After Principal Denies Continued Disability Benefits, Attorney Alexander Palamara Gets Claim Reinstated for a Vienna Beef Employee

Our new client was a dedicate employee of Vienna Beef who worked as a Customer Service Representative (a sedentary occupation) since August 2013. He was a dedicated employee as she enjoyed the job and loved her employer. Unfortunately for our now client, medical issues seemed to be piling up and they began to affect her ability to perform the duties of her own occupation.

The Former Customer Service Representative had a list of various diagnoses which included Fibromyalgia, Hypoglycemia, Osteomyelitis, Venus Insufficiency, Headaches, Fatigue and Myofascial Pain. When taken globally, her ability to work was clearly severely impacted. Thankfully, her employer provided its employees with disability insurance coverage. Thankfully, that coverage was with Principal.

After initially stopping work in January of 2018, our client applied for Short Term Disability (STD) Benefits under her employer’s STD policy. After a thorough review, Principal approved her STD claim and commenced payment of benefits which were paid fully through the expiration of the STD policy. Her claim was then submitted for review and approval under the Vienna Beef Long Term Disability (LTD) Policy. Thankfully, the LTD claim was approved with benefits beginning in May of 2018. Benefits were ultimately paid for a total of 24 months, through May 1, 2020.

Unfortunately, continued benefits beyond May 1, 2020 were denied as this coincided with the date that the “change in definition of disability” occurred. What this means is that under the LTD policy governing this claim, what it means to be disabled changes after 24 months. This is very common for Policies employees have coverage under by way of their employers. Typically, for the first 24 months, in order to qualify for benefits, one must be unable to “perform the majority of the Substantial and Material Duties of his or her Own Occupation.”  However, after 24 months, in order to continue to receive LTD benefits, at that point, the claimant must then prove that he or she “cannot perform the majority of the Substantial and Material Duties of any occupation for which he or she is or may reasonably become qualified based on education, training, or experience.”

It was at this “change in definition of disability” when Principal decided to deny further benefits and this decision to deny continued benefits was conveyed via a denial letter dated April 30, 2020. Through this letter, Principal explained that following its review, it found that “The information we reviewed supports you can perform other occupations, which means you aren’t eligible for LTD benefits after 5/1/2020.” It later stated that it actually believed that our client was “able to perform (her) Own Occupation as a Customer Service Representative.” Thus, not only were they denying the claim due to the change in definition of disability, but now they were saying that she actually had the ability to perform her old job, despite the fact that they had just paid disability benefits for 24 months because they had previously determined otherwise.

In support of its decision to deny benefits, Principal mostly relied upon a stale paper review dated February 19, 2019 by an “independent” Internal Medicine and Endocrinology doctor. Beyond that review, there were a few reports of Principal nurses, but nothing strong enough to support Principal’s contention that our now client could perform any occupation or her old occupation.

Alexander Palamara of Dell Disability Lawyers Files Appeal

Knowing that there was no way that she could return to any occupation and knowing that this denial was wrong, the former Vienna Beef employee found Dell Disability Lawyers and worked with Attorney Alexander Palamara. After a review of the old and updated medical records as well as a review of Principal’s Claim File, it was clear that Principal’s decision was wrong and without sufficient justification or support. A timely appeal was filed and the appeal focused on a few things, including: 1. The staleness and deficiency of the “independent” physician’s review and opinion; 2. The lack of support for Principal’s decision; 3. The objective evidence which supported our client’s diagnoses and symptoms; and 4. The support from each of the treating providers who each agreed that there was no way that their patient could perform her own or any occupation.

Although it took some time, in early 2021 we finally got word the Principal was righting its wrong and overturning its decision to deny benefits. A few days later, a large check for benefits owed from 5/1/20 to the present arrived and we forecast that many additional checks will continue to arrive as our client remains disabled. Our client knows that we will work hard to make sure her claim is never denied again and to ensure that her benefits remain approved until she is age 67 or has the ability to return to work.

If you have been denied disability benefits by Principal or any other disability insurance company, please do not hesitate to contact Attorney Alexander Palamara at Dell Disability Lawyers for a free consultation. 

