MetLife disability insurance plan has terrible language, but it complies with ERISA
Everyone has heard the expression “You get what you pay for.” Disability insurance policies are contracts and the better the policy language for a disabled claimant; then the more expensive it is going to be to buy. Some employers that buy short term or long term disability insurance policies of their employees may look to spend as little as possible. Unfortunately, employees may be stuck with a disability policy that does not provide the protection that was anticipated.
The case against MetLife, which was not handled by our law firm, is a perfect example of a MetLife disability policy with horrible language. Certainly this claimant’s employer could have purchased a disability policy with better language, but choose not to.
Beware of disability insurance policies that limit the pay period for any condition
Every year thousands of claimants file claims for disability benefits due to the inability to work as a result of neuro-musculoskeletal issues (affecting their cervical and lumbar spine). Some claimants undergo conservative treatments such as injections and medications to attempt alleviate their discomfort. Others undergo high-risk spinal surgeries in an attempt to obtain some relief. Often times, neither remedy alleviates their pain, leaving them to contend with this disabling condition for the duration of their lives.
As a result, most of these individuals are unable to perform even sedentary work as the pain is too distracting, they are unable to sit at a desk for extended periods of time and the medication they take daily has severe side effects such as drowsiness and fatigue. Knowing that they are insured should the day come that they will no longer be able to work is somewhat comforting; however, it may come as a surprise to these claimants that should they become disabled due to a back or neck problem, even if they were to become a quadriplegic, their policy may only pay them for 24 months.
Federal Judge in Georgia holds employer may limit benefits to 24 months for neuro-musculoskeletal disorders with no exceptions
In the case of Bland v. MetLife the Plaintiff was injured in an automobile accident and underwent an L5 laminectomy with discectomy and fusion at L5-S1. She returned to work after her surgery, but fell down the stairs and reinjured her back. She filed for STD and was paid by her employer. She then received long term disability benefits for 24 months, until MetLife informed her that since her disability was due to a neuro-musculoskeletal or soft tissue disorder her benefits were limited to 24 months.
Plaintiff filed a lawsuit alleging that the plan failed to define “neuro-mulsculoskeletal disorder” and also failed to contain exceptions to the 24 month limitation. Most plans that carry this limitation also provide exceptions. Here, the employer modeled their plan after MetLife’s; however, it removed the exceptions which would allow for benefits past 24 months if you could provide objective evidence of radiculopathies, myelopathies, spinal tumors, seropostive arthritis or musculopathieis. Under the MetLife version of the policy, the Plaintiff would surely be able to show objective evidence that would provide her benefits beyond 24 months.
But MetLife agrees that I am disabled
According to the Court in this case, “however unfair it may seem, the Plaintiff cites no law, and the Court has found none that bars her employer from drafting its Plan any way it chooses, so long as it complies with ERISA. The employer is the master of its plan and no ERISA provision bars it from excluding coverage for neuro-musculoskeletal disorders.”
Even though MetLife agrees that the Plaintiff is unable to work as a result of her back condition and objective evidence supports this fact, she is still not eligible for benefits beyond 24 months.
Resources to Help You Win Disability Benefits
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
Q: Would any new disabling conditions be considered by Metlife when considering whether or not to continue my benefits?
Q: Do I have to sign and return MetLife's authorization to disclose my info in order to continue my claim?
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
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.