Engineer With Depression Wins Prudential LTD Appeal
The claimant is a former Senior Technology Services Engineer for Accolade, Inc. who was forced to cease working on May 25, 2021 and to apply for disability insurance benefits under his policy with Prudential because of severe symptomatology related to depression and anxiety. Prudential initially approved his claim for LTD benefits as his symptoms were demonstrated to be of a severity that would prevent him from performing the material and substantial duties of his occupation. Unfortunately, without any demonstrable evidence of improvement, Prudential, by its letter dated August 30, 2022, terminated his claim effective August 1, 2022 wrongly asserting that he was no longer disabled in accordance with the terms of the policy.
Prudential has abused its discretion in terminating benefits as the medical evidence substantiated that the claimant continued to be symptomatic and unable to resume his occupational duties as of August 1, 2022. In an office note dated July 14, 2022, less than one month prior to Prudential effective date of termination, his medical doctor, Dr. Jason Cheng, documented that his symptoms remain “uncontrolled” and he was “still unable to work in any capacity”.
The claimant’s GAD7 and PHQ-9 screening scores, at that time, substantiated an ongoing severity of depression and anxiety that would preclude reasonable or reliable return to work. It was noted that his medication Wellbutrin XL had to be increased from 150 mg to 300 mg in May of 2022 due to his condition and he continued to pursue therapy services as an additional source of treatment along with psychiatric care and medication. In a subsequent note dated August 22, 2022, Dr. Cheng indicated that propranolol was also added to the claimant’s treatment regimen because of his persistent severe anxiety. He also endorsed physical symptomatology of bilateral hand tremors, which impacted his ability to type. Dr. Cheng again affirmed his opinion that the claimant was unable to work assessing him with:
- Severe recurrent major depression without psychotic features, chronic, uncontrolled
- Adjustment reaction with anxiety and depression
- PTSD
- Tremor of both hands
The claimant’s psychiatric treatment notes affirmed Dr. Cheng’s opinion and substantiated an ongoing severity of impairment that would preclude his ability to work. The July 19, 2022 psychiatric visit note from Bayless Integrated Healthcare reflected that the claimant presented “visibly anxious” and has been experiencing tremors with anxiety, which was more pronounced when holding papers. It was also noted that his anxiety was increasing daily and he was experiencing recurrent anxiety attacks. It was further indicated that he had trouble concentrating due to anxiety. The claimant’s August 19, 2022 (less than 3 weeks after Prudential’s effective date of denial) psychiatric visit note reflects his condition to be unchanged and he continued to struggle with severe anxiety and depression, which had worsened due to life stressors.
Working closely with the claimant’s treating mental health physicians, Attorney Rachel Alters was successful in convincing Prudential to overturn their previous determination to deny the claimant’s LTD benefits. Prudential reinstated his claim and paid his back benefits owed. Attorney Alters continues to oversee his claim in order to help ensure he remains on claim as long as needed.
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Denied but Not Denied but I am Denied
California State Disabilty "OFFSET" never mentioned or outlined when enrolling for STD coverage.
Prudential terminated my LTD, so now I have no income
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Prudential cancelled my policy amid COVID crisis
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I was sold a policy that I cannot use and no one will show me the policy
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Prudential verbally approved my claim and then sent me a denial letter
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It would cost me more to fight Prudential than to let them get away with their games
Prudential told me I would have a decision today, and now the need another week. Guess what, I'm still broke
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Q: I made a Short term disability claim with Prudential but they right away went to consider long term disability
Q: Prudential denied me STD due to a doctor who wrote personal things about me, like I still drive.
Q: Prudential is sending me to an IME but refuses to allow recording. Should I refuse to go to the IME?
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