Microsoft employee denied disability benefits by Prudential

A Microsoft account representative and her disability lawyer filed suit against Prudential Insurance and Tanaka’s employer under the Employee Retirement Income Security Act of 1974 (ERISA) on August 1, 2011 in an effort to get a Federal Court to order the insurer to pay her entitled disability benefits. The Employee became disabled in March 2006 due to the worsening of her fibromyalgia condition which included symptoms of pain, fatigue and cognitive dysfunction. Initially approved for receipt of her disability benefits in May 2007 retroactive to September 13, 2006, Tanaka thought she was set for continuing disability benefits per the terms of her employee Prudential policy.

Prudential Terminates Claimant’s Disability Benefits

Unfortunately, Prudential did not come through for Tanaka, and her disability benefits were terminated on September 9, 2008, when the insurer took away Tanaka’s benefits, “claiming that her disability was based primarily on ‘self-reported symptoms’ and thus she was limited to 24 months of benefits.” Submitting medical evidence documenting her disability, Tanaka appealed the insurer’s decision and was again turned down by the insurer for the same reasons as given for the termination of her disability benefits. The denial letter also stated that Prudential attributed Tanaka’s condition to “mental illness,” a condition that precludes the receiving of disability benefits. And, in addition, Tanaka’s live insurance plan premium waiver was denied in that the insurer alleged that Tanaka was never disabled in the first place and did not qualify for the waiver.

Claimant and Her Disability Lawyer File a Complaint In California District Court

After exhausting all of her administrative appeals, Tanaka saw no other alternative but to hire a disability lawyer to bring her case to District Court. Tanaka and her lawyer allege that Prudential’s decision to terminate Tanaka’s benefits was “wrongful, unreasonable, contrary to the medical evidence, contrary to the provisions of the Plan, and contrary to law.” Tanaka and her attorney seek relief from the District Court, asking the Court for:

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There are 2 comments

  • Brenda,

    If you have another appeal available, then please contact us for a free consultation to discuss your options. There are always industry secrets, but you need to hire a law firm that has extensive experience dealing with Prudential. Regardless of any secrets, you have the burden to prove that you are disabled.

    Gregory DellJan 10, 2012  #2

  • I have been struggling with Prudential concerning my LTD benefits. Fibromyalgia was just one of a long list of serious health conditions that left me unable to work per my doctor and specialists, however I have been denied twice already. I have just began looking for a lawyer to help me with the final appeal and possible lawsuit. Is there some industry secret that I should know when dealing with Prudential? They are not denying any of my illnesses including Ecoli pneumonia, gastroparesis, irritable bowel syndrome, post traumatic stress disorder, degenerative disc disease, and osteoarthritis of the spine, diabetes, chronic obstructive asthma and a partially collapsed lung.

    Brenda MuseJan 5, 2012  #1