MetLife Reinstates Benefits to Financial Advisor Suffering From Restless Leg Syndrome & Insomnia

Our client had been a highly successful financial planner who had spent his adult life working in a field he not only excelled in, but loved. For some time he had been suffering from Restless Leg Syndrome (“RLS”), which resulted in Insomnia, which in turn resulted in anxiety, depression and cognitive difficulties. Despite numerous attempts to adjust his work schedule, he found it harder and harder to be able to focus at work. He constantly found himself being awoken at night due to his RLS, and from there the pattern of sleepless nights began. As the lost hours of sleep began to compile he faced the realization that his ability to provide his clients with the top notch financial advice and investing they deserved and he demanded of himself was being compromised. Faced with this difficult reality he filed a claim for short term disability benefits with MetLife under his employer’s group disability policy.

The Application For Short Term Disability Benefits with MetLife

At first things ran relatively smooth for our client. He submitted his application on his own, and his disability claim was initially approved. For approximately five months benefits were paid without any hitches or indications of trouble on the horizon. However, with one month left on short term disability and a pending long term disability claim, MetLife terminated his claim for benefits, essentially disregarding the overwhelming amount of medical evidence that it had once used to approve his claim.

The MetLife ERISA Appeal

After the denial of his claim, our client contacted Attorneys Dell & Schaefer and met with Attorneys Gregory Dell and Stephen Jessup to discuss his claim in detail. Attorneys Dell and Jessup were surprised that MetLife had denied the claim in the face of numerous objective medical tests and records from a half dozen physicians they had on file. We quickly obtained a copy of the claim file and our client’s medical records. Review of the claim file indicated that MetLife only had the file reviewed by a general practitioner who was not qualified to comment on our client’s medical records from a neurological or neuropsychological perspective. Our evaluation of the claim revealed that the final disability denial was based on a single note in a medical record that indicated our client was “sleeping better.” These two words were enough for MetLife to terminate the benefit and cause our client financial hardship.

With the information before him, Attorneys Jessup and Dell set to work to undermine every erroneous comment and assertion made by MetLife. We coordinated with our client’s treating physicians to respond to the report created by MetLife’s doctor; to provide additional statements in support of disability; consulted with an independent sleep expert and even a physiatrist to conduct a functional capacity evaluation to document how the lack of sleep our client experienced resulted in levels of fatigue that would prevent him from physically working full time. When all was said and done, Attorneys Jessup and Dell submitted a 54 page written appeal letter along with 364 pages of documentation to support our client’s claim for continued benefits.

MetLife Reverses Their Decision to Deny Disability Benefits

Faced with the overwhelming amount of information and arguments we presented, MetLife overturned the denial of our client’s claim for short term disability benefits. However, it should be noted that the story does not end there. As mentioned, MetLife denied the claim for STD benefits with one month of benefits left, so in overturning its decision to deny benefits, MetLife approved the remaining month only. MetLife is now reviewing the claim to determine eligibility for long term disability benefits. However, based upon the strength of the appeal it is expected that MetLife will also approve the claim for LTD benefits. We will continue to represent our claim on an ongoing basis to make sure the disability claim is paid on a monthly basis.

Has your carrier denied your claim with only a few months left on short term disability or prior to a change in definition in your policy?

Insurance companies will often terminate or deny a disability benefit just prior to a claim for long term disability benefits (as is the case above), or just before the change in definition from “own occupation” to “any occupation.” This, in turn, builds in the ability for the insurance company to overturn a decision for the limited amount of time left under short term disability or under the own occupation definition of disability and then deny the claim again based upon the new policy language. It serves as another strong-arm delay tactic and is just another example of the techniques and tactics employed by the insurance companies.

If you’re experiencing difficulty with your insurance carrier or your claim has been denied prior to the start of long term disability benefits or just before your definition of disability is about to change from “own” to “any” occupation then please feel free to contact Attorneys Dell & Schaefer for a free consultation to discuss how we may be able to assist you.

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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.

Dell & Schaefer Client Reviews   *****

Jeffrey G.

Excellent legal services From Dell & Schaefer.

I had the opportunity to use the law firm of Dell & Schaefer of Hollywood, Florida. Greg Dell met with me during the initial consultation and explained my policy benefits. My situation was rather unique due to the fact it was a Mental/ Nervous condition which are often the most challenging to get approved. The firm spent a significant amount of time on my case and at a very reasonable fee. Through their hard work and legal expertise my claim was approved in a timely fashion. I would highly Greg Dell to anyone in need of a disability attorney.

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