MetLife Denial of Disability Benefits For Woman With Fibromyalgia Remanded By Massachusetts Federal Judge

A Massachusetts Federal Court recently held that MetLife wrongfully denied long term disability benefits and abused its discretion by failing to address contrary evidence and placing undue weight on certain evidence. The court remanded the case back to MetLife with specific instructions to re-evaluate the claim. This case was not handled by Attorneys Dell & Schaefer but it is a good victory for disability claimants suffering with fibromyalgia.

MetLife Failed to Address the Contrary Evidence

The Court pointed out three important pieces of evidence in the record that MetLife admitted it reviewed in rendering its decision to deny the Plaintiff’s LTD benefits, but failed to properly consider. The Plaintiff underwent a Functional Capacity Evaluation which revealed impairments in fine dexterity, range of motion, upper and lower body strength, overhead reaching and endurance. MetLife neither addressed those findings in its denial letter, nor did it provide any reason for dismissing those finding.

arthritis_fibromyalgiaThe Plaintiff also provided MetLife with a vocational assessment report which concluded that the Plaintiff would be unable to perform her occupational duties, or the occupational duties of any work for which she could reasonably qualify by education, training or experience, due to her functional impairment. Again, MetLife neither addressed the vocational assessment report nor did it provide any explanation to why it failed to consider the findings.

The Court also found that MetLife referenced certain notes by the Plaintiff’s treating physician, but failed to mention or give weight to other notes in which the treating physician found that there was objective medical evidence that the Plaintiff was functionally limited.

MetLife Failed to Consider the Plaintiff’s Disabling Symptoms and Instead Based the Denial on the Lack of a Clear Diagnosis

Moreover, the Court concluded that MetLife abused its discretion because instead of considering the Plaintiff’s functional limitations imposed by the Plaintiff’s disabling symptoms, MetLife based its denial on the fact that none of the Plaintiff’s treating physicians had been able to provide a definitive diagnosis for her neurological symptoms. MetLife’s medical consultants concluded that there was no basis for long term disability because there was no ‘objectively verifiable diagnosis that would account for her symptoms.” This is a fairly typical denial that the lawyers at Dell & Schaefer see on a routine basis from MetLife.

The Court also found that MetLife mischaracterized the evidence by stating that “many” of the Plaintiff’s treating physicians found her subjective complaints outweighed the objective findings when, in actuality, the medical evidence only revealed two instances where such comments were noted. The Court stated that MetLife made credibility judgments about the Plaintiff that were not supported by the record as a whole because none of the treating physicians ever suggested that the Plaintiff was malingering or exaggerating her symptoms.

As a result of these findings, the Court concluded that MetLife abused its discretion and that its denial of the Plaintiff’s claim for long term disability benefits was arbitrary and capricious. The case was remanded back to MetLife for further review.

Unfortunately, it is not uncommon for disability insurance companies to omit or mischaracterize medical evidence which might otherwise support that the claimant is unable to perform her occupational duties and is disabled. It requires the trained eye of an attorney experienced in ERISA disability cases carefully examining the claim file and medical evidence to catch these types of errors and omissions by the insurance company. If your claim for disability benefits has been denied by MetLife or any other disability insurance company, it is crucial to have the denial reviewed by an experienced attorney to ensure that you have not fallen victim to this type of unscrupulous claim handling practice.

If you have questions regarding your claim for disability benefits, or if your disability claim has been denied, feel free to call Disability Attorneys Dell & Schaefer for a free consultation.

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FAQ

Do you help MetLife claimants nationwide?

We represent MetLife 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 MetLife disability insurance policy?

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

How do you help MetLife claimants?

Our lawyers help individuals that have either purchased a MetLife 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 MetLife:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

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.

Do I have to come to your office to work with your law firm?

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.

How can I contact you?

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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Jamie K.

From the moment I called and spoke with Rachel Alters, I knew I was in the right place. I had called many attorneys prior to calling Dell & Schaefer and got turned down because my case was too difficult to win. Rachel Alters took the time to explain the whole process to me and promised that she’d do her best to win my case. Along to way, she was extremely patient, knowledgeable, and always took the time to answers my questions, putting me at ease. In the end, we won my disability case and I was more than happy with the settlement results. I HIGHLY recommend Rachel Alters to anyone with a short term/long term disability case. The amount of professionalism and care you will receive will make the process that much more smoother. Thank you, Rachel! :)

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