Prudential Overturns Another Long Term Disability Denial After Dell & Schaefer Appeal

Prudential denied continued long term disability benefits for a former Stroke Coordinator for HCA Healthcare beyond March 31, 2014 by way of a denial letter dated April 24, 2014. According to the aforementioned denial letter, as of April 1, 2014, Prudential believed that the Stroke Coordinator, who eventually became our client, was able to perform the material duties of her regular occupation. This was in light of the fact that Long Term Disability (LTD) benefits had been previously approved and paid for 19 months after our eventual client went out of work on April 6, 2012. This was also in light of the fact that our eventual client suffered from and continued to suffer from Low Back Pain with Radiation to the Right Lower Extremity, Bilateral Lower Extremity Pain, Lumbar Radiculitis, Lumbar Spondylosis, Lumbar Spinal Stenosis, Arthralgias, Obstructive Sleep Apnea, Severe Hypersomnolence, Hypoxia, Apnea Hypopnea, Chronic Bronchitis, Chronic Obstructive Pulmonary Disease, Upper Respiratory Infection, Reactive Airways Disease, Hypoventilation Syndrome, Dizziness/Lightheadedness, Obesity, Diabetes Mellitus Type 2, Right Hand Paresthesias, Bilateral Carpal Tunnel Syndrome, Right Eye Corneal Transplant, Right Eye Cornea Replacement Rejection, Bilateral Glaucoma, Penetrating Keratoplasty (PKP), Right Eye Cataract, Headache, Gastroesophageal Reflux Disease, Nausea, Reflux Esophagitis, Chronic Gastritis, Hypercholesterolemia, Hyperlipidemia, Hypothyroidism, Hypertension, Tachycardia, Palpitation and Chest Pain, Depression and Anxiety.

In support of its position, Prudential solely relied upon internal reviews by its own employees to conclude that our eventual client should no longer continue to receive LTD benefits.

Long Term Disability Appeal Filed

Fortunately for the former Stroke Coordinator, she was able to find Attorney Alexander Palamara at Dell & Schaefer to represent her with her claim. After having a chance to review the medical records and Prudential’s Claim File for our now client’s LTD claim, an administrative appeal challenging Prudential’s determination was timely and properly filed. The Administrative Appeal was able to focus on the strengths of the client’s medical records as well as the weaknesses of Prudential’s internal reviews. It pointed out that Prudential’s reviewers possessed an inherent conflict of interest and it noted that Prudential decided to terminate our client’s claim without having a physician examine her. Even further, it noted that Prudential did not even have an “independent” physician review our client’s medical records. Prudential solely relied upon internal reviews by its employees who, of course, possessed the aforementioned inherent conflict of interest in deciding claims for benefits. On top of all the mistakes made by Prudential, the biggest mistake was how Prudential overlooked the abundant medical documentation which objectively supported our client’s claim as well as the abundant support of her treating physicians.

LTD Denial Overturned by Prudential

In today’s mail, we received a check for our client’s full benefit for the period of April 1, 2014 through January 31, 2015. Our client will continue to receive her LTD benefit for the foreseeable future as Prudential has also found that she satisfies the new definition of disability that became active after 24 months of benefits were paid. This new definition of disability requires that our client be “unable to perform the duties of any gainful occupation for which (she is) reasonably fitted by education, training or experience…”.

Our client is relieved to be back on claim, but she recognizes that the fight continues. As a client of Dell & Schaefer, she feels assured that her attorneys will do whatever it takes to keep her on claim until she is able to return to work or until her policy expires.

If you have been denied Long Term Disability Benefits by Prudential or any other insurance provider, please do not hesitate to contact the Attorneys at Dell & Schaefer for a free consultation.

Read more about Prudential disability claims on this page.

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FAQ

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.

Reviews   *****

Kirsten S.

It was a pleasure working with Dell & Shaefer. Mr. Palamara was very professional, courteous, and respectful of my situation. He worked quickly and efficiently to resolve my disability dispute with a positive outcome. The paralegal, Danielle, was extremely helpful and polite.

The firm of Dell & Schaefer was responsive to my request for assistance in obtaining the disability claim owed to me. I have only praise for their help in resolving my situation. Thanks.

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