Lawyer Wins 24 Month Mental Nervous Prudential Disability Denial
Our client, a former law partner of a large national law firm, filed for disability with Prudential due to severe mental health conditions that resulted in hospitalization. Prudential approved her claim for short and then long term disability benefits and in doing so asserted the 24 month limitation on benefits due to mental health conditions that was contained in the policy. However, as time progressed and our client’s mental wellbeing stabilized, she continued to experience ongoing problems with her memory and began treatment with a neurologist. An MRI ordered by the neurologist confirmed the presence of a brain lesion and small vessel ischemic change. Our client presented this information to Prudential for consideration, but Prudential continued to assert that disability benefits were predicated solely on her mental health condition. Around this time, she contacted our office and spoke with Attorney Jessup.
The Prudential Disability Claims Process
Attorney Jessup was keenly aware that given the large monthly disability benefit being paid, Prudential had every incentive to terminate our client’s claim at the end of the 24 month mental health period. To establish the nature and extent of our client’s ongoing cognitive complaints, Attorney Jessup had our client undergo neuropsychological testing to formally any deficits in cognitive function, as well as to confirm that any loss was due to her neurological condition and not a mental health condition. In preparation of the testing Attorney Jessup provided the neuropsychologist with pertinent medical information as well as information regarding the language in our client’s policy and a detailed description of her occupational duties and educational background so an accurate assessment of pre-morbid functioning could be determined. The neuropsychological testing confirmed a diagnosis of mild neurocognitive disorder attributable to the small vessel ischemic changes and brain lesion. Attorney Jessup provided the testing as well additional support from her neurologist to Prudential for further consideration.
Some time passed without Prudential providing a response to the testing information submitted. The 24 month limitation on mental health conditions passed and Prudential continued to issue monthly benefits to our client. Eventually, Prudential notified our office they were requesting that our client undergo an independent medical examination (IME) with a neuropsychologist of their choosing. According to Prudential’s “independent” doctor, the results from that testing indicated that our client had no deficits due to a neurological condition and that any cognitive issues were attributable to her a mental health condition. Based on this report, Prudential denied our client’s claim for continued disability benefits.
The Prudential Disability Appeal
In preparing our client’s appeal of her Prudential denial, Attorney Jessup focused on the ultimate issue- were her documented cognitive deficits due to a mental health condition or a neurological condition. He obtained a copy of Prudential’s claim file, to include the neuropsychological exam report, as well as a specific request that the raw data from the IME be sent to the neuropsychologist who initially performed testing on our client. Our client’s neuropsychologist disagreed wholeheartedly with Prudential’s doctor and wrote an extensive rebuttal to their report. Attorney Jessup also worked with her treating neurologist to provide additional support to her claim.
During the review of the appeal Prudential continued to requested updated records from our client’s mental health providers, to which Attorney Jessup argued that the 24 month period for mental health had already passed and any mental health records were not relevant to the appeal and contested basis of disability. As the final day Prudential had to render a decision approached, Attorney Jessup received notice from Prudential that it was overturning its denial of benefits and reinstating our client’s claim. In the approval letter Prudential indicated that an independent neuropsychologist hired to review the testing from our client’s doctor and Prudential’s IME doctor agreed with our doctor’s findings as to disability.
Attorney Jessup continues to represent our client and will continue to do everything he can to make sure her benefits remain payable for as long as needed.
Resources to Help You Win Disability Benefits
Submit a Strong Prudential Appeal Package
We work with you, your doctors, and other experts to submit a very strong Prudential appeal.
Sue Prudential
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Prudential.
Get Your Prudential Disability Application Approved
Prevent a Prudential Disability Benefit Denial
Negotiate a Prudential Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.