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Massachusetts Court Reverses Liberty Disability Denial for Failure to Examine or Consider Subjective Pain

In Tracia v. Liberty Life Assurance Co., of Boston, despite an extended discussion of the history of the plaintiff’s disability, his various medical conditions, reports of treating physicians and analysis of independent reviewers, the court divided the case into two main issues:

#1- Liberty erred by failing to advise the plaintiff of the type of objective evidence it required in order to consider his claim, and in not giving him an opportunity to provide it;

#2- Liberty made its decision based on flawed peer reviews of Tracia’s medical records.

The court remanded the case to Liberty with instructions to, “identify the type of objective evidence it requires, and Tracia shall be given the opportunity to provide such information prior to Liberty’s reconsideration of his claim.”

Plaintiffs Must Be Informed of the Type of Objective Evidence Which is Required to Support Their Claim That Their Subjective Pain Makes It Impossible to Perform Job Duties

Bruce Tracia worked for Comcast for almost 20 years and was employed there as a Business Account Executive at the time he had surgery on his ankle and became disabled. Liberty initially awarded him disability benefits under the definition that he was disabled from performing the essential duties of his own occupation. When the definition changed to being disabled if unable to perform the duties of “any occupation,” Liberty determined he had not provided objective evidence of a disability and, since it determined he could work at a sedentary position, it denied his request for long term disability benefits.

The Massachusetts federal court clarified the “distinction between requiring objective evidence of the diagnosis, which is impermissible for a condition…that does not lend itself to objective verification, and requiring objective evidence that the plaintiff is unable to work, which is allowed.” Even though it is allowed to require claimants to provide objective evidence of how their subjective pain prevents them from working, the court clarified that “plan participants must be informed of those requirements.” Since Liberty never informed the claimant that he was required to provide evidence, and what type of evidence it was seeking, the court found Liberty’s failure “deprived Tracia of a full and fair review under ERISA.” It remanded to Liberty for further consideration consistent with the court proceedings.

Liberty Erroneously Relied on Flawed Opinions of Reviewing Physicians

Liberty essentially ignored the reports of Tracia’s treating physicians and relied solely on the opinions of two peer reviewers of Tracia’s medical records. Neither reviewer ever met or spoke with Tracia. Although the court acknowledged that plan administrators are not required to give any special weight to the opinions of treating physicians over those of reviewing physicians, when, as here, the reports are relied on to the exclusion of all other conflicting reports of both treating physicians and Liberty’s other peer reviewers, the reliance upon them is “arbitrary and capricious.”

Our office did not handle this case, but we believe it may be helpful to claimant’s who suffer from subjective pain that makes it impossible for them to perform the job duties of any occupation the plan administrator may deem appropriate. If you need assistance with a similar matter, or any other issue regarding your short term or long term disability claim, please contact any of our lawyers for a free consultation.

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Do you help Liberty Mutual claimants nationwide?

We represent Liberty Mutual 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 Liberty Mutual disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Liberty Mutual. 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 Liberty Mutual.

How do you help Liberty Mutual claimants?

Our lawyers help individuals that have either purchased a Liberty Mutual 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 Liberty Mutual:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
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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.

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.

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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.

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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.

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