Prudential Denial Overturned on Appeal After Attorneys Dell & Schaefer Established that Medical Device Representative Could Not Perform Duties of Any Gainful Occupation

Our client, Luis, worked as a Medical Device Sales Representative and Territory Manager for Olympus Corporation. In 2015 at 48 years old he was forced to stop working due to chronic pain and severe functional limitations due to cervical spondylosis, radiculopathy, lumbar disc disease and post laminectomy syndrome. In 2012 he underwent a C5-C6 fusion surgery, and a later that year underwent a revision of that surgery. In late 2015 he underwent an anterior cervical discectomy, decompression and fusion at C6-7. Despite surgery, multiple rounds of therapy, injections, and pain management he continued to suffer debilitating pain. His job required him to lift and carry up to 25 pounds, as well as sit, stand and walk up to eight hours a day. Furthermore, he was expected to operate a motor vehicle and drove nearly 70,000 miles per year for his sales occupation.

Despite his best efforts to work through his pain and discomfort, Luis was eventually forced to file for disability with Olympus’ long-term disability insurer, Prudential Insurance Company of America (“Prudential”). After collecting his medical records, reviewing his claim forms and forms completed by his treating physicians, and conducting 3 different reviews of the medical file by an internal nurse, Prudential approved Luis’ claim for benefits.

Approximately 12 months later Prudential subjected the claim to a paper review by Board Certified Physical Medicine and Rehabilitation physician, Dr. Philip Marion. Dr. Marion’s reputation as a bias, impartial, insurance company hired gun precedes him. Despite never examining Luis, and only conducting a review of the medical records, Dr. Marion concluded that Luis was capable of performing work within the light to sedentary exertional demand category. However, he did find physical restrictions relating to neck hyperextension activities and that the restrictions, at least in term of that, were permanent. Soon after receiving Dr. Marion’s report Prudential brought the axe down on Luis’s claim and terminated his benefits.

Luis sought the representation of Attorney Cesar Gavidia and his Appeal Team of Andrenette Morris (Appeals Specialist) and Michal Mizrahi (Legal Assistant). Attorney Gavidia and his team formulated and applied a strategy of both supplementing Luis’s long-term disability claim with a Functional Capacity Examination Report that concluded Luis had less than sedentary work capacity, and attacking the sham report produced by Dr. Marion.

After seeking a 45 day extension of time Prudential overturned its decision, paid all benefits owed through the date of the decision, and reinstated the claim. Luis’s claim has been successfully managed by Attorney Gavidia and his team, who work to ensure that Prudential will not again wrongfully terminate Luis’ claim for benefits. Feel free to call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.”

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Do you help Prudential claimants nationwide?

We represent Prudential 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 Prudential disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Prudential. 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 Prudential.

How do you help Prudential claimants?

Our lawyers help individuals that have either purchased a Prudential 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 Prudential:

  • 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

Do you work in my state?

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.

Do I have to come to your office to work with your law firm?

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, 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.

How can I contact you?

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.

Dell & Schaefer Client Reviews   *****

Dr. Robert F.

A year ago in August I had the unfortunate situation where I injured my left hand playing in a recreational adult ice hockey game. My first reaction was fear, panic, and my work career is in danger. Having a job as a physician my hands are critical in day to day life but more important to do my job. I remembered at that point a local radio discussion about disability and knew that I had bought a policy 20 years ago and never thought I’d need it but always paid the policy just in case of a potential need.

I contacted Dell and Schaefer and I must say it was one of the best decisions of my life. Now my attorney, Cesar all I can say is THANK YOU! Michal THANK YOU! It at times going through the process was nerve racking scary but they walked me through it and always were there for my questions and concerns. When your life changes in one second you don’t know how to react. The group at Dell & Schaefer do. They understand not only what your going through but realise its individual for each client but always take a personal interest in your concerns. All I can say is my life has changed but choosing Dell & Schaefer to assist me in my claims process was one of the best decisions I ever made in my life

Thank you Cesar, Michal, and the whole firm. I’m with you for life.

Regards, Dr. Rob F.

***** 5 stars based on 202 reviews

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