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, 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   *****

Paige M. (Oklahoma)

I had an excellent experience working with the team at Dell & Schaefer. Ms Rachel Alters & her assistant Sonia Nogueira kept me updated on the status of my appeal on a regular basis & provided same day responses to my email inquiries, often calling to explain certain details that may have been too overwhelming otherwise. They were respectful, professional & extremely patient with me. Rachel was very clear & confident in our conversations & effective in communications with my physicians during the course of documenting my condition.

My case involved a 10-year disability income stream that was suddenly & unexpectedly terminated. The financial situation it created & future uncertainty left me very stressed, so having such an experienced professional representing me was a huge comfort. I am very pleased & grateful that Ms Alters won my appeal. I feel as if a huge weight has been lifted!

***** 5 stars based on 202 reviews

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