Prudential denies disability benefits to KPMG employee suffering from “sick sinus” syndrome

A disability attorney was forced to file a federal ERISA lawsuit against The Prudential Insurance Company of America after his client was wrongfully denied continued long-term disability benefits.

The Facts of the Case Against The Prudential Insurance Company Of America

Plaintiff was employed by KPMG and was covered under the Long-Term Disability Plan that was provided by Prudential.

Plaintiff became disabled on September 15, 2005 because of “sick sinus” syndrome, where the sinus node, the heart’s natural pacemaker, does not function properly. This syndrome caused the Plaintiff to experience several falls and a motor vehicle accident.

Plaintiff has a pacemaker installed on October 20, 2005 to regulate the rhythm of his heart.

On or about February 28, 2006, Plaintiff files a claim for LTD benefits under the Plan.

On or about September 14, 2006, Prudential approved the claim, beginning on September 15, 2006. Plaintiff receives LTD benefits based upon his psychiatric condition only.

Denial of Prudential’s Disability Benefits Claim

On or about September 4, 2008, Prudential terminated LTD benefits beginning on September 15, 2008, based on the Plan’s 24-month mental illness benefit limitation provision.

On or about July 13, 2009, Plaintiff appealed Prudential’s termination of LTD benefits.

On or about October 7,2009, Prudential denied Plaintiff’s appeal and upheld its decision to terminate Plaintiff’s LTD benefits.

On or about June 4, 2010, Plaintiff appealed original denial and Prudential’s subsequent denial from October 7, 2009.

On or about August 19, 2010, Prudential again denied Plaintiff’s appeal and upheld its decision to terminate Plaintiff’s LTD benefits.

Plaintiff has exhausted all administrative remedies, leading to him filing this lawsuit.

Disability Lawyer Files Lawsuit Against Prudential

According to this lawsuit, Plaintiff claims that Prudential did the following to him:

Relief Sought By Plaintiff In The Prudential Lawsuit

As a result of Prudential’s actions, Plaintiff seeks the following from the Court:

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I contacted Jay Symonds with Attorneys Dell & Schaefer, he was the lead attorney on my case. I was very happy with every aspect of how my case was handled. Jay kept me informed every step of the way. Vanessa who worked with Jay on my case was also very professional and helpful. I had many, many questions and they both answered every one of them. I was prepared for a long drawn out wait, but was surprised that less than 2 weeks after Jay submitted my appeal documents Liberty Mutual reversed their denial and deposited a check for all back pay into my account! If you have been denied disability benefits I urge you to call Attorneys Dell & Schaefer, trust me YOU WILL BE GLAD YOU DID!

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