• Mutual of Omaha Reverses Long Term Disability Benefit Denial

Mutual of Omaha Reinstates Benefits of Business Development Manager after Appealing the Termination of Her LTD Benefits

Our Client, a successful Business Development Manager began experiencing severe physical limitations resulting from fibromyalgia, low back pain, L4-5 spondylolisthesis, L4-5 degenerative disc disease and chronic fatigue. As a result she was unable to perform with reasonable continuity at least one of the material duties of her regular occupation on a part-time or full-time basis.

Denial Based Solely on Nurse Consultant Review

Mutual of Omaha’s decision to deny her claim for LTD benefits was based on the review of medical records performed by Mutual of Omaha’s in-house nurse consultant, who after merely reviewing the medical records, concluded that fulltime and full duty working activities are not contraindicated with a diagnosis of Fibromyalgia. In her opinion, “this condition and the symptoms associated with Fibromyalgia are typically treated with increased activity, regular exercise program, and regular working activities.”

It was the opinion of this nurse reviewer that it was reasonable to expect the claimant to be able to walk or stand for 6 hours out of an 8-hour day. Lift no more than 20 pounds on an occasional basis and up to 10 pounds on a frequent basis. She further opined that the claimant presented with self-reported symptoms with no acute physical findings. The severity of symptoms documented was inconsistent to provide a clear explanation that she would have any restrictions and limitations.

Claimant Physicians Disagree with Nurse Reviewer Opinions

Mutual of Omaha’s nurse was incorrect in her opinions regarding the claimant’s functional capacity and Mutual of Omaha acted with bias and in conflict of interest when it relied solely on their in-house nurse’s opinion in reaching its decision to deny the claim for long term disability benefits without retaining a physician in the proper specialty to perform a peer review of the claim. The nurse consultant was clearly not qualified to render a medical opinion with regard to the claimant’s functional capacity to perform work duties, nor was she qualified to provide an opinion as to what might be the best medical treatment for her medical conditions.

All of the claimant’s treating physicians concluded, based on their physical examinations and treatment over an extended period of time, the claimant did not have the functional capacity to perform even sedentary work due to severe pain all over her body, fatigue and cognitive deficits.

In her peer review report, the nurse failed to explain on what evidence she based her conclusion that the claimant could walk or stand for 6 hours out of an 8-hour day and could lift no more than 20 pounds occasionally and up to 10 pounds frequently. Further, she failed to explain how the claimant would be able to perform both the physical and cognitive demands of her regular occupation in light of her complaints of severe, disabling pain and fatigue. Her occupation required more than just standing, walking and lifting 10 to 20 pounds. Her occupation as a Business Development Manager required long hours, the ability to multi-task, to think on her feet and ability to focus. The nurse reviewer failed to give consideration to the fact that the claimant suffers flares of her symptoms which prevent her from performing the material duties of her occupation with reasonable continuity, 8 hours per day, 5 days per week, on a continuing basis. During periods when the claimant experienced a flare up of her symptoms, she is completely disabled and barely able to care for herself.

Mutual of Omaha’s Determines It’s Decision Was Wrong

After Attorney Alters submits a length appeal accompanied several physicians’ opinions and medical records all supporting the claimant’s inability to work, Mutual of Omaha overturned its denial and reinstated the claimant’s LTD benefits. She is still unable to work and remains on claim. Attorney Alters will continue to manage the claim the help ensure that her benefits are paid until she is able to return to work.

Read more about Mutual of Omaha disability claims.

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Do you help Mutual Of Omaha claimants nationwide?

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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