Prudential reverses denial of long term disability benefits to engineering manager suffering from coronary artery disease

Our client, an Engineer Manager specializing in Fluid Power Engineering, suffers from severe Coronary Artery Disease. Despite the fact multiple diagnostic tests performed indicated there were no abnormalities with his heart, he suffered two heart attacks in the span of six months. Following his second heart attack in July 2006, he applied for long-term disability benefits under his employer’s long term disability plan through Prudential. Prudential initially approved his claim for disability benefits, and following his elimination period he began receiving long term disability benefits in September 2006.

In July 2008, Prudential terminated his disability benefits, citing a lack of objective medical evidence to support his disability and resulting inability to perform his job. Upset and confused by Prudential’s denial of his disability benefits, he contacted Attorneys Dell & Schaefer to retain our services in the filing of his appeal. Review of the claim file by Attorneys Gregory Dell and