How We Help To Appeal Your Mutual of Omaha Disability Denial

Let’s discuss how you can win your Mutual of Omaha Disability Appeal. Mutual of Omaha disability denials are usually unreasonable and with preparation of a strong appeal package you can get your benefits paid. There is only one chance to submit a Mutual of Omaha appeal and it must be drafted strategically in order to win your disability benefits. Our disability insurance lawyers have reviewed thousands of Mutual of Omaha short and long term disability denials on behalf of claimants nationwide and we are available now to provide you with a free phone consultation with one of our attorneys. We have seen every type of Mutual of Omaha disability denial and we know exactly what is required in order to give you the best chance to win your Mutual of Omaha disability benefit appeal.

Why Is It Important to Prepare a Strong Mutual of Omaha Appeal? 

We want you to become educated about the Mutual of Omaha appeal process and learn how our law firm can help give you the best chance to win your Mutual of Omaha disability appeal. In our Mutual of Omaha Disability Appeal Tips video attorneys Gregory Dell and Alex Palamara discuss the following: 

• What is your first step to appealing a Mutual of Omaha denial?
• What evidence did Mutual of Omaha rely upon to deny your disability claim?
• Should you submit additional medical evidence for your Mutual of Omaha appeal?
• How does Mutual of Omaha determine the duties of a job?
• Why is it important for you to submit a strong appeal package to Mutual of Omaha?
• Does Mutual of Omaha require objective medical evidence to win benefits?
• Who is responsible at Mutual of Omaha for reviewing your disability appeal?
• Can Mutual of Omaha rely exclusively only on the medical opinions of their hired doctors? 
• How can we help prepare a strong appeal package to Mutual of Omaha?

How Can You Win Your Mutual of Omaha Disability Appeal?

With strategy, collaboration, and execution, you can get your Mutual of Omaha disability claim approved. Every Mutual of Omaha disability benefit denial is unique because everyone has different medical conditions that prevent them from working, the definition of disability is different in most Mutual of Omaha disability policies, and lastly, your prior work experience and education will have a big impact on the ability to perform any job. Our law firm’s history of winning disability appeals comes from working very closely and strategically with you, your treating doctors, and vocational consultants. We take a custom approach to how we handle every appeal and we look forward to discussing your Mutual of Omaha disability denial with you. As you begin the process to get your Mutual of Omaha disability denial reversed you should watch our video below:

Most Mutual of Omaha disability benefit denials are based on Mutual of Omaha’s determination that you do not have sufficient medical limitations which prevent you from working in a specific occupation or any occupation. While Mutual of Omaha may first notify you of a disability denial via telephone, the basis for Mutual of Omaha’s denial is required to be included in their denial letter and the documents supporting the disability denial must be contained in the claim file. In your Mutual of Omaha denial letter, Mutual of Omaha gives you the right to request a complete copy of your claim file and that is the first step we take.

Why is Mutual of Omaha Required To Send You All Information Used To Deny Your Disability Claim?

ERISA regulations require Mutual of Omaha to prepare and send your claim file within 30 days of a written request. The claim file is supposed to include all information relied upon to deny your disability benefits, which would include medical records, financial records, internal emails, memos and notes, your disability plan documents, video surveillance and any medical reviews and vocational reviews conducted by Mutual of Omaha. Upon receipt, your Mutual of Omaha disability claim file must be reviewed with great detail. Depending on how long your disability claim has been pending, your claim file can range from 500 to 10,000 pages. 

The Mutual of Omaha claim files are often intentionally disorganized and require legal experience in order to know what information in the claim file is relevant to preparing a strong Appeal. We always request the claim file for our clients and upon receipt we immediately organize and analyze all information so that we can prepare a plan of attack that puts our client in the best position to have their short term or long term disability benefits reinstated.

There is only one chance to submit a Mutual of Omaha appeal and it must be drafted strategically.

How Does A Plan of Attack Help You Win a Mutual of Omaha Disability Appeal?

After our lawyers complete a full review of your Mutual of Omaha claim file and review all of your up to date medical records, we formulate a plan of attack that we believe must be followed in preparation of your Mutual of Omaha appeal. Every plan is focused on determining what additional medical documentation and support we can obtain to prove your disability. You only have 180 days from your date of benefit denial to submit an appeal so it’s important to act quickly in order to submit a timely appeal package. 180 days may seem like a lot of time, but you really want to have as much time as possible so that you can obtain as much additional medical and occupational support as possible. It’s not easy to get in quickly for doctor appointments and it takes time for doctors to complete documentation on your behalf. 

