MetLife Approves Disability Benefits to Dentist With De Quervain's
Prior to contacting our office, our client filed a claim for long term disability benefits under his individual disability insurance policy with MetLife on account of de Quervain’s Tenosynovitis, a condition affecting the tendons of the thumb and wrist that resulted in severe pain in his dominant hand, especially with grasping. Given the nature of his occupation as a Dentist, and the fact his condition was affecting his dominant hand it was clear that he would pose a risk to patients should he continue to practice dentistry. Accordingly, MetLife initially approved our client’s claim. While on disability he underwent surgery to alleviate the symptoms but the results of surgery were less than ideal.
Continued Claim Review
Despite undergoing the surgery our client continued to experience throbbing pain in his wrist and hand, which his surgeon could not determine the basis of in light of the surgery performed. With uncertainty as to the cause of pain, as well as what MetLife deemed to be the subject nature of same, in light of a “successful” surgery, MetLife began to question whether our client continued to meet the requirements of disability under his policy. In an effort to gain a better understanding of his continued symptoms our client sought a second opinion, which ultimately determined that our client was experiencing nerve damage, which was continuing to affect his ability to use his hand.
MetLife’s doctor’s review of the medical findings was not so clear and MetLife notified our client that it was denying his claim for continued benefits. Our client reacted immediately and availed himself of the voluntary appeal process MetLife offered under his individual disability policy. Shortly after filing the appeal, MetLife informed our client that it had arranged for him to undergo an Independent Medical Examination (IME) to better assess the extent of his medical conditions and ultimately determine whether MetLife would reinstate his claim for disability benefits.
Our client believed that the IME was positive/favorable to his claim and that the examining doctor agreed with his treating physician as to the nature of his continued complaints and there impact on his ability to perform the duties of a dentist. However, MetLife continued to drag its feet in finalizing its review and informed our client that it was seeking additional clarification from the IME doctor before it could render a decision. As nearly six months had passed since MetLife stopped paying benefits, and with no end in sight as to MetLife’s delay tactics, our client contacted our office to seek legal representation and spoke with Attorney Stephen Jessup.
The Claim Decision
Having represented numerous dentists over the past decade, Attorney Jessup was familiar with our client’s medical condition and how a private disability insurance carrier like MetLife would be evaluating the information to finalize a claim decision. Attorney Jessup’s first course of action was contacting MetLife to advise them that our client was now represented by counsel and to demand clarification as to the status of MetLife’s review of our client’s claim. A request was made that MetLife make payments to our client under Reservation of Rights while the review of his appeal took place, but MetLife was adamant that no benefits would be paid during the course of the appeal review.
Not willing to approve benefits without a fight and due to differing opinions of its doctors and our client’s, MetLife arranged for our client to undergo another IME with an occupational therapist specializing in examinations of the hand. Following this second examination, Attorney Jessup was able to secure a copy of the IME report from MetLife. Review of the IME report did in fact indicate that the examiner agreed with the findings our client’s doctor (and that of the initial IME doctor) of nerve pain that was resulting in not only continued pain of the right hand and wrist with use, but also numbness and loss of sensation throughout our client’s hand. Despite these findings MetLife did not approve our client’s claim immediately and advised Attorney Jessup that its medical reviewers were seeking clarification from the two IME examiners and our client’s doctor.
Attorney Jessup pressed our client’s position with MetLife and threatened to bring suit under the policy to secure our client’s benefits. In light of all the information in our client’s file, MetLife was left with little choice but to reinstate our client’s individual disability benefits and pay nearly a year in past due benefits. However, Attorney Jessup knows that the approval of the claim will not be the end of MetLife’s continued review and inquiries into the future of our client’s claim.
Is your disability carrier challenging your claim?
Our office has represented numerous dentists and other medical professionals in disputes with their disability carriers as they relate to medical conditions that limit the ability to perform occupational duties, but otherwise have very little negative impact on the client’s day to day activities. Insurance companies will challenge these claims when there is limited diagnostic evidence to support the claim, or as was the case with our client, standard diagnostic testing (EMG/Nerve Conduction Studies) did not clearly define a diagnosis. Rather, the diagnosis was made based on clinical examination.
It is imperative that an insured’s medical records accurately reflect the symptoms, restrictions and limitations that the insured is experiencing, especially in the absence of firm objective medical evidence.
If you have questions regarding your disability insurance policy/claim, please feel free to contact our office to speak with one of our disability insurance attorneys.
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Policy Holder Rating
They will do anything to not approve your claim
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They FULL OF ****
MetLife for disability? Avoid the surgery unless it's life-threatening
Only care about $$$$$
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They demanded an overpayment, stopped my claim, and lied about it
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Your decision making process is absurd!
My husband has 2-5 yrs to live, yet MetLife has been giving him the run around
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Inappropriate conduct!! Rude, discriminatory, etc
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5 Ways We Help Get Your Benefits Paid
Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.
If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.
Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.
98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the little guy against the multi-billion dollar insurance company giants.
We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.
Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.
Questions About Hiring Us
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
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 insurance 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.
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.
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. 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.
When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers 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.