MetLife reverses decision to terminate LTD benefits after Dell Disability Lawyers files an appeal showing Metlife completely ignored physical conditions of claimant
The claimant is a 44 year old female who worked as a Campaign Delivery Director for American Express. She was forced to go out of work on disability on April 7, 2014, after being psychiatrically hospitalized due to the onset of severe symptoms of depression and anxiety. In addition to her behavioral health symptoms, she also suffers from chronic diffuse pain and had been diagnosed with Ehlers-Danlos syndrome (EDS), autoimmune syndrome, and fibromyalgia. She applied for Long Term Disability insurance benefits under the terms of her policy with MetLife. MetLife approved her claim as of her date of disability of April 7, 2014, and in a letter dated November 17, 2014 informed her that her claim for LTD benefits was payable effective October 5, 2014. MetLife further advised that:
Therefore, after paying benefits for a period of 24 months, MetLife arbitrarily terminated her LTD benefits effective October 4, 2016, on the basis that she met the maximum benefit duration for a limited condition (mental illness) under the terms of the Policy.
MetLife blatantly ignored all physical claims and automatically terminated benefits after 24 months
Upon further review of MetLife’s claim file, it is evident that its reviews, assessments, and conclusion were not only flawed but clearly tailored to meet MetLife’s goal of averting further liability under the LTD policy. MetLife ignored the medical evidence of significant physical impairments due to her “non-limited” conditions of Ehlers-Danlos syndrome, autoimmune syndrome, and fibromyalgia which supported ongoing restrictions and limitations that would have precluded her ability to perform the material duties of her job or any gainful work beyond October 4, 2016. Furthermore, given the ambiguous nature of the LTD Policy’s mental health limitation, MetLife’s application was not appropriate as it did not afford consideration to the causative nature of her disability.
MetLife determination gave no deference to the impact non-limited conditions have on overall functionality
The medical evidence demonstrated that the claimant had a long-standing history of severe diffuse joint pain. She was initially diagnosed with an auto immune syndrome and Ehlers-Danlos syndrome (EDS) which is a hereditary connective tissue disorder characterized by joint hypermobility, widespread musculoskeletal pain and tissue fragility. She was later diagnosed with fibromyalgia as well.
She commenced treatment with acupuncture in early January of 2015, subsequent to her disability effective date, due to progressively worsening symptoms of joint pain particularly in her neck, shoulders, back, hands, knees, and thighs. It was noted her condition worsened with prolonged sitting, extended work hours, stress, anxiety, sickness and weather change. The claimant was seen on a weekly basis for acupuncture treatment to reduce the severity of her pain but received minimal to no improvement.
In February of 2015, the claimant commenced care with a rheumatologist, Dr. Levine. The initial evaluation on February 25, 2015 confirmed that she was hyper- extensible on examination and that her pain was related to EDS. However, during a subsequent visit on July 21, 2015, it was noted that she continued to have chronic pain with aches in her joints and at times her right hip intermittently popped out. Laboratory testing performed revealed ANA 2+ as well as low complements. In addition, Dr. Levine confirmed numerous tender points on examination. These findings, as well as her associated depression, trouble sleeping, and sense of feeling better after cardiovascular exercise were noted to be consistent with a diagnosis of Fibromyalgia. Dr. Levine further reiterated that her pain was also attributable to EDS.
In a Physician Statement from dated September 28, 2015, Dr. Levine opined, based on her physical examination, she was only able to sit 2-4 hours total and intermittently in an 8 – hour workday due to her physical non-limited conditions. She further noted limitations in fine motor coordination due to “finger pain & swelling”. Dr. Levine confirmed that she had not yet attained maximum medical improvement and noted that she required frequent breaks and rest due to body pain and fatigue.
MetLife admits claimant is disabled due to a physical condition and overturns its decision after appeal
MetLife’s actions to include selectively ignoring the medical evidence of physical disability and failure to perform a complete and thorough review of all of the claimant’s disabling conditions were arbitrary and capricious and demonstrated an abuse of any purported discretion it may have under the LTD Policy. Clearly the medical evidence demonstrated that her disability extended far beyond her mental diagnoses. As confirmed in Dr. Levine’s follow up office note dated January 19. 2017:
She continues to struggle with body pain and fatigue. She has some joint pain, particularly in hips bilaterally, as well as pain in the neck, shoulders, and upper back. She fatigues easily, both physically and mentally. It is evident based on the aforementioned that even in absence of mental diagnosis; she would continue to be disabled in accordance with the terms of her LTD policy due to her chronic pain stemming from her rheumatological conditions.
MetLife erred in its decision to deny benefits based solely on the policy’s mental health limitation. After reviewing an extensive appeal submitted by attorney Rachel Alters, Metlife overturned its determination to terminate benefits and reinstated the claimant’s LTD benefits paying all back benefits owed. The claimant remains on claim for her inability to work in any gainful occupation due to fibromyalgia and EDS.
Resources to Help You Win Disability Benefits
Submit a Strong MetLife Appeal Package
We work with you, your doctors, and other experts to submit a very strong Metlife appeal.
Sue MetLife
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Metlife.
Get Your MetLife Disability Application Approved
Prevent a MetLife Disability Benefit Denial
Negotiate a MetLife Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
They will do anything to not approve your claim
Reply
They FULL OF ****
MetLife for disability? Avoid the surgery unless it's life-threatening
Only care about $$$$$
Reply
They demanded an overpayment, stopped my claim, and lied about it
Reply
Your decision making process is absurd!
My husband has 2-5 yrs to live, yet MetLife has been giving him the run around
Reply
Inappropriate conduct!! Rude, discriminatory, etc
Reply
Q: Can Metlife reduce my LTD benefit due to SERP payments that were not paid to me (they went directly to FICA taxes)?
Q: Do I have an option after my appeal is denied?
Q: My daughter died in 2019
Q: Can I sue Metlife for non payment of approved claim?
Q: How far behind in payments does Metlife have to be to take legal action?
Q: Does Metlife pay Disability payments ahead? Example: December payment is for January.
Q: Would any new disabling conditions be considered by Metlife when considering whether or not to continue my benefits?
Q: MetLife: Mental Health and Physical Disabilities
How Does Having A Disability Lawyer Help Me Fight For Metlife Disability Benefits?
What Should I Expect if Metlife Wants to Send Someone to Interview me?
MetLife Disability Buyout and Lump Sum Settlements are Back
Metlife - Latest trends seen in handling ERISA and private disability insurance claims
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
Teacher's Disability Benefits Reinstated by MetLife
MetLife Denies Disability Benefits and Tells TFORCE Truck Driver Its Safe For Him to Drive
Contracts Manager With Toxic Encephalopathy Wins MetLife Long Term Disability Denial Appeal
MetLife Approves Long Term Disability Claim For Executive Assistant with Neck Pain
MetLife Approves Disability Benefits to Dentist With De Quervain's
Dell Disability Lawyers Successfully Appeals Metlife Denial of Benefits to Veteran
Metlife Overturns Denial on Appeal by Dell Disability Lawyers
Senior Global Tax Director for billion dollar worldwide industrial company is again receiving disability benefits from MetLife after Appeal by Attorney Alexander Palamara
Reviews from Our Clients







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.