Veradigm Expert Solutions Specialist With PTSD and Conversion Disorder Wins New York Life Long-Term Disability Insurance Appeal in Arizona After Initial Denial

New York Life denied long-term disability benefits to an Arizona-based Veradigm Expert Solutions Specialist — a highly skilled IT professional responsible for delivering complex technical presentations to healthcare executives — based almost entirely on a paper review by a physician who never examined her, never spoke to her, and never evaluated the cognitive demands of her occupation.

Our client suffered from Post-Traumatic Stress Disorder, Major Depressive Disorder, and Conversion Disorder — a condition that produced very real cognitive deficits even though standard neuropsychological testing appeared largely normal. These are exactly the kinds of claims where insurance companies exploit the gap between test scores and real-world functionality, and we have seen New York Life claims handled this way many times. The Social Security Administration had already found our client disabled from all occupations — a far stricter standard — yet the insurer dismissed that determination without explanation.

Attorney Stephen Jessup filed a comprehensive ERISA administrative appeal that dismantled every basis for the denial, and New York Life reversed its decision and approved full benefits with retroactive pay. Below, we break down the denial tactics the insurer used, the evidence we assembled, and why this case matters for anyone facing a similar fight. If New York Life or any other disability insurance company has denied your claim, speak with one of our disability insurance lawyers for a free consultation. We represent claimants nationwide and charge no fee unless you collect benefits.

Table of contents

• Why this case matters for every New York Life claimant
• Our client’s occupation and the cognitive demands New York Life ignored
• The conditions that ended a decades-long career
• New York Life’s denial: a paper review, daily activities, and a misreading of Conversion Disorder
• The appeal: exposing every flaw in the denial
• New York Life reverses its denial and approves full benefits
• Denied by New York Life or another disability insurance company?

Why This Case Matters for Every New York Life Claimant

A paper review cannot override a treating physician’s two decades of clinical observations. The insurer’s entire denial rested on the opinion of Dr. Gitry Heydebrand, a physician who never examined our client. Her treating psychiatrist — who had treated her since 2006 — documented progressive cognitive decline that left her unable to perform her job. Under an own-occupation definition of disability, a claimant is considered disabled if they cannot perform the material duties of their specific job, regardless of whether they might be able to do some other type of work. In paper review denials, the insurer bets that a desk opinion will hold up against the weight of a real clinical relationship. It did not.

Insurers use daily activities to deny mental health claims — and the comparison is almost always false. New York Life pointed to our client’s ability to drive, do laundry, and perform yard work as evidence she could handle her occupation. But being able to drive to a grocery store is not evidence that someone can deliver complex IT presentations to healthcare executives under time pressure and employer scrutiny. The appeal reframed the comparison to the actual cognitive demands of the job.

If your claim is based on cognitive or psychiatric impairments, the insurer must evaluate the mental demands of your occupation. The carrier classified the job as “Light” — a physical exertion level — and never addressed the mental and cognitive requirements of the Expert Solutions Specialist role, even though the claim was based entirely on psychological impairments. That omission undermined the entire review.

A favorable Social Security disability determination cannot be arbitrarily ignored. The Social Security Administration found our client disabled from performing any occupation in the national economy — a far more stringent standard than her own-occupation policy required. New York Life acknowledged the award but dismissed it, and our appeal exposed this as procedurally unreasonable.

Conversion Disorder is a real, disabling condition — even when neuropsychological testing appears normal. Conversion Disorder — also known as Functional Neurological Symptom Disorder — is a condition in which neurological symptoms such as memory loss, paralysis, or seizures are real and functionally impairing, but are not explained by standard neurological or neuropsychological testing. An insurer that denies a claim because testing “doesn’t show anything” fundamentally misunderstands the diagnosis.

Our Client’s Occupation and the Cognitive Demands New York Life Ignored

Our client worked as an Expert Solutions Specialist at Veradigm, Inc. (formerly Allscripts Healthcare, Inc.), a healthcare technology company. This was not a routine desk job. The position required her to develop and deliver tailored technical presentations to highly complex prospective customers — hospital executives, IT directors, and clinical leaders evaluating multimillion-dollar software platforms.

