Prudential Claimants Unsuccessful At Challenging The Offsetting Of Dependents' SSDI Benefit Award

Challenging the calculation that Prudential Insurance Company made when reducing their private benefit payments, Kathleen Schultz and Mary Kelly filed a class action lawsuit in hopes of receiving a positive, definitive decision concerning their claims.

Per ERISA (the Employee Retirement Insurance Security Act of 1974), when a disability claimant qualifies for Social Security Disability (SSD) Benefits and receives those benefits, the private insurer can deduct the amount of that Social Security Disability Insurance (SSDI) benefit from its payment to the claimant. In the case of these two women, their children also receive SSDI benefits and the two contend that “the plans do not authorize Prudential to include in the offset calculation the benefits paid to their dependent children on account of the plaintiff’s disability.”

Claiming that the language in Prudential’s insurance policy terms and conditions concerning this calculation are ambiguous and “should be construed against Prudential,” Schultz, Kelly and their Illinois disability lawyer appeared on January 17, 2012 to be heard on the matter.

Did Prudential Correctly Calculate Disability Benefits?

The primary issue at bar in this case are whether the insurer correctly reduced the plaintiffs’ Private disability benefits “based on their children’s Social Security disability benefits” and whether a child’s Social Security disability benefits payment that are  based on a parent’s disability qualify as “loss of time” disability benefits per their respective policies.

According to the Court’s opinion, the argument raised by the plaintiffs in this appeal concerned the purpose of Social Security payments to a “dependent child of a disabled parent is not to replace the income that the household has lost as a result of the parent’s inability to work. The purpose is instead to provide additional ‘support’ to the child.'” While the plaintiffs may have thought that the phrase “loss of time” is in reference to the loss of time to support their children, according to the Appellant Court, it means loss of time at work.

District Court Determine that Dependent Children’s SSDI is Subject to Offset

Stating numerous cases in which various courts have considered this issue and “found that dependent children’s social Security benefits were subject to offset under nearly identical policy language, the Illinois Circuit Court had to agree.  And, while the plaintiffs’ attorney did find at least one case where “loss of time” was considered to be a term of art “that permits the offset of payments made to compensate for the insured’s lost income, but no to compensate for the insured’s disability or for support to the insured’s children,” the Appellant Court, in this case, found that case to be of little merit.(Carstens, 520 F.Supp.2d at 1166). Ultimately, the Court, after hearing oral arguments on this case stated that “we wish to make abundantly clear that the offset language in these plans would not apply to social security benefits paid because of the child’s disability. The result the plaintiffs seek is not a reasonable interpretation of the plans’ use of the phrase ‘loss of time disability benefits.'”

See other cases and more information regarding Prudential disability claims.


Did you find this helpful?
Unhelpful (1)

Resources to Help You Win Disability Benefits

Disability Benefit Denial Options
Submit a Strong Prudential Appeal Package

We work with you, your doctors, and other experts to submit a very strong Prudential appeal.

Submit a Prudential disability appeal

Sue Prudential

We have filed thousands of disability denial lawsuits in federal Courts nationwide against Prudential.

Sue Prudential

Protect Your Benefits
Get Your Prudential Disability Application Approved
We help claimants throughout the entire application process.

Apply for Prudential disability benefits

Prevent a Prudential Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.

Prevent a Prudential disability denial

Negotiate a Prudential Lump-Sum Settlement

Our goal is to negotiate the highest possible buyout of your long-term disability policy.

Prudential disability buyout settlement

Prudential Reviews
(653)

Policy Holder Rating

1.5 out of 5
Read 28 reviews
0%would recommend
5
0%
4
0%
3
0%
2
53%
1
46%
Timely Payments
2.0out of 5
Handling Claim
2.0out of 5
Customer Service
2.0out of 5
Dependable
2.0out of 5
Value
1.9out of 5
Showing 8 of 653 Reviews
Prudential

Denied but Not Denied but I am Denied

Reviewed by KDDK on July 5th 2024   Verified Policyholder | August 2022 date of disability
I went out in Aug. 2022 for neck pain. After seeing a neurologist I had to get an ACDF C5-7, it was also determined I had carpal tunnel in my right hand and bulging disk i... read more >
Prudential

California State Disabilty "OFFSET" never mentioned or outlined when enrolling for STD coverage.

