Question

Why is MOO saying my husband does not have MS to receive LTD when they approved his STD because of MS? Should I hire an attorney?

Asked on September 21st 2012 by Marilyn Krebs
My husband was diagnosed with MS in February/2012. He tried to work for a few weeks, but he became worse. He applied for short term disability after his neurologist said he needed to stay away from work. Mutual of Omaha responded fairly quick and started receiving his check. They (Mutual of Omaha) led us to believe that should he need to go on long term disability, the process should be seamless. He received his last short term check the first week of June/2012. Then this crazy nightmare began. Giving us the run-around is an understatement. There were so many times they kept requesting more detailed records. The doctor was called many times and told us the requested records were sent to Mutual. Mutual would then say they did not receive the information. There has been two times after waiting for the insurance board to review, they came back and said that the medical records do not support a diagnosis of MS. My husband has been to four doctors, two very good neurologists among them, has had MRI’s, CAT scans, and numerous other tests. ALL of his doctors confirm MS is the diagnosis. Just yesterday, Mutual called and now says my husband must go get a third opinion from a doctor they pick and send him to. More waiting… My husband has not received a disability check from Mutual since June/2012. In the meantime, he applied for SSDI and has been accepted and approved. Believe me, that is a blessing! I am so puzzled as to why Mutual approved his short term disability because of a diagnosis of MS, but now they are saying the records do not support MS as a diagnosis for him to receive long term disability. I want to know: does Mutual of Omaha know something we don’t? Has my husband been cured of MS and they forgot to tell us? How can some mysterious heads sitting in some office at some table determine the welfare of my husband’s life? We are so at the end of our rope. Is is time to get an attorney?

Answer

Answered on December 22nd 2012 by Attorney Gregory Dell

Marilyn, Hiring an attorney is obviously optional, but you are trying to deal with a multi billion dollar insurance company that can afford to delay and possibly never pay your husband’s claim. Mutual of Omaha has the right to make decisions without ever having a doctor exam him. There are many things that can be done to make sure your husband is protecting his right to benefits. It would great if Mutual of Omaha had a cure for your husband and if they did I am sure you would give up his disability benefits. But let’s be honest, they don’t know more than your husband’s doctors and they are trying to build a strong claim in order to support a claim denial. Please contact us privately and we will discuss your husband’s claim options in detail.