The role demanded sustained high-level cognitive function across multiple domains:

• Memory and recall: Maintaining expert-level knowledge of Veradigm’s technical architecture, product features, integration options, and competitive positioning — and retrieving that information fluidly during live presentations
• Executive function: Managing the entire presentation event process from discovery through post-event debrief, coordinating across sales teams, marketing, and technology support
• Communication under pressure: Explaining complex technical solutions to audiences with both technical and non-technical backgrounds, probing customer needs in real time, and adapting presentations on the fly
• Problem-solving: Demonstrating that Veradigm’s solutions could address highly complex, prospect-specific business scenarios

The insurer’s own Occupational Identification Report acknowledged that the position required directing and planning activities, influencing people, making judgments and decisions, and performing a variety of duties. The Dictionary of Occupational Titles classifies the physical exertion level as “Light,” but the denial letter never once analyzed whether our client’s documented cognitive deficits prevented her from meeting the mental demands of the role. The carrier treated the claim as if the only question was whether she could lift twenty pounds.

The Conditions That Ended a Decades-Long Career

Our client’s psychiatric history began with an unimaginable tragedy. In 2005, she lost her only son in an apartment fire. She developed Major Depressive Disorder and Post-Traumatic Stress Disorder — conditions compounded by a history of childhood abuse and neglect. Over the following two decades, she endured multiple psychiatric hospitalizations, a suicide attempt, several intensive outpatient programs, numerous medication trials, and electroconvulsive therapy.

Each time her symptoms improved, she returned to work. Her treating psychiatrist — who had treated her since 2006 — consistently described her as a motivated, driven woman who found purpose and self-esteem in her career. She always wanted to work, and she performed at a high level when she could.

The Breaking Point

By mid-2023, the demands of her role overwhelmed her declining cognitive capacity. She was required to present IT systems to executives — work that demanded flawless recall, fluid communication, and the ability to handle pressure. Her memory deficits had become impossible to compensate for. During a work presentation, she lost track of her thoughts entirely, and her supervisor removed her from the building. She was unable to recover from that episode and ceased working altogether.

The Diagnoses

Our client’s treating psychiatrist diagnosed her with three interrelated conditions:

• Major Depressive Disorder, recurrent and severe — a mood disorder characterized by persistent depressive episodes requiring ongoing pharmacotherapy, including Lithium, Nortriptyline, and Clonazepam
• Post-Traumatic Stress Disorder (PTSD) — triggered by the traumatic loss of her son and compounded by childhood trauma
• Conversion Disorder (Functional Neurological Symptom Disorder) — a condition in which neurological symptoms, in this case severe memory and cognitive deficits, are real and functionally impairing but are not explained by standard neurological testing. The DSM-5-TR lists Conversion Disorder as a legitimate neurological condition in which symptoms cause clinically significant impairment in occupational functioning, even when neuroimaging and neuropsychological evaluations appear largely normal.

Her neurologist evaluated our client for memory issues and altered mental status. He documented concerns including confusion, brain fog, difficulty recalling conversations, and word-finding problems. An MRI of the brain revealed supratentorial white matter disease (abnormal changes in the brain’s white matter, which can be associated with chronic small vessel disease or migraines). The neurologist assessed memory issues, depression, PTSD, disorientation, altered mental status, and syncope.

A neuropsychological evaluation confirmed that our client’s cognitive abilities had remained broadly stable with no evidence of neurodegenerative disease. However, the evaluating neuropsychologist attributed the decrease in cognitive efficiency to psychological and situational factors — persistent PTSD, anxiety, long-standing depression, and increased stress. This finding was entirely consistent with a Conversion Disorder diagnosis: the deficits are real, they impair functioning, but they do not stem from structural brain damage.

New York Life’s Denial: A Paper Review, Daily Activities, and a Misreading of Conversion Disorder

New York Life denied our client’s claim for long-term disability benefits after what it characterized as a thorough review. In reality, the denial was built on a series of flawed arguments that reflected a fundamental misunderstanding of Conversion Disorder and a deliberate refusal to evaluate the cognitive demands of the occupation. An ERISA-governed claim requires a full and fair review — and this was neither.

