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Mutual of Omaha disability denial remanded for wrongful evaluation of occupation

A Mutual of Omaha disability claim was sent back for further evaluation according to a recent decision by a Maryland Federal Judge. The issue dealt with how should Mutual Of Omaha determine the occupation of a disability claimant. Which is a better tool for determining occupation? ONET or DOT?

If O*Net has replaced the DOT, why can an insurance company rely on the DOT?

Unfortunately, there is no simple answer to this question. However, a Federal Court in Maryland asked the same question in the recent case of Patel v. United of Omaha Life Insurance Company (a Mutual of Omaha company). Unique to the disability policy that governed Patel’s claim was the fact that the policy expressly stated that “regular occupation” would be based on a comparable job description as set forth in the most current edition (emphasis added) of the DOT. The Policy went on to state that Omaha had the right to substitute or replace the DOT with a service or other information it determined to be comparable.

In the Patel case, Omaha Life initially approved Ms. Patel’s benefits under the regular occupation definition of disability. However, within a few short months Mutual of Omaha had terminated her claim stating that based upon the information in the claim file she could return to her former occupation. Ms. Patel appealed this determination, but ultimately Omaha Life would deny her appeal and the case would end up in litigation. In motions filed with the court, both Patel and Omaha requested that the Judge decide the case in their favor.

Based on a review of the claims procedure and argument made by both sides, the Court ruled that neither side had made convincing enough argument in their motions to prevail. Instead the Court remanded (sent the case back) Ms. Patel’s claim back to Omaha Life for further review. In doing so the Judge ordered Omaha Life to consider the O*Net Occupational definition rather than the DOT to determine whether Ms. Patel was disabled in light of same. The Judge’s logic was if the Policy indicated Omaha Life would determine what constituted Ms. Patel’s regular occupation based upon the most recent edition of the DOT, and if O*Net replaced the DOT, then Omaha should review it in light of O*Net.

So does this mean the Insurance Company can no longer rely on the DOT?

No. The Patel case is the opinion of one Judge as to the application of DOT vs. O*Net. However, it does reiterate the importance of an in depth and complete analysis of an “occupation” based on all available sources. Insurance companies will continue to rely upon the DOT, and that’s why it is important to consult with an attorney who has experience in combating the insurance industry’s position on this matter.

It should be noted that in rendering its decision the Court did not award Ms. Patel benefits. Her claim was simply returned to Omaha Life to conduct further review of her claim in accordance with the Judge’s order. There is no guarantee that in doing so Omaha Life will change its decision to deny benefits.

If you have any questions regarding your rights under a short or long term disability policy please contact Attorneys Dell & Schaefer at 1-800-828-7583 for a free consultation.

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We represent Mutual Of Omaha 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 Mutual Of Omaha disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Mutual Of Omaha. 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 Mutual Of Omaha.

How do you help Mutual Of Omaha claimants?

Our lawyers help individuals that have either purchased a Mutual Of Omaha 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 Mutual Of Omaha:

  • 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

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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.

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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.

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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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