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Prudential Relies on Paper Medical Reviews to Deny Long Term Disability Benefits

Prudential Relies on Paper Medical Reviews to Deny Long Term Disability Benefits

Presented by Attorney Cesar Gavidia

Cesar Gavidia is a Partner at Dell Disability Lawyers who has helped thousands of claimants recover tens of millions of dollars in long-term disability benefits. Cesar began working as a law clerk at the firm in 2003 and has dedicated his entire legal career to disability insurance. He has assisted claimants in nearly every state, across all occupations — including surgeons, dentists, lawyers, judges, and corporate executives. Cesar has litigated against every major disability insurance company and has gained unparalleled knowledge about their internal claims handling processes. He is admitted to the State Bars of Florida and California.

Published Aug 15, 2023. Last modified Sep 19, 2023.

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Prudential Reviews

(28)

Policy Holder Rating

1.5 out of 5

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Showing 4 of 28 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...

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...

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 ...

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...

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 in ...

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Answered Questions by Our Lawyers

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Showing 4 of 42 Answered Questions

Q: Scheduled IME. Should I be concerned about my future LTD?

Answered on April 15th 2026 by Attorney Gregory Dell

A: Hi Dave,Thanks for reaching out top us regarding your Prudential claim. Any time a claimant is scheduled f...

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...

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...

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...

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Helpful Videos

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Disability Benefit Tips

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Showing 4 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...

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 ...

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....

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...

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Our Resolved Cases

(388)

Showing 4 of 388 Our Resolved 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 ...

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...

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...

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 ...

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Disability Lawsuit Stories

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Showing 4 of 766 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...

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...

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...

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...

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Reviews from Our Clients

Keith G.

They were very professional with their responds and on time with keeping you inform about everything with your case. I would recommend My lawyer Stephen Jessup, he was on point with everything, thank you. You guys are awesome people to work with. God bless you guys.

Keith L.

I was not able to work as a physician for about 14 months due to neck/back issues. Even though I had 3 medical doctors explicitly state that I was not to work AT ALL as a physician at that time, New York Life (NYL) Disability Insurance denied my long term disability claim (which apparently they deny a high percentage of people similar to me- only they know why they do this to so many- I have my own suspicions). I was in pain from my medical issues and so frustrated with NYL considering I had many bills coming due. I then decided to call Dell Disability Lawyers. One of their attorneys, Alex Palamara, spoke to me on the phone right then to hear and understand my story and then offer ways he could help. Long story short, within a few months of me returning back to work, he was able to persuade NYL to pay me my long term disability claim. He (and his kind assistant, Tabitha) were always very helpful, informative, and available to me. I feel quite certain that NYL would NEVER have paid me what was appropriate based on my insurance agreement/ contract with them without the help of Alex. I highly recommend him/Dell Disability Lawyers. If you find yourself in a similar situation of disability insurance denial of your own personal/group policy, especially if you are a medical provider/physician like me, then consider contacting them for advice/direction PRIOR to appealing your claim on your own.

Kyle D.

Jay Symonds and his assistant, Sonia helped me tremendously. The insurance company that worked for my former employer did everything they could to make my life literally miserable. That all changed when I hired Jay. He and Sonia fought for my rights and forced the insurance company to pay what they should have.

If you have a disability claim hire Jay as if you go it alone the insurance company will screw you. Jay and Sonia will fight for everything you are entitled for. I couldn’t recommend them more highly.

Frank R.

I cannot say enough positive things about my experience with Dell Disability Lawyers. Attorney Stephen Jessup and Amanda offered an opportunity to provide clarity on a complex issue regarding my disability claim. Mr. Jessup offered advice on an offset to my claim after my insurance company asked for additional information from Social Security. With counsel from Mr. Jessup, I was able to address the outstanding issue with the Social Security office and provide my insurance company with the required documentation to address their concerns. Mr. Jessup always responded in a timely manner with expert advice and offered the opportunity for follow up. I strongly recommend Dell Disability Lawyers to those seeking legal counsel for disability matters.

Wesley D.

I have been able to help others as a soldier, a police officer, and a pharmacist. I needed help forcing the insurance company to keep their commitment to take care of me and my family. I called Dell. Alex, Tabitha, and their entire team were very compassionate, extremely patient, and extraordinarily knowledgeable. Many thanks Dell!

Samar A.

My husband had applied for Long Term Disability and was denied. We sought out Rachel Alters at Dell Disability Lawyers to help us with our appeal. Rachel and her team were so diligent and meticulous in every aspect of the process. The process was seamless, and we never had any doubts that she would get it done and that she did! We are forever grateful to Rachel and Catherine for all of their determination and tenacity to get us the outcome we needed and deserved.

We could not recommend better representation and are indebted to them for making us whole again. Thank you so much Rachel and team!

Jam

Alex Palamara is one of The Best lawyers in the world and Dell Disability Lawyers are the Best by Far. Alex and his Assistant Tabitha helped me get the compensation I needed for a Horrific Disabling heath condition I’ve been dealing with for over a year. Alex and his team were so professional and caring. They treated me like I was there own family. Alex Knowledge, Expertise and skills as a Lawyer is among the Best of the Best in his field and I would HIGHLY recommend that if you ever have any issues with any Insurance Company over your Disability issues, please don’t hesitate to seek out Dell Disability and Alex Palamara. They truly are Amazing and caring. Thank God for them. Outstanding Job Alex and Tabitha

G.T.

9 years ago when I had to apply for disability benefits from my private disability policy the insurance company ignored my inquiries until Dell and Schaefer represented me and I have received the benefits without interruption til my policy expired at age 65. I have appreciated not having to deal directly with the insurance company and having attorney Greg Dell and assistant Danielle Lauria handle all communications which included monthly progress reports. I thank them for their efforts on my behalf and highly recommend them to all those in need of disability benefits.

Misty A.

I’m so thankful I chose to reach out to the attorneys at Dell. They have always been quick to respond to any and all questions I have had. The anxiety I had while dealing with Lincoln Financial on my own has decreased immensely since Alex and Danielle took my case. They were able to get my LTD denial reversed and I am so very grateful!

View All Reviews (503)

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Five Ways We Help Get Your Disability Benefit Paid

5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability insurance 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.

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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 long-term disability attorneys for a free immediate review of your disability denial.

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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.

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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.

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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.

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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.

Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. 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 LTD 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 900 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.

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