The Paper Review by Dr. Gitry Heydebrand

A paper review — also called a file review — is when an insurance company has one of its physicians review the claimant’s medical records without ever examining the claimant in person. The insurer’s Medical Director, Dr. Gitry Heydebrand, who holds a Ph.D. in Neuropsychology and Psychology, conducted exactly this kind of review. He never met our client, never observed her cognitive deficits firsthand, and never assessed her ability to perform the specific duties of her occupation.

Dr. Heydebrand concluded that restrictions and limitations were “not supported.” His reasoning rested on three pillars — each of which crumbled under scrutiny.

The Daily Activities Argument

Dr. Heydebrand pointed to our client’s ability to complete daily routines — laundry, yard work, and driving — as evidence that she possessed adequate functional capacity. He stated that driving is a “cognitively complex task” and that an inability to focus or concentrate would mean she should not be driving at all.

This reasoning is a pattern we see constantly in disability claim denials. The insurer equates the ability to perform self-paced household tasks with the ability to deliver high-stakes technical presentations to healthcare executives. The comparison is false on its face. People with limited educations and no professional experience drive cars every day — that does not mean they can function as Expert Solutions Specialists. And notably, our client reported that she frequently lost track of where she was going even when driving to familiar places, which underscored rather than undermined her cognitive impairment.

The “Low Treatment Frequency” Argument

Dr. Heydebrand characterized our client’s three-month treatment intervals as evidence of “psychiatric stability.” He argued that the low frequency and intensity of treatment demonstrated that her conditions were not as severe as her treating psychiatrist reported.

This argument ignored the full picture. Our client had already undergone every intensive treatment available — multiple hospitalizations, electroconvulsive therapy, several intensive outpatient programs, and numerous trials of pharmacotherapy over two decades. Therapy had been tried repeatedly and never resulted in meaningful symptom reduction. Her current medication management regimen reflected the reality of a treatment-resistant condition, not an absence of impairment.

The Neuropsychological Testing Argument

Dr. Heydebrand relied heavily on the neuropsychological evaluation, which showed a “largely intact cognitive profile with no evidence of neurodegenerative disease.” He used this finding to override the treating psychiatrist’s clinical assessment of disabling cognitive deficits.

This is precisely the mistake insurers make with Conversion Disorder. The entire diagnostic framework of the condition is built on the reality that neurological symptoms are genuinely impairing even when standard testing appears normal. Our client’s psychiatrist — who had treated her for nearly two decades — explained repeatedly that the deficits are real, that they represent a Conversion Disorder, and that normal neuropsychological testing does not disprove the diagnosis. It confirms it.

The Appeal: Exposing Every Flaw in the Denial

Under the Employee Retirement Income Security Act (ERISA), claimants whose employer-sponsored disability benefits are denied must exhaust the insurer’s administrative appeal process before filing a lawsuit in federal court. Attorney Stephen Jessup assembled a comprehensive appeal that attacked each basis for the denial with evidence the carrier could not ignore.

Establishing the Cognitive Demands of the Occupation

The appeal opened by laying out the full scope of our client’s job duties — not the generic “Light” classification the insurer relied on, but the actual cognitive, communicative, and executive function demands of the Expert Solutions Specialist role. The appeal documented that the position required sustained memory recall, real-time problem-solving, fluid communication under pressure, and the ability to manage complex multi-stakeholder presentation events. The carrier had failed to evaluate any of these requirements.

The Treating Psychiatrist’s Longitudinal Clinical Assessment

The appeal presented the full weight of nearly twenty years of clinical documentation from our client’s treating psychiatrist. He provided multiple detailed statements spanning the course of the claim, each documenting progressive cognitive decline that rendered our client unable to function in her occupation:

• Our client lost track of conversations mid-sentence, forgot the topic of discussions, and could not maintain a train of thought — the very skills her job demanded
• She got lost driving to familiar places, needed constant reminders to take her medication, and was completely dependent on written notes to manage basic daily tasks
• Her cognitive problems worsened under stress — and her occupation was defined by high-pressure, high-stakes interactions
• Her psychiatrist stated unequivocally that returning to work would exacerbate her conditions and would “almost certainly incapacitate her”

The treating psychiatrist also provided an extensive explanation of Conversion Disorder, its diagnostic criteria under the DSM-5, and why normal neuropsychological testing does not contradict the diagnosis. He recommended that New York Life have our client evaluated by an independent psychiatrist familiar with Conversion Disorder. The insurer declined to do so.

