Dell Disability Lawyers ERISA Administrative Appeal Proves to MetLife that Client is Still Disabled and Claim Not Subject to Certain Policy Limitations
Dell Disability Lawyers is happy to report that a client of ours is back on claim and receiving Long Term Disability (LTD) Benefits once again from the Metropolitan Life Insurance Company. Our client contacted us after receiving a denial letter from MetLife dated June 26, 2014. Prior to this time, she had received LTD benefits with no issue for almost two years. Unfortunately for our client, MetLife incorrectly determined that our client’s main disabling condition was fibromyalgia. The Long Term Disability Policy governing our client’s claim is a policy she was covered under due to her employment at The ServiceMaster Company. This particular policy limited benefits to 24 months for certain disabling conditions which include “mental or nervous disorders” or “for disabilities due to neuromuscular, musculoskeletal or soft tissue disorder and chronic fatigue syndrome and related conditions.” After receiving MetLife’s June 26, 2014 denial letter, our client found us and quickly became a client of Dell Disability Lawyers.
MetLife’s Denial Letter
In its denial letter of June 26, 2014, MetLife stated that our client’s “current disabling diagnosis of fibromyalgia falls under the limited benefit provision” of the Plan and benefits are limited to 24 months to the date of July 15, 2014. MetLife’s denial letter also stated that its medical director “took into consideration (her) diagnoses of lupus, diabetes, diabetic neuropathy, shoulder pain, osteoarthritis and coronary artery disease and determined that the medical information did not support that (she) would be prevented from performing the duties of (her) sedentary occupation for these diagnoses.”
Administrative Appeal filed by Dell Disability Lawyers
As The ServiceMaster Company LTD Policy is governed by the Employee Retirement Income Security Act of 1974 (ERISA), 180 days was given for our client to file an administrative appeal. With the help of Disability Attorney Alexander Palamara of Dell Disability Lawyers, a timely appeal was filed. The appeal noted that MetLife’s denial was primarily based on an internal review by one of its own employees. As such, MetLife did not have any independent physicians examine our client nor did any independent physicians conduct a review of our client’s medical records. Instead MetLife merely relied upon a biased review of one of its own employees. Furthermore, the appeal focused on the tremendous amount of support by our client’s treating physicians who supported our client’s claim as well as the extensive objective documentation that proved that our client’s conditions beyond fibromyalgia were enough to satisfy the definition of disability in the policy.
Re-Approval for Long Term Disability Benefits
Within 90 days of the filing of the administrative appeal, our client was informed that MetLife had overturned its previous decision to deny our client’s continued claim for benefits. MetLife has found that our client is “unable to earn more than 80% of her predisability earnings at any gainful occupation for any employer in her local economy for which she is reasonably qualified taking into account her training, education and experience.”
Our client is aware that the fight will continue as MetLife can attempt to deny her claim at any point in the future. However, our client can rest assured that Dell Disability Lawyers will continue to fight MetLife so that she continues to receive her monthly LTD benefits so that treatment can continue.
If you have been denied Long Term Disability Benefits by MetLife or any other insurance provider, please do not hesitate to contact Dell Disability Lawyers for a free consultation.
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Senior Global Tax Director for billion dollar worldwide industrial company is again receiving disability benefits from MetLife after Appeal by Attorney Alexander Palamara
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Very satisfied with the work of this team. Took well care of my case and took all the necessary time to be responsive and attentive when I had questions. Guided me through recovery and returning to normalcy. All thanks to Jason & Tabitha, thank you!
I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
It’s unfortunate when disability insurance companies come after older disabled policyholders just to help their bottom line. It can be a living nightmare the damage they can do to a family. Dell Disability Lawyers are polite, understanding and knowledgeable. They call you back and answer any question you have no matter how unimportant it can be. The amount of stress they took off of myself and family was incalculable. I recommend them highly to take care of any disability case whether it be filing for benefits or reversing a claim decision. They are outstanding.
I could not have been happier or more appreciative of the hard work they performed on my behalf. I was well briefed on my case and it was closed in a timely manner with a financially successful resolution.
Mr. Symonds and Sonia as well as everyone else we have worked with throughout this process have been very helpful, professional and caring to our situation. We are very thankful to have this great team on our side.
Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
I was denied long term disability benefits from The Hartford after being on it for years. I found Dell Disability Lawyers after doing research online. In a matter of days they responded and explained to me everything that would be done. Dell Disability Lawyers were able to settle my suit against The Hartford very quickly and responded to me quickly. I would definitely recommend this team of lawyers for anyone that is fighting for their disability insurance.
I have had nothing but a great experience with Dell Disability Law Firm. Mr. Alex Palamara and his team went above and beyond my expectations. They will respond to emails and phone calls in a timely manner. Thank you once again for taking my case.
This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.