We Help You Prove That Mutual of Omaha’s Doctors Are Wrong

Mutual of Omaha usually relies on their own employed doctors or nurses to deny your disability claim. Regardless of what your doctors may have concluded, Mutual of Omaha will almost always favor the opinions of their own doctors over yours.  The way to overcome this inherent bias is to present strong medical evidence in support of disability that no reasonable person could disagree with. 

As a practical matter, Doctors don’t like dealing with insurance companies, and while they want to help you they get frustrated. Your doctors document your medical records for the purposes of treating you and not for an insurance company review. As a result, most doctors do not document all of your limitations and complaints for purposes of a disability claim. Through our experience in helping thousands of disability claimants we educate your doctors about your disability insurance policy language and work with your doctors to document your medical conditions appropriately.

Obtaining strong written support from all of your treating doctors is usually the most challenging aspect of preparing a Mutual of Omaha Disability Appeal.

Custom Attending Physician Statements Are Essential

Our job during the appeal process is to work with you and your treating doctors to obtain medical evidence that rebuts Mutual of Omaha’s doctors (or hired doctors) written opinions. The attending physician statements created by Mutual of Omaha and previously completed by your treating doctors are generic and intentionally designed by Mutual of Omaha to offer limited support for your claim.

In every appeal we handle, we draft custom attending physician statements for completion by your doctors. Our physician statements are specific to your Mutual of Omaha Long Term disability policy definition of disability and your specific medical condition(s). With every type of medical condition we know the exact information Mutual of Omaha and their doctors are seeking as evidence of disability. If you have more than one condition that may impact your ability to work, and are treating with more than one physician we will reach out to all relevant treating doctors.

In addition to a custom physician statement we may suggest additional diagnostic testing or medical consultations with different medical specialists if we believe it will help bolster your claim. In some appeals, we will have you undergo a Functional Capacity Exam (FCE) or an Independent Medical Exam (IME). The results of an FCE are shared with your treating doctors as they can provide strong support for your functional limitations. We may alsoIn some appeals, we will submit medical literature from leading medical publications which support your symptoms, limitations and potential risks associated with your condition.

Mutual of Omaha Appeal Success Story

Our client was a Medical Device Manager who became unable to work due to a significant shoulder injury. Mutual of Omaha, however, denied his claim based on an internal medical review, and was forced to appeal. As explained in the video below, Attorney Gregory Dell and Cesar Gavidia discuss how we assisted our client to achieve an approval of benefits by Mutual of Omaha.

Why Must Your Appeal Contain Strong Occupational Evidence?

In most Mutual of Omaha disability denials, Mutual of Omaha will argue that if you can sit in a chair for 6 hours a day then you should be able to work. This is obviously a ridiculous conclusion , but you must submit occupational evidence that any job requires more than just an ability to sit. Mutual of Omaha’s denial letters will usually misrepresent your job duties or list other jobs they think you can perform for 40 hours a week. Depending upon the applicable definition of “disability” at the time you become disabled, it is critical to review how Mutual of Omaha has determined the duties of a job they say you can perform. 

The occupational evidence that must be presented in your appeal will depend upon whether your definition of “disability” is either the inability to perform your “Own occupation” or the inability to perform “Any Gainful Occupation”. Own Occupation and Any Gainful Occupation are defined terms in your Mutual of Omaha disability policy. In most Mutual of Omaha disability policies the definition of disability is Own Occupation for the first 24 months and then it switches to the more difficult definition of Any Gainful Occupation. Most Mutual of Omaha disability denials happen either at the inception of a disability claim or when the definition of disability changes at the 24 month mark.

How Does Mutual of Omaha Determine The Duties of an Occupation?

Mutual of Omaha will rely on their own vocational consultant to determine how either your job is performed in the national economy or how any other job is performed in the national economy. This means that Mutual of Omaha ignores the way you actually performed your job for your employer and randomly determines how your job is performed nationally. Mutual of Omaha will also come up with their own opinions about how any job is performed regardless of who the employer may be. 

To rebut Mutual of Omaha’s unreasonable occupational assessments, we regularly work with vocational experts in order to clearly define the duties of a specific job and the physical requirements to perform a specific job for 40 hours a week. A vocational expert will prepare a detailed report which reviews the duties of all jobs suggested by Mutual of Omaha, review your medical records, review your restrictions and limitations, and explain why you are unable to perform the job duties suggested by Mutual of Omaha. If necessary, the vocational expert may also perform a labor market analysis discussing the availability and salaries of specific jobs. 

