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MetLife Disability Denial of MetLife Employee Upheld by California Court


  • Hiring A California Disability Attorney For A Disability Insurance Claim or Denial is Important

MetLife not only denies disability long term disability benefits to one of their own employees, but the court allows them to supplement the record after MetLife fails to respond within the 90 day ERISA appeal time period. The California ERISA disability lawyer that handled this case filed a disability lawsuit after MetLife failed to respond to his client’s ERISA appeal within 90 days. After the lawsuit was filed, MetLife introduced two external file reviews which were completed by doctors hired by MetLife. MetLife gave the claimant the opportunity to respond to the reports, but the claimant and his disability attorney refused to respond as they believed that the court would not consider the reports. Unfortunately, since the case was subject to a de novo review, the court determined that they would allow the external reports to be considered. The claimant claimed that he was being sandbagged, but the court disagreed. Based upon all of the evidence presented during the appeal and after, the court ruled that MetLife’s decision to deny benefits was correct. The case is being appealed. Read the California Court’s 20 page complete opinion.

Legal Analysis By Cesar Gavidia, A Disability Insurance Lawyer

Had this case been subject to an arbitrary and capricious standard of review, it is likely that the court would not have considered the external reports that were completed after a lawsuit was filed. The disability attorney handling this claim may have been better off responding to the letters and stating that he reserves the right to argue that the letters are not admissible. I hope the Plaintiff wins this case on appeal as the court should not have allowed the additional reports after the 90 day Appeal deadline. If you need assistance with a long term disability claim, contact us for a free phone consultation.



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