Federal ERISA Lawsuit Filed Against Prudential After It Denies Long-term Disability Benefits to Insured With Parkinson's Disease
Mr. G had previously worked as a foreman for a large fertilizer company. One day at work Mr. G suffered a fall into a bin of fertilizer. Although Mr. G suffered some injuries, he soon began developing serious neurological symptoms which included parkinsonian type symptoms, seizure episodes and muscle spasms. Initially, he believed his symptoms were related to his fall into the bin of fertilizer, however, they persisted and worsened. His symptoms forced him to cease working and file a long-term disability claim under his employer’s long-term disability insurance plan funded and administered by Prudential.
Prudential Denies Disability Claim After Medical Consultant Notes that Insured Can Get Into Raised Truck
Shortly after submitting his disability claim, Prudential approved Mr. G’s benefits for approximately 3 months before abruptly terminating his claim and informing him that he was not disabled under the terms of the group disability policy. Although Prudential attempted to cite several, mostly vague, reasons it did not believe Mr. G met the definition of disability, the primary reason seemed to be based on the fact that Mr. G’s physicians were perplexed and not prepared to diagnose him with a definitive diagnosis. On his own, Mr. G set out to appeal and challenge Prudential’s unreasonable and baseless decision.
After submitting his first appeal, Prudential assigned a medical consultant to conduct a paper review of Mr. G’s medical records. The medical consultant concluded that Mr. G’s medical condition did not restrict or limit his ability to sit, walk, reach, lift, carry or perform upper extremity activities. They also noted that recent surveillance video showed Mr. G as having the ability to get into a raised truck. On this basis, Prudential and its medical consultant denied Mr. G’s first appeal.
Following the denial of his first appeal, Mr. G contacted Attorneys Dell & Schaefer and hired Attorney Cesar Gavidia who promptly took over the case and began preparing Mr. G’s second appeal to Prudential. Although Attorney Gavidia could have immediately filed suit against Prudential after denying Mr. G’s initial appeal, new medical evidence existed that had not been provided to Prudential showing that Mr. G’s tremors were worsening and that his treating physician had prescribed a walker with wheels and a seat as a result of his progressive weakness and impaired gait resulting from a now definitive diagnosis of Parkinson’s Disease. Despite the new evidence and confirmed diagnosis of Parkinson’s Disease, Prudential denied the appeal submitted by Attorney Gavidia and his team.
Federal ERISA Lawsuit Filed Against Prudential For Wrongful Denial of Long-term Disability Benefits and Violation of Federal Law.
After receiving the denial of Mr. G’s second appeal Attorney Gavidia prepared and filed a lawsuit in federal court against Prudential alleging that the disability insurance company violated ERISA by arbitrarily and capriciously denying Mr. G’s long-term disability insurance benefits. In addition to demanding that Prudential pay all benefits owed under the plan, the lawsuit requests that Prudential pay Mr. G’s attorney fees and costs. Mr. G’s case is currently pending in U.S. District Court.
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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?
Q: What can I do about my long term benefits that’s ending after 2 years?
Q: My mother paid many years for a long-term care policy. When she had to be put in an assisted care facility, Prudential won't pay. Do you accept cases like this?
Q: Can Prudential deny me if SSDI approves me?
Q: How does Prudential calculate attorney fees?
Q: Can I sue my PRUDENTIAL LTD for the cost of hiring a disability attorney to get my benefits reinstated?
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