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 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.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

Chad B. (Illinois)

I originally spoke with 3 other long term disability lawyers about my case before contacting Dell and Schaefer. None of those law firms would take it. They said the chances of me winning was not good. After finding Dell and Schaefer online I spoke with one of the attorneys that has since left. He did take my case but later it was picked up by Rachel Alters. Rachel is amazing and a very intelligent attorney. She not only won my case but also was able to get my back pay for 6 months.

I also cannot say enough about Sonia Nogueira. Sonia was always quick to answer any of my questions. I would usually hear back from her within hours of sending her a email. I do not know where I would be if I hadn’t contacted them. My family and I cannot thank them enough. Don’t let an insurance company tell you they are not responsible for paying you. I paid them for 20 years monthly and they looked for any reason they could not to have to pay me when I needed my benefit. Thank you Rachel and Sonia for all you guys do.

Paul L. (New York)

Words can only scratch the surface regarding my experience working with Attorneys Dell & Schaefer. It’s a very emotional experience making the decision to utilize disability insurance. The unknowns were/are scary. From the very first phone call, the support staff was/are very professional and reassuring. I have been working with Attorney Steven Dell for approximately 10 years. He is confident, reassuring, listens to and addresses all my concern, and is extremely dilligent in understanding my specific policies for how they impact me. It is very reassuring that Steven handles and deals with the insurance company on my behalf. Attorney Dell’s team, and specifically Merlin, Attorney Dell’s assistant, is simply fantastic. Her professionalism and attention to detail have made all my communications with the office seamless.

Simply put, my experience with Dell & Schaefer made the emotional rollercoaster experience of my neck surgery seem like a walk in the park.

Thank You, Thank You, Thank You, to both Attorney Steven Dell and to Merlin for how you have helped me over these past 10 years.

Dilligence, Reassurance, Professionalism at every step, Confidence, Results.

With 10 years experience with working with Dell & Schaefer, taking that step to call Attorneys Dell & Schaefer was one of the best professional and personal decisions I have ever made.

You want to know what you can do – the below comment about posting your first name and last name initial on our website. Put up my full name, phone number, and email address. I will gladly speak to anyone about your office and tell them my story and how instrumental Steven and Merlin have been in my life over the past 10 years.

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