Prior to filing for disability insurance benefits under her employer provided Short Term Disability Policy administered by Mutual of Omaha, our client was a successful Software Developer with a history of chronic back pain and prior surgery. She was the prototypical successful, highly motivated, driven worker who selflessly threw herself head first into her work. Although it was a labor, it was truly a labor of love as evidenced by the fact that following a back surgery she did everything in her power to return to work as soon as possible. For over three years, despite continued pain and medical treatment to include blocks, injections, and spinal cord stimulators on account of her diagnosis of post laminectomy syndrome and radiculopathy she found a way to physically will herself to work. However, with time, the demands of her job and her deteriorating physical condition began to finally take a toll on her physically, mentally and emotionally.
Application, Denial and Outrage
Coming to the realization that she could no longer work at the level the she demanded of herself, she made the very personal and difficult decision to file for short term disability benefits with Mutual of Omaha. Believing that Mutual of Omaha would do the right thing and approve her benefits, our client was taken aback when less than a month after filing her claim she received a letter from Mutual of Omaha denying her claim. At that time she contacted Attorneys Dell and Schaefer to assist her in filing her administrative appeal of the disability denial and spoke with Attorney Stephen Jessup.
The Denial Letter From Mutual of Omaha
Attorney Jessup reviewed the denial letter and was again confronted with the unfortunately all too common insurance industry tactic to minimize the occupational duties of one’s “Own Occupation” as nothing more than the physical demand associated to it by the Department of Labor. In our client’s case, Mutual of Omaha’s denial of benefits amounted to nothing more than, “We think you can do sedentary work.” If only making a living as a Software Developer was as easy as the ability to lift 10lbs occasionally, sitting most of the time and exerting a negligible amount of force frequently!
The Appeal of Mutual Of Omaha’s Disability Denial
Attorney Jessup set out quickly to obtain a complete copy of our client’s claim file from Mutual of Omaha and began to gather our client’s medical records, which proved to be a multi-year saga of our client attempting nearly every medical remedy in hopes of finding relief for her pain. Review of the claim file indicated that Mutual of Omaha’s medical review amounted to focusing on four medical appointments over the course of a month with one of her treating physicians. From these four appointments, Mutual of Omaha cherry picked the snippets of information that were in line with its agenda to deny the claim, and discarded the rest. Attorney Jessup was quick to dissect Mutual of Omaha’s medical review, discrediting same, and highlighting our client’s medical history in an over 20 page medical review analysis.
Understanding that it was crucial to not only elaborate the true occupational duties of our client’s occupation, but also to undermine the assertion our client could perform sedentary work, Attorney Jessup coordinated functional testing to document our client’s residual physical abilities to work, as well as created fact specific questionnaires for her doctors to complete that would not only invalidate Mutual of Omaha’s positions, but also position our client’s claim for future security.
The Victory Against Mutual of Omaha
After all medical and non-medical was compiled, Attorney Jessup submitted a 32 page appeal letter to Mutual of Omaha systematically undermining each of Mutual of Omaha’s flawed assertions. Upon receipt of the appeal and not willing to give up easily, Mutual of Omaha requested that our client submit to an independent medical examination. Although Mutual of Omaha would not release the results of same, it was clear that in light of her extensive medical history and the information provided in support of her Appeal, Mutual of Omaha knew it had no choice but to overturn it’s decision to deny benefits, reinstate same and begin an immediate review of entitlement for long term disability benefits. Our law firm will continue to represent our client throughout the LTD stage and until she is no longer eligible for benefits.
Has your claim been wrongfully denied?
One of the most common times for a claim denial is upon application for benefits. If you are considering filing for benefits, or your application for same has been denied, please feel free to call Attorneys Dell and Schaefer for a free consultation to determine how we may be able to assist you.