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Principal Reviews

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Sorry, Principal. My residual and renewal commissions aren't "earned"

Reviewed by Ron on August 24th 2020   Verified Policyholder
(CAPS are added by me for emphasis:) I am a self-employed insurance broker working only on commissions. I was disabled due to surgeries and received some income replacemen... read more >
Sent on August 24th 2020 by Attorney Rachel Alters

Ron: You certainly can challenge Principal’s interpretation of the various provisions at issue through an appeal, if you have not already.


Principal will do anything not to pay

Reviewed by George on October 7th 2018   Verified Policyholder
Hello, I’m writing this on behalf of my wife. Her vision has degraded to the point that she no longer is able to see a pc screen without extreme headaches within a few m... read more >
Sent on October 7th 2018 by Attorney Gregory Dell

George, it sounds like your wife is a victim to the very common 24-month denial. It is unfortunate that Principal will not accept the opinions of the numerous doctors w... read more >


Principal is absolutely ridiculous. I'm in financial harship after not receibing my full pay from work and exhausting my long term sick

Reviewed by Michelle P. on December 19th 2017   Verified Policyholder
I was placed on medical leave after suffering from vertigo and later diagnosed with Meniere’s Disease. I was put on Meclizine and Klonopin and Prednisone. During these e... read more >
Sent on December 19th 2017 by Attorney Stephen Jessup

Michelle, will your ENT complete the applicable Attending Physician’s Statement? The APS will allow the doctor to place all restrictions and limitations he/she is imp... read more >


Principal owes me 60k

Reviewed by Daniel S. on March 15th 2017   Verified Policyholder
I had a lawyer for my long term disability claim but they wouldn’t sue them for me because the company I worked for sent them a letter saying I didn’t work but 3 hrs a... read more >
Sent on March 15th 2017 by Attorney Stephen Jessup

Daniel, we would need to see copies off your denial letters and your policy to determine how we may be able to assist you.


I lost everything when Principal terminated my benefits without calling or emailing me

Reviewed by Ray T. on September 22nd 2016   Verified Policyholder
I went on short term disability August 1st of 2013 I had to get my left thumb total reconstructed. After 6 months of short-term I went on long-term. My company told me I h... read more >
Sent on September 22nd 2016 by Attorney Stephen Jessup

Ray, have you received a formal denial letter denying the benefit? If the initial denial occurred in October 2015, there are concerns as to time expiring to file an adm... read more >


I cant but feel I am being starved out and given the runaround.

Reviewed by Christopher on June 7th 2016   Verified Policyholder
I went off of work may 29, 2015, with a blood clot in my leg. I have had vein surgeries in the past to alleviate pain and discomfort, all of which I took vacation on a Fri... read more >
Sent on June 7th 2016 by Attorney Stephen Jessup

Christopher, I am not sure the reason for the proof of good health- was this from a different department? If the claim is already in appeal review then there would be l... read more >


Principal owes me 4k

Reviewed by Louann W. on April 28th 2016   Verified Policyholder
Purchased short term disability through my employer with this group. I’ve been out of work since 2/29/16. Haven’t received the first pay. Contract is I’m supposed to... read more >
Sent on April 28th 2016 by Attorney Stephen Jessup

Louann, if they uphold the denial of your claim on appeal please feel free to contact our office to discuss what your rights/next steps are. Hopefully they will not nee... read more >


I've never worked with people that are so obviously stalling before. Bunch of crooks

Reviewed by Mike on March 2nd 2016   Verified Policyholder
I have been disabled for over 10 weeks and Principle kept saying the forms incomplete so they needed all the medical records from my doctor, including office notes. After ... read more >
Sent on March 2nd 2016 by Attorney Rachel Alters

Mike, is this a policy you purchased on your own? From what you’re saying it seems that they are investigating to determine whether or not there are grounds to rescin... read more >

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A: Michele, I am sorry to hear of your loss. We would need to see a copy of the disability policy to determine an... Read More >
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