Liberty Reinstates Long Term Disability Benefits for the Second Time
Author: Attorney Stephen Jessup
Our client, a former Liberty Mutual employee, has had a less than ideal experience with Liberty – both as an employee and as a recipient of disability insurance benefits. Issues she experienced in the workplace as a Liberty employee resulted in exacerbation of existing behavioral health issues that made her workplace environment so volatile she filed for disability benefits in order to take herself out of a harmful environment and address her mental and emotional health and well-being. Shortly after she filed her claim for Short Term Disability she contacted our office and spoke with Attorney Stephen Jessup. At that time she vocalized her concerns regarding Liberty’s handling of her STD claim and believed that Liberty’s action in handling the claim was in retaliation against her for filing an employment complaint against the company due to her workplace experience. To assist in alleviating the incredible amount of stress in dealing with Liberty she retained Attorney Jessup to handle her STD claim and to assist her in the transition of her claim from short to long term disability.
The First Denial
Before the effective start date of our client’s long term disability claim our client was notified by the Social Security Administration that it her claim for Social Security Disability benefits had been approved. The fact that the Social Security Administration had approved her claim for SSDI within a few short months of application was very surprising given how long the SSA can be in making a claim decision, as well as the high rate of denials experienced by first time applicants. The approval of her SSDI claim was evidence of the severity of our client’s behavioral health condition, and certainly strong evidence that in conjunction with the opinions of our client’s treatment providers supported our client’s entitlement to LTD benefits. However, Liberty’s position was anything but positive as our client received a denial of her claim for LTD benefits.
Despite having been approved and paid throughout the short term disability benefit period, Liberty’s so called “independent” peer review doctors drafted reports in which they opined that there was no evidence of any psychiatric impairment that would result in workplace restrictions and limitations since the time our client ceased working. Not only were these opinions the exact opposite of our client’s treatment providers and those of the Social Security Administration, they were in complete contradiction with the opinions of Liberty’s doctors who reviewed the same records and provided opinions that led to the approval of her STD claim.
Given the information contained in her file, our client and Attorney Jessup were convinced that Liberty was in fact retaliating against her for the employment complaint she had filed against them by denying her LTD claim. Attorney Jessup quickly and vehemently attacked Liberty’s denial of benefits and was ultimately successful in winning our client’s appeal.
Claims Handling and the Second Denial
Following the approval of our client’s benefits Liberty notified our office that our client’s claim was subject to an 18 month limitation for mental health conditions. The application of this limitation came as no surprise and was completely expected by both Attorney Jessup and our client. As with any claim for continued disability benefits, Liberty required ongoing proof of disability on a near monthly basis – specifically requesting updated medical records and claim forms. However, Liberty’s persistence in tormenting our client would culminate in another denial of benefits, which was again predicated solely on the review of our clients records by an outside doctor who never examined our client or spoke to her treatment providers.
It did not go unnoticed by Attorney Jessup that this most recent denial coincided with movement in her employment complaint against Liberty. Liberty’s denial was certainly an intimidation tactic that effectively upset our client resulting in additional symptoms of her disabling conditions. Attorney Jessup again attacked Liberty’s position and called them out for denying our client’s claim when there was less than six months of benefits payable, and again called into question the real motive for denial in light of the ongoing investigation of the employment complaint our client filed against them. In appealing the denial Attorney Jessup argued the illogical position proffered by Liberty’s doctor, as well as provided in depth responses to Liberty’s doctor’s report by our client’s treatment providers.
Within the initial 45 day deadline provided by ERISA to review the appeal, Liberty notified Attorney Jessup that it was reinstating our client’s long term disability benefit. This case serves as an example as to the lengths an insurance carrier will go to avoid liability under a policy. Despite the fact our client’s claim for long term disability benefit was being offset by SSDI (resulting in a very low monthly benefit payable by Liberty) and the limited time left on claim (approximately six months) Liberty still tormented its own insured and even worse- a former employee. With only a few months left of disability benefits Attorney Jessup is confident that after losing two times, Liberty will issue the remaining benefits to our client without issue.
If you have a disability insurance claim with Liberty or any other disability carrier and have questions and/or concerns with how your claim is being administered, please do not hesitate to contact our office to speak to one of our disability insurance attorneys.