Dismantling Dr. Heydebrand’s Paper Review

The appeal systematically addressed each of Dr. Heydebrand’s arguments:

• Daily activities: The appeal demonstrated that performing self-paced household tasks is not equivalent to delivering complex technical presentations. The appeal noted that Dr. Heydebrand was effectively suggesting that everyone who can drive a car can work as an Expert Solutions Specialist — a position that is nonsensical on its face.
• Treatment frequency: The appeal documented two decades of intensive treatment — hospitalizations, ECT, intensive outpatient programs — that had failed to resolve the underlying condition. Current medication management was appropriate care, not evidence of stability.
• Neuropsychological testing: The appeal explained that Conversion Disorder, by definition, produces functional impairment that is not captured by standard neuropsychological testing. Using normal test results to deny the claim demonstrated a fundamental misunderstanding of the diagnosis.
• Risk of relapse: The appeal invoked the “risk of disability” doctrine — that a claimant need not prove mathematical certainty of worsening, only a medically unacceptable risk. The treating psychiatrist’s opinion established that returning to work posed exactly that risk.

The Social Security Disability Award

The appeal emphasized that the Social Security Administration had found our client disabled from performing any occupation in the national economy — a standard far more stringent than her own-occupation policy required. The carrier had encouraged her to apply for Social Security benefits and then dismissed the favorable result. The appeal argued that a plan administrator may not arbitrarily disregard a favorable Social Security determination, particularly when it provides independent support for the conclusion that the claimant is unable to work.

The Insurer’s Failure to Examine Our Client

The appeal highlighted a critical procedural failure: New York Life had every opportunity to arrange an independent examination of our client but chose not to. The insurer also declined the treating psychiatrist’s recommendation that an independent psychiatrist familiar with Conversion Disorder evaluate her. When an insurer bases a denial entirely on a paper review and refuses to conduct or arrange an in-person evaluation — particularly in a mental health claim — it has failed to provide the full and fair review that ERISA requires.

New York Life Reverses Its Denial and Approves Full Benefits

Faced with an appeal that exposed every deficiency in its review, New York Life reversed its denial and approved our client’s claim for long-term disability benefits. The insurer issued a retroactive lump-sum payment covering more than two years of back benefits — dating to the end of the twenty-six-week elimination period, the waiting period a claimant must satisfy before long-term disability benefits begin — plus ongoing monthly benefits. After months of having her legitimate claim wrongfully denied, our client finally received the benefits she was entitled to under her policy.

This outcome was not a concession — it was a correction forced by an appeal that left the insurer no room to defend its position. As attorney Stephen Jessup wrote in the appeal, “Dr. Heydebrand is suggesting that everyone who can drive a car can work as an Expert Solutions Specialist. [His] conclusion is nonsensical.”

The case illustrates what happens when a disability insurance company denies a claim based on a paper review without understanding the claimant’s diagnosis or the demands of their occupation. When the appeal filled those gaps with the right evidence, the insurer had no choice but to reverse course.

Denied by New York Life or Another Disability Insurance Company?

If you are wondering whether you can appeal a New York Life disability denial — or any long-term disability denial based on a paper review, daily activity arguments, or a misunderstanding of your disabling condition — the answer is yes. Under ERISA, the administrative appeal is typically your last chance to build the record before litigation, and the evidence you present in that appeal can change everything.

Our firm has represented tens of thousands of disability insurance claimants nationwide since 1979 and has recovered more than $2 billion in benefits. We handle claims against New York Life and every other major disability insurance carrier, and we understand how to build appeals that force insurers to reverse bad decisions.

We have helped other claimants win their New York Life disability benefits, including:

• New York Life approves disability benefits for school teacher with multiple sclerosis
• NY Life Disability Benefits Reinstated on Appeal Despite Independent Medical Examination
• Project Manager with Migraines Gets NY Life Disability Benefit Denial Reversed

Speak with one of our long-term disability lawyers today for a free legal review of your claim. We represent claimants in every state, and you pay no fee unless we get your benefits paid.