Reviewed by MartyG on June 29th 2023   Verified Policyholder | May 2023 date of disability
All terms and conditions of receiving a claim benefit not made available when enrolling. Hidden elements of eligibility... not fully transparent with issues that might eff... read more >
Prudential

Prudential terminated my LTD, so now I have no income

Reviewed by Carlos M on June 10th 2022   Verified Policyholder
I was working at a shipyard at San Diego and hurt my back again while working. Hurt my back in the US Navy in 98 and had issues since then so I decided to get the surgery ... read more >
Reply
Sent on June 11th 2022 by Attorney Rachel Alters

Carlos, yes we may be able to help. Please email your denial letter to Rachel@diattorney.com and cc Amanda@diattorney.com. Thank you.

Prudential

Prudential cancelled my policy amid COVID crisis

Reviewed by Patricia M. on September 15th 2020   Verified Policyholder
In the mist of the covid crisis Prudential decided I needed to prove my disability, yet again. I have been physically disabled since 10/31/1989. I now know that I have bee... read more >
Reply
Sent on September 15th 2020 by Attorney Jay Symonds

Patricia: This is a terrible situation. You likely have a right to appeal the decision. I suggest you contact our office and speak with one of the attorneys to discuss ... read more >

Prudential

I was sold a policy that I cannot use and no one will show me the policy

Reviewed by Jacqueline G. on August 18th 2020   Verified Policyholder
I had Prudential STD and LTD through my employer. I received my STD with no problem. Started receiving LTD for a while, then Prudential said I owed them because I receive ... read more >
Reply
Sent on August 18th 2020 by Attorney Stephen Jessup

Jacqueline, in many cases a disability carrier cannot offset for SSDI benefits that were in place prior to the date of disability under the applicable policy. Your empl... read more >

Prudential

Prudential verbally approved my claim and then sent me a denial letter

Reviewed by Jacquieline C. on April 3rd 2020   Verified Policyholder
I have been denied twice from Prudential for my LTD case. Back injury 2009 – knee injury 2011. Back doctor took me out of work (July 2018) due to me working 35 hrs per w... read more >
Reply
Sent on April 3rd 2020 by Attorney Jay Symonds

Jacqueline: Sounds like you have a pretty complex medical situation. And the fact that they verbally approved your claim over the phone then sent a denial letter is unu... read more >

Prudential

It would cost me more to fight Prudential than to let them get away with their games

Reviewed by Tim W. on December 9th 2017   Verified Policyholder
I’ve been thru all the same things everyone complains about here. I’ve always been one step ahead of their game due to research. I just got notice they are stopping my... read more >
Prudential

Prudential told me I would have a decision today, and now the need another week. Guess what, I'm still broke

Reviewed by Cancer Patient on June 22nd 2017   Verified Policyholder
Just called them and now they need another week and a half so they can do an occupational review on my job description or something like that. Even though the case manager... read more >
Reply
Sent on June 22nd 2017 by Attorney Stephen Jessup

DL, many state insurance commissioners will not get involved in ERISA governed disability insurance policies as these polices are governed under federal law. Please fee... read more >

Answered Questions by Our Lawyers
(41)
Showing 8 of 41 Answered Questions

Q: I made a Short term disability claim with Prudential but they right away went to consider long term disability

Answered on August 1st 2024 by Attorney Jay Symonds
A: Nick: Depending on the timing of when you filed the STD claim, the Elimination period for the LTD may have alr... Read More >

Q: Prudential denied me STD due to a doctor who wrote personal things about me, like I still drive.

Answered on May 27th 2024 by Attorney Gregory Dell
A: We are sorry to hear about your denial. Please contact us and we will review your denial letter. We can discus... Read More >

Q: Prudential is sending me to an IME but refuses to allow recording. Should I refuse to go to the IME?

Answered on May 7th 2024 by Attorney Gregory Dell
A: Mike:This is always a tough situation. You cannot refuse to go. I would show up with a witness and a recor... Read More >

Q: What can I do about my long term benefits that’s ending after 2 years?

Answered on June 6th 2023 by Attorney Gregory Dell
A: Prudential is likely telling you that they will stop paying you in September because they either think you sho... Read More >

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?

Answered on March 23rd 2023 by Attorney Gregory Dell
A: Allan, I am sorry to hear about Prudential’s long term care denial for your Mom’s care. We have handled ma... Read More >

Q: Can Prudential deny me if SSDI approves me?

Answered on December 28th 2020 by Attorney Steven Dell
A: Lauraine, unfortunately you can be denied even if SSDI approved you. If you need assistance managing your LTD ... Read More >

Q: How does Prudential calculate attorney fees?

Answered on July 31st 2010 by Attorney Stephen Jessup
A: Lomy, calculate attorney fees for what exactly? Under ERISA, the federal law that governs employer provided po... Read More >

Q: Can I sue my PRUDENTIAL LTD for the cost of hiring a disability attorney to get my benefits reinstated?

