Claimant Wins Summary Judgment Motion against MetLife After Court Determined that MRI was Sufficient to Diagnose Radiculopathy
In the recent case, Charneski v. Metro.Life 2013 U.S.Dist.Lexis 176855, an Alabama judge determine that MetLife’s decision to terminate the LTD benefits of a service employee of a car dealer who suffered a back injury requiring surgery, was de novo wrong. Charneski‘s doctors all state that he is disabled from performing any gainful occupation due to pain in his back as well as radiculopathy (nerve damage causing pain shoot down the leg). He was approved for Social Security benefits as well. However, MetLife’s plan had a provision stating that it will only pay LTD benefits for 24 months for conditions that are self-reported including any neuromuskuloskeletal and soft tissue disorders. MetLife retained a physician to perform a paper review of Charneski‘s records who determined that there were no exceptions to the 24 month self-reported illness limitation, leading to MetLife’s termination of benefits.
A Treating Physician Appropriately Diagnosed Radiculopathy Based on MRI Findings
Contained MetLife’s 24 month Self-Reported Pain Limitation are several exclusions, one being radiculopathy. If a claimant can show that he or she has been diagnosed with radiculopathy through objective testing, then he or she can be paid beyond 24 months for a musculoskeletal condition. In this case, MetLife argued that an MRI was not sufficient to diagnose radiculopathy, that an EMG was necessary but was never performed. The Judge reviewed all the medical records and test results and determined that an MRI is absolutely appropriate to diagnose radiculopathy and that an EMG or other testing was not necessary. Furthermore, the plan did not state that an MRI was not considered objective evidence for the diagnosis of radiculopathy. Even though MetLife’s physician stated that other tests can be done to diagnose radiculopathy, there was no evidence presented that an MRI in itself was not objective medical evidence that could be used to support a diagnosis of radiculopathy.
If you have a MetLife plan that contains a similar 24 month limitation, be sure to inform your doctors that in order for you to remain on disability you must provide your insurance company with testing indicating objective proof of one or more of the exceptions spelled out in your plan.
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
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
Haven't been paid since MetLife denied my appeal months ago
Reply
Metlife closed my STD claim amid several injuries
Reply
Metlife's COLA recalculation cut my payments with no explanation why
Reply
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
Q: Can my employer switch my job because I go on LTD?
Q: Can MetLife deduct the ssdi benefits I receive for my dependent kids from what they pay me?
Q: Is MetLife entitled to overpayment if they realized 15 years later?
Q: Do I have to sign and return MetLife's authorization to disclose my info in order to continue my claim?
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
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
How Do You Fight a Long-Term Disability Denial?
Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
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






