Liberty initially approved our client’s claim for long term disability benefits after determining he was unable to perform the duties of his occupation as District Manager due to physical and cognitive limitations resulting from his Multiple Sclerosis. However, after paying the benefit for only four months, Liberty had a change of heart and terminated his LTD benefits, claiming that he no longer met the definition of disability under his policy.
It is well known that Multiple Sclerosis is a progressive disease which causes a plethora of debilitating and at times life threatening symptoms. As such, once a person is rendered disabled as a result of Multiple Sclerosis, the likelihood of re-entering the work force is extremely limited as the symptoms of the condition only progress with time. Apparently, Liberty Mutual doesn’t always seem to agree.
Liberty’s denial was based on a very limited amount of video surveillance in an attempt to discredit our client as a liar and to prove that he would be able to return to work. Based on only 40 minutes of video surveillance obtained over a three day period, which depicted our client driving, walking through a parking lot, entering a store and carrying a small bag, Liberty ascertained that he would have no problem working 40 hours a week in his occupation. The ability to run errands for a couple hours over the course of three days is in no way, shape or form indicative of the ability to work full time.
Liberty’s Terminates Benefits Even After Its Own Hired Expert Renders Opinions Supporting Claimant’s Disability.
Making this denial even more egregious is the fact that Liberty’s own hired expert stated in his peer review report that the video surveillance was not indicative of the ability to perform sustained work activity. Specifically, he stated:
“[T]he surveillance data is consistent with the claimant’s descriptions of his daily activities in the Activities Questionnaire, and does not provide enough information to assess the claimant’s capacity for sustained work.”
Liberty’s expert went on to support our client’s claim, stating that he would have permanent work restrictions as a result of his balance difficulties and that his complaints of significant fatigue were supported by the medical evidence and would cause disability. However, Liberty decided to ignore its own doctor as much as it had ignored our client’s own treating physicians and denied the claim any way.
Armed with an overwhelming amount of evidence in support of continued disability, Rachel Alters of Dell & Schaefer filed an extensive appeal containing medical opinions from our client’s doctors, additional objective functional testing and securing additional expert opinions that refuted Liberty’s position that our client was no longer disabled. Being confronted with its dishonest, disingenuous and improper claims handling, Liberty overturned its decision to terminate benefits.
Disability insurance carriers will find any reason to deny a claim. In this instance our client’s claim wasn’t denied because a hired insurance doctor said he was able to work, but rather because of 40 minutes of inconsequential video surveillance. Regardless of the severity of a medical condition, this case is a reminder that a claim for long term disability benefits is never guaranteed.
If your claim has been denied or you are concerned that your insurance carrier is looking to deny your claim please feel free to contact our office to discuss how we may be able to assist you in enforcing your rights under your policy.