Answered on June 1st 2020 by Attorney Jay Symonds
A: Loretta: Assuming the attorney was successful and got the denial overturned, the short answer is no you cannot... Read More >
Helpful Videos
(904)
Showing 12 of 904 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips

Prudential Lump Sum Disability Policy Buyout Options

If you're a Prudential long term disability insurance claimant who has been on claim for a month or two, you may be interested in getting a lump sum buyout of your insurance policy. But although Prudential does offer this as an option for many claimants, it's never obligated to buy out disability claimants - and when it comes to your lump-sum disability buyout o... Read More >

Is Exhaustion of Remedies Required before filing an ERISA Lawsuit?

In Deborah Holmes v. The Prudential Insurance Company and Bekaert Corporation, the Plaintiff was employed by the Bekaert Corporation (Bekaert) when she was injured at work. She filed a lawsuit unrelated to ERISA and her employer settled with her. In addition, Plaintiff and Bekaert entered into a separation agreement in which Plaintiff signed a general release of legal claims ... Read More >

What Should I Expect When Suing Prudential for a Disability Insurance Benefit Denial?

Disability benefit lawsuits against Prudential is a daily occurrence for our lawyers.In this video, disability insurance lawyers Gregory Dell and Rachel Alters discuss their experience in handling ERISA lawsuits against Prudential.... Read More >

Do I need to disclose my disability insurance claim if I filed for bankruptcy?

Do I need to disclose my disability insurance claim if I filed for bankruptcy?Yes. If you file for bankruptcy it is imperative that you disclose your disability insurance claim regardless of the stage that your claim is in - application, denial, appeal, pending litigation, etc.The Bankruptcy Code and Rules impose an express and affirmative duty on individuals filing for bankruptcy to disclose all asset... Read More >

Can I submit a long-term disability claim if my employment has been terminated?

It is not uncommon for employees to struggle and suffer through sickness or injury and work, even if working is counter-intuitive to their own health and effective productivity at their occupation. Unfortunately, these employees often find themselves as targets of work-force reduction or layoff, because despite their best efforts they are unable to keep up with their employer’s expectations and requirements.... Read More >

How Much Time Does Prudential Have to Make A Determination On an ERISA Disability Appeal?

The amount of time that an insurance company is allotted to provide a decision for an ERISA disability appeal is often confusing to claimants and can be for attorneys as well. Insurance companies frequently drag out the ERISA appeals process beyond the allotted 90 days by requesting additional documentation, providing unwanted extensions and sending the claimant for independent medical testing. The question st... Read More >

If I File A Short Term Disability Claim With My Carrier And My Claim Is Denied, Do I Also Need To File A Separate Long Term Disability Claim?

An issue that comes up often during litigation of a claim for disability benefits is: After exhausting all of your administrative remedies for a clam for STD benefits, may a lawsuit be brought for LTD benefits as well? Insurance companies frequently move to dismiss claims for LTD benefits, claiming that the Plaintiff failed to successfully appeal the denial of the STD claim, therefore the LTD claim was never a... Read More >

Can the disability company limit my disability benefits to 24 months if I have been diagnosed with depression as a result of my physical disability?

This is an issue that our disability lawyers face on an almost daily basis. Disability insurance companies, such as Prudential Insurance Company, will often argue that a claimant is disabled by a mental condition and not a physical condition. This is done so that they can limit the payment of disability benefits to a limited pay period of either 12 or 24 months.... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases

Prudential reverses decision to terminate LTD benefits of MRI Tech with Primary Progressive Multiple Sclerosis and degenerative Disc Disease

The claimant is a 58-year-old former MRI Technologist for Fairview Health Services who has long suffered from the debilitating effects of her chronic medical conditions. She has a history of neck pain as well as right arm pain and numbness dating back to 2005 with a reoccurrence of severe symptomatology in 2013. MRI of her cervical spine performed in August of ... Read More >

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 demonstrat... Read More >

Dell Disability Lawyers Win Disability Insurance Appeal Against Prudential for KPMG Employee

Our client, a former Managing Director - Tax Consultant for KPMG contacted our office after his claim for short term disability benefits was denied by Prudential. He spoke with Attorney Stephen Jessup, who has handled multiple cases for KPMG employees whose disability benefits had been denied by Prudential. In this case our client had filed for disability due to... Read More >

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 ... Read More >

Research Epidemiologist with chronic fatigue / ME wins LTD appeal against Prudential

Our client is a former Mental Health Epidemiologist who unfortunately suffered the progressive onset of pervasive fatigue, malaise, muscle aches, headaches, difficulty with concentration/focus, difficulty with information processing, and depression. Her symptoms were attributed to the medical diagnoses of chronic fatigue syndrome / Myalgic encephalomyelitis by her treating phy... Read More >

