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

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 and Schaefer

Within days of receiving the denial letter from MetLife, the claimant contacted Disability Attorneys Dell & Schaefer 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 and Schaefer 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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FAQ

Do you help MetLife claimants nationwide?

We represent MetLife clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a MetLife disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from MetLife. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by MetLife.

How do you help MetLife claimants?

Our lawyers help individuals that have either purchased a MetLife long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with MetLife:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

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 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.

What are your fees?

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.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. 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.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer 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.

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