Prudential overturned previous denial of long term disability benefits for Mississippi Nuclear Medicine Tech

Our client, Mr. T, formerly worked as a Nuclear Medicine Tech for a large hospital. In May 2011 a number of medical issues, chronic pain syndrome, cervical spine degenerative disc disease, cervical radiculopathy and neuropathy forced Mr. T to stop working and submit his claim for disability benefits first under his employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. Both benefits were funded and administered by Prudential Insurance Company of America (Prudential). Under his employer’s disability policies Mr. T would be considered totally disabled after 24-months if he was unable to perform the material and substantial duties of any gainful occupation, which was defined as any occupation he was qualified to perform by education, training and experience and considering any/all documented functional restrictions and limitations.

After paying Mr. T for more than 3½ years under the LTD Policy, Prudential denied further LTD benefits on the basis that he allegedly no longer met the policy definition of disability. Specifically, Prudential determined that “the medical information received did not support impairment that would prevent [him] from performing the material and substantial duties of any gainful occupation.” After receiving the denial, Mr. T contacted Dell & Schaefer and discussed his case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Prudential’s denial letter and in the evidence it relied on and agreed to prepare and submit Mr. T’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Prudential’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of Prudential’s denial and significant inconsistencies with its medical reviewer’s findings. The appeal next addressed the fact that Prudential’s denial letter grossly misstates and mischaracterizes the record evidence regarding communications between its 3rd party medical consultant (Consultant) and Mr. T’s primary treatment provider. In particular, Prudential claimed that Mr. T’s physician offered a signed agreement with its Consultant’s opinion that Mr. T had light work functional abilities yet the undisputed medical evidence confirms the exact opposite. The appeal also addresses the fact that despite acknowledging Mr. T suffered from twenty-five (25) chronic medical conditions and despite having never examined or observed Mr. T, Prudential’s Consultant assigns to him functional capabilities far in excess of any of his treatment providers or Prudential’s own prior medical reviewer, who concluded that “the claimant had multiple medical conditions when taken individually and in total render him functionally impaired from sustaining even a part time sedentary capacity.” Finally, the appeal addressed the fact that Prudential did not comply with its obligations under 5th Circuit and Supreme Court precedent by failing to meaningfully address Mr. T’s award of Social Security Disability benefits.

Approximately nine weeks later, and after reviewing the appeal and hundreds of pages of exhibits and medical records, Prudential overturned its decision to terminate benefits, paid full LTD back benefits and reinstated Ms. T’s LTD benefits. Attorney Symonds continues to represent our client to best ensure that Prudential will not terminate his benefits again. Feel free to call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.

Questions About Hiring Us

Do you help Prudential claimants nationwide?

We represent Prudential clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Prudential disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Prudential. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Prudential.

How do you help Prudential claimants?

Our lawyers help individuals that have either purchased a Prudential long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Prudential:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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 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 telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. 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 attorney. We can be reached at 800-682-8331 or by email. Lawyer 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.

Dell & Schaefer Client Reviews   *****

Leza A.

Desperarate & feeling like I was on a raft floating farther… out to sea. By the time I was diagnosed (it was close to a year) with fibromyalgia. I was in so much pain “ALL” over my body, feeling desperate for relief of my pain and the feeling of foggy headed (foggy headed is one of the conditions of Fibro). I wasn’t getting better instead my pain was getting worse. I was thinking about my career that I worked so hard to get where I was. I more than missed and loved my career.

My husband used to say that I loved my career more than him (so wasn’t true) but, I would do things like cancel a trip (40th birthday trip) in order to get the job done at work/make it happen (New Home R/E Sales). My career was a “very” physical and also required to be mentally sharp at all times.

What I thought at the beginning of feeling ill was going to be out from work for maybe a few days to a week, didn’t happen. Then I got to the point of being out from work for a year and realizing this was going to be a challenging and long road. In dealing with the short/long term disability company was getting to the point I couldn’t handle it. So… I got on the computer when I had short breaks from being foggy minded (took weeks of searching). So the search for someone/company who could take the challenge to keep up with the demands of paper work from the disability company with my short/long term disability company and who was successful at fighting this kind of case and with my medical diagnoses of fibromyalgia (I had been denied after the first few months of short term disability). I found Dell & Schaefer Law Firm who had a successful out come with not only the disability company that I had but, also against working with a fibromyalgia case.

I am blessed to have come across Dell & Schaefer and then I was blessed to have/be working with Rachel Alters! I found it was/hasn’t been easy in any way to deal with a case of fibromyalgia but, I am so more than happy I have/am working with Dell & Schaefer “Rachel Alter”. If I was up to it (not with fibro) I would be dancing all night long celebrating (I loved to dance all the time before fibro)! The many… appeals, time and all the hard work it took, my/our case has been over turned! I was caught off guard when I received the call from Rachel Alter! When I answered it I was thinking we were needing more documentation or another specialists to state where I am with my illness but, I got the best news in years and I just started crying out of control with tears of happiness! Tears of happiness have not been a part of my life in many years. Yea!!!!!! FYI… This was a challenge for me to write due to not being able to sit or type due to my pain of fibromyalgia but, so worth sharing my experience with choosing Dell & Schaefer “Rachel Alter & Team” ! Again… I am so blessed to have contacted Dell & Schaefer!!! Thank You Dell & Schaefer “Rachel Alter & Team”… :-)

***** 5 stars based on 202 reviews

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