In many denial letters, Mutual of Omaha will come up with jobs that are not available in your area and that make these job suggestions unreasonable. As additional occupational evidence we may also submit employer statements from your co-workers, your job description, a personal statement from you about a typical day at the job, industry reports, and samples of work products produced in your job. 

We provide a lot of detail in our Appeals to explain why you cannot perform the specific job duties of either your job or any job. Depending upon your definition of disability when you are denied, we also present evidence in our Appeals that can get you approved for benefits if your definition of disability will change at the 24 month mark. We don’t want you to win an Own Occupation appeal only to be denied again because you don’t qualify under the Any Occupation definition of disability.

Mutual of Omaha Appeal Success Story

We assisted a claimant who worked as a Building Manager, diagnosed with back pain and back disorders resolve his appeal. Mutual of Omaha denied his disability claim, asserting that he could perform his own occupation. In our video below, attorneys Gregory Dell and Stephen Jessup explain how after preparing an appeal Mutual of Omaha reversed their decision to deny his disability claim.

How Courts Review Mutual of Omaha Disability Appeals

This paragraph may contain some technical legal information and we will try to make it as simple as possible. 95% of Mutual of Omaha appeals are governed by a law called ERISA and you must understand ERISA laws in order to prepare and write a strategic appeal. There is only one chance to submit a Mutual of Omaha appeal and it must be drafted in a manner so as to not tell Mutual of Omaha everything they did wrong. Most people, including lawyers that don’t focus their legal practice on Mutual of Omaha appeals, will submit appeals where they basically give Mutual of Omaha a roadmap on how to review the appeal by telling Mutual of Omaha everything they did wrong on the initial review. They will include lots of case law and a detailed criticism of everything Mutual of Omaha did wrong. This is not the proper way to submit an appeal and really does nothing more than guide Mutual of Omaha as to how to conduct a “reasonable review” of your initial claim denial.

What Does A Reasonable Review Mean Under ERISA For A Mutual of Omaha Appeal?

The “reasonable review” language is key because if your appeal is denied by Mutual of Omaha and an ERISA lawsuit is filed, a judge must review the denial and apply an unfair legal standard called “abuse of discretion”. The abuse of discretion standard requires a judge to first determine if you are disabled. If the Judge concludes you are disabled, then the Judge can only reverse the benefit denial if he or she thinks the review conducted by Mutual of Omaha was unreasonable. So a Judge can find that you are disabled, but Mutual of Omaha’s unfavorable review of your claim was reasonable. In this scenario your denial will be upheld as the Judge must defer to the reasonable review conducted by the insurance company.

No matter how big or scary Mutual of Omaha may seem, we have recovered disability insurance benefits for our Mutual of Omaha clients in more than 95% of the Mutual of Omaha disability cases our law firm has accepted.

Why Drafting A Strategic Mutual of Omaha Disability Appeal Is Crucial 

Because of the abuse of discretion standard that applies to any Mutual of Omaha disability policy that contains a “discretionary clause”, we always draft a strategic appeal that focuses on your medical restrictions/limitations and how you are disabled in accordance with your disability policy’s definition of disability, rather than simply saying what Mutual of Omaha did was wrong. By telling them what they did wrong, it actually helps Mutual of Omaha create a record for litigation that could be perceived as more reasonable. There are a few states where the discretionary clause is illegal and the judge’s decision on the claim will be final regardless of the reasonableness of Mutual of Omaha’s appeal review.

Regardless of the standard of review that will apply to your Mutual of Omaha disability appeal denial, our lawyers have a very specific style of organizing, preparing and drafting Mutual of Omaha disability appeals letters which have helped thousands of disability claimants nationwide to receive their disability insurance benefits.

Let’s Discuss Your Mutual of Omaha Disability Denial

When we review your claim we will give you an immediate and honest opinion about your chances of recovering disability insurance benefits from Mutual of Omaha. Don’t let Mutual of Omaha or anyone else convince you to handle your Appeal without legal help as you are about to go to battle against a company that generates billions of dollars a year in revenue. To help you learn as much as possible about Mutual of Omaha and the ERISA Appeal process we encourage you to review all of the helpful information listed below. We welcome you to contact any of our disability insurance lawyers for an immediate free phone consultation.