computers or dealing with the general public. Love’s appeal was denied.

Failure to Explain Sufficiently

Love filed a lawsuit in the Illinois Federal District Court against the insurance company, citing ERISA law and claiming:

The Illinois District Court ruled in favor of Liberty Mutual, pushing Love to appeal their decision to the Seventh Circuit Court of Appeals.  Since ERISA requires all insurance companies who deny policyholders to “set forth the specific reasons for such denial, written in a manner calculated to be understood by the participant,” the appeal court felt that Liberty Mutual had not done so.  The court found that neither the termination of benefits letter nor the appeal denial letter properly explained to Love why she would no longer be receiving disability benefits.

Another thing Dr.’s Sands or Dr. Winkler did not address was the contradiction they held with Mrs. Love’s attending physicians. Every physician that personally examined Mrs. Love felt that she was not able to work at any job, and that she was unable to perform even small tasks for more than a few hours at a time.  Dr. Sands and Dr. Winkler did not address those issues. They did not go over the statements or medical tests and explain why they weren’t credible or able to be used as proof of Mrs. Love’s disabilities. Therefore, the court found that there was insufficient explanation on this part as well.

The case was remanded to Liberty Mutual with requirements to fully review the case of Mrs. Love and determine her eligibility for disability benefits in the fairest of ways. While this is a victory for Mrs. Love, the truth is that she should not have had to fight so long in order to get what she deserved in the first place. With as many physicians’s reports as Mrs. Love had – all stating her disability made it unable for her to work – she should not have had to fight so hard for what she deserved, but she did. Perhaps, the ruling in this case will make future cases easier for Libert Mutual policyholders who are unable to work and have credible medical support.

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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.

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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.

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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Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

Chad B. (Illinois)

I originally spoke with 3 other long term disability lawyers about my case before contacting Dell and Schaefer. None of those law firms would take it. They said the chances of me winning was not good. After finding Dell and Schaefer online I spoke with one of the attorneys that has since left. He did take my case but later it was picked up by Rachel Alters. Rachel is amazing and a very intelligent attorney. She not only won my case but also was able to get my back pay for 6 months.

I also cannot say enough about Sonia Nogueira. Sonia was always quick to answer any of my questions. I would usually hear back from her within hours of sending her a email. I do not know where I would be if I hadn’t contacted them. My family and I cannot thank them enough. Don’t let an insurance company tell you they are not responsible for paying you. I paid them for 20 years monthly and they looked for any reason they could not to have to pay me when I needed my benefit. Thank you Rachel and Sonia for all you guys do.

Paul L. (New York)

Words can only scratch the surface regarding my experience working with Attorneys Dell & Schaefer. It’s a very emotional experience making the decision to utilize disability insurance. The unknowns were/are scary. From the very first phone call, the support staff was/are very professional and reassuring. I have been working with Attorney Steven Dell for approximately 10 years. He is confident, reassuring, listens to and addresses all my concern, and is extremely dilligent in understanding my specific policies for how they impact me. It is very reassuring that Steven handles and deals with the insurance company on my behalf. Attorney Dell’s team, and specifically Merlin, Attorney Dell’s assistant, is simply fantastic. Her professionalism and attention to detail have made all my communications with the office seamless.

Simply put, my experience with Dell & Schaefer made the emotional rollercoaster experience of my neck surgery seem like a walk in the park.

Thank You, Thank You, Thank You, to both Attorney Steven Dell and to Merlin for how you have helped me over these past 10 years.

Dilligence, Reassurance, Professionalism at every step, Confidence, Results.

With 10 years experience with working with Dell & Schaefer, taking that step to call Attorneys Dell & Schaefer was one of the best professional and personal decisions I have ever made.

You want to know what you can do – the below comment about posting your first name and last name initial on our website. Put up my full name, phone number, and email address. I will gladly speak to anyone about your office and tell them my story and how instrumental Steven and Merlin have been in my life over the past 10 years.

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