JP Morgan Chase Financial Advisor With Cancer Wins Prudential Long Term Disability Appeal

Our client was a 58 year old private client advisor for JP Morgan Chase Bank. He was forced to stop working due to squamos cell carcinoma of the mandibular jaw. He underwent numerous operations on his jaw including reconstruction, tracheostomy and postoperative radiation therapy. Apart from chronic pain suffers dysphagia and is limited in terms of... Read More >

Prudential Fails to Pay Long Term Disability Benefits of Claimant Suffering from Addison’s Disease

What is Addison’s Disease?Our client is a 43-year-old male who was employed as a Manager for Microsoft for many years. He was forced to discontinue working in his highly rewarding career after being hospitalized for progressively worsening symptoms of fatigue, nausea, dizziness, diffuse pain and weight loss (20-30 pounds) which was later deemed attributab... Read More >

Successful Appeal Against Prudential Gets Breast Cancer Survivor Back on Claim for LTD Benefits

Nearly ten years after initially beating breast cancer, our client was distraught to hear that she had a reoccurrence of the disease in 2015. She quickly underwent a left mastectomy, chemotherapy and radiation therapy, followed by a course of lymphedema therapy. In 2016, she had expander placement but unfortunately she suffered from a non-healing wound in her left chest from the expander that had to eventually... Read More >
Disability Lawsuit Stories
(765)
Showing 8 of 765 Lawsuit Stories

Court Finds Prudential Abused its Discretion in Denying LTD Benefits

In James Ampe v. The Prudential Insurance Company of America, et al., Plaintiff Ampe worked for several years for the Massachusetts Institute of Technology (MIT) as a senior development and test engineer. In August 2011, Ampe slipped and fell in his bathroom, hitting his head.He noticed some cognitive decline over the next few months and took intermittent FMLA leave. Meanwhile, his performance re... Read More >

Prudential Wrongfully Relies on Neuropsychological Report to Deny LTD Benefits After 12 Years

Initial denialMr. Paquin became disabled in 2003 after contracting encephalitis from a mosquito infected with the West Nile virus. The infection resulted in brain damage and cognitive impairment rendering Mr. Paquin unable to continue working as a business development director for his employer, Transistor Devices. He qualified for short term and long term disability benefits under his employer sponsored di... Read More >

California Court Overturns Prudential Denial of LTD Benefits

In reviewing long term disability denial letters we find that there are a handful of industry wide arguments made by insurance companies to minimize the nature of one’s occupation. The most common being the downplaying of the cognitive demands of a given occupation in favor of focusing solely on the physical demands of the occupation. This often occurs when (1) the nature of the disability is due to a medica... Read More >

California Court Overturns Prudential Denial of Disability Benefits

In the case of Gallegos v. Prudential, a California Federal District in the Northern District of California entered an order instructing Prudential to reinstate the benefits to an insured suffering with Lupus. This ruling provides a plethora of useful information in arguing claims for disability stemming from Lupus, but also for any physical medical condition in which an insurance carrier argues a “lack of o... Read More >

Prudential Denies Long Term Disability Claim Due to Insurance Fraud

Our office was recently contacted by an insured whose claim for long term disability benefits had been recently and abruptly denied by Prudential based on allegations of insurance fraud stemming from answers provided in an Activities of Daily Living Questionnaire (ADLQ) form and a subsequent field interview. For anyone on claim with Prudential, or with any disability insurance company for that matter, the ADLQ... Read More >

Texas Court Dismisses ERISA Lawsuit due to Judicial Estoppel

The case of Kidd v. The Prudential Insurance Company of America demonstrates the importance of disclosing all potential assets on a bankruptcy petition. This includes an administrative claim for long-term benefits and potential for a lawsuit if those benefits are denied. Because of the plaintiff’s claim she had no assets in Bankruptcy Court, she was judicially estopped from pursing her ERISA lawsuit in the T... Read More >

Prudential Denial of Disability Benefits to Employee that Was Disabled While Working is Reversed

Long-term disability attorneys Cesar Gavidia and Gregory Dell discuss a recent case against Prudential Insurance Company in which long term disability benefits were denied because the claimant claimed LTD benefits after he was terminated by his employer. This is a very specific fact pattern in this case, but it worked out well for the claimant. People seeking di... Read More >

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 ... Read More >

Reviews from Our Clients

Request a Free Consultation

Our Lawyers Respond Same Day

5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our attorneys for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We offer disability insurance attorney representation nationwide and we welcome you to contact any of our lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 850 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

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 insurance 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 phone, email, fax, or video conferencing sessions. 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 insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers 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.

Helpful Resources