MetLife Overturns its Decision to Deny Long Term Disability Benefits After Receiving an ERISA Appeal from Dell Disability Lawyers

An Alabama woman previously employed as a Senior Account Representative since 1999 for the Southern Company’s subsidiary SouthernLINC Wireless was awarded long term disability ERISA benefits after Attorney Alex Palamara filed an ERISA appeal on her behalf. Forced to leave work on May 21, 2010 due to a countless number of conditions, the claimant was forced to file for disability benefits. The claimant’s conditions included cervical spine pain with radiculopathy, low back pain with radiculopathy, degenerative disc disease, osteoarthritis, past surgeries, etc.

MetLife Denies Benefits After 24 Months

Although initially paid for 24 months, the claimant’s benefits were denied when MetLife determined that she no longer qualified for benefits due to the change in definition of what it means to be disabled under the policy. This change in definition of disability is commonly found in group policies provided to employees.

Under these policies, when a person first makes a claim for benefits, to be considered disabled the person must satisfy that they are unable to perform each of the material duties of their own occupation. After 24 months, the definition of disability then requires that the person’s medical records prove that they are unable to perform the duties of any gainful occupation for which the person is qualified for by education, training or experience.

As you can see this new definition of disability (the any occupation definition) is much harder to satisfy than the previous definition (the own occupation definition). Insurance companies love to deny claimants continued benefits after the change in definition of disability. This was the case for the SouthernLinc employee.

Appeal Filed By Dell Disability Lawyers

Within days of receiving the denial letter from MetLife, the claimant contacted Dell Disability Lawyers for assistance in getting back on claim. Disability Attorney Alexander Palamara timely ordered and reviewed the claim file from MetLife, the Social Security Administration’s Disability Claim File, as well as the medical records from each of the claimant’s treating physicians. With the support of the claimant’s records an administrative appeal was timely filed challenging MetLife’s determination. Dell Disability Lawyers was able to point out the inconsistencies in MetLife’s decision and the weaknesses of its internal reviews. They were also able to point out the strong objective medical evidence that was contained in the claimant’s medical records. Faced with this strong evidence, MetLife was forced to overturn its previous decision to deny benefits.

Today, the claimant is now receiving a monthly benefit check. Should she continue to be disabled, her policy will pay her until the year 2023.

If you have a similar case or are thinking of making a claim for disability benefits with MetLife, please do not hesitate to contact our office for a free consultation and review of your claim.


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MetLife Reviews
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Showing 8 of 51 Reviews
MetLife

They demanded an overpayment, stopped my claim, and lied about it

Reviewed by Diana R. on May 28th 2022   Verified Policyholder
Metlife over paid me. Stopped my Ltd claim. The overpayment were not done right. They lied and said they deposited money in my account.
Reply
Sent on May 28th 2022 by Attorney Alex Palamara

Diana, I am sorry to hear of this denial and the demand for an overpayment. Please contact us so that we can review your claim and see if we can get you back to receivi... read more >

MetLife

Your decision making process is absurd!

Reviewed by Brian on June 1st 2021   Verified Policyholder
My wife went through a nightmare with a back surgery for two discs. When the first surgery took place, the Dr. cracked a different vertebrae as they placed the metal rods ... read more >
MetLife

My husband has 2-5 yrs to live, yet MetLife has been giving him the run around

Reviewed by Tina on March 19th 2021   Verified Policyholder
My husband has STD and LTD with his employer. He was dx with ALS/Lou Gehrig’s Disease Aug 2019, made official after many many test, as of Jan 2020 but continued to work ... read more >
Reply
Sent on March 19th 2021 by Attorney Gregory Dell

Tina, I am so sorry to hear that MetLife and the employer have been giving you the run around. From everything that you described, your husband’s claim should be a qu... read more >

MetLife

Inappropriate conduct!! Rude, discriminatory, etc

Reviewed by Deanne on January 31st 2021   Verified Policyholder
Have you ever dealt with a case where the person is receiving LTD benefits but there have been issues with the case manager? For instance, the person was badgered about an... read more >
Reply
Sent on January 31st 2021 by Attorney Jay Symonds

Deanne: This certainly does not sound like appropriate conduct on the part of the claims personnel. Are you still collecting an LTD benefit? I suggest you contact our o... read more >

MetLife

Haven't been paid since MetLife denied my appeal months ago

Reviewed by Rosanne on December 8th 2020   Verified Policyholder
I was denied my appeal with Metlife, and I am still seeking medical diagnosis for other health issues. I was diagnosed with Chronic Gastritis and am now being tested for R... read more >
Reply
Sent on December 8th 2020 by Attorney Gregory Dell

Rosanne, I am sorry to hear of your denial. Please contact at once for a free consultation. We should be able to assist you with the next available steps.

MetLife

Metlife closed my STD claim amid several injuries

Reviewed by Donnette S. on October 14th 2020   Verified Policyholder
I am currently on STD with Metlife due to an accident on July 2nd. The accident broke my femur in have and I was care flighted to a trauma unit in Houston. The body scans ... read more >
Reply
Sent on October 14th 2020 by Attorney Jay Symonds

Donnette: This is a very unfortunate set of circumstances. Have you received a written denial letter? I suggest you contact our office and speak with one of the attorne... read more >

MetLife

Metlife's COLA recalculation cut my payments with no explanation why

Reviewed by Tori on September 10th 2020   Verified Policyholder
Are you aware of any class action lawsuits against Metlife Disability over their COLA adjustment method of calculations and application Of COLA? MetLife contacted me this ... read more >
Reply
Sent on September 10th 2020 by Attorney Gregory Dell

Tori, we are not involved in any class action at this time with MetLife, however, we will gladly review your policy to see if their updated calculations for your COLA a... read more >

MetLife

MetLife stopping my benefit plan. I'm still disabled

Reviewed by Teresa B. on June 1st 2020   Verified Policyholder
I experienced a macular tear in my right eye in Oct 2016 The other eye has been blind since childhood. I applied for LTD and got them. Now they say they are stopping the b... read more >
Reply
Sent on June 1st 2020 by Attorney Rachel Alters

Teresa, if you need assistance with an appeal then please email your denial letter to rachel@diattorney.com and we can try to assist you.

Answered Questions by Our Lawyers
(66)
Showing 8 of 66 Answered Questions

Q: Is MetLife entitled to overpayment if they realized 15 years later?

Answered on December 1st 2020 by Attorney Rachel Alters
A: Walyn, you can appeal the decision, but unfortunately they are entitled to the overpayment, even if they did n... Read More >

Q: Do I have to sign and return MetLife's authorization to disclose my info in order to continue my claim?

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Q: Will Met Life set me up on a payment plan if I have already spent my back pay from SSDI? Can they arrest me?

Answered on May 25th 2020 by Attorney Rachel Alters
A: Linda, you have nothing to worry about as it relates to being arrested – this is not a criminal matter. At b... Read More >

Q: Can MetLife remove my LTD claim from their web site?

Answered on May 19th 2020 by Attorney Rachel Alters
A: Jack, yes, this is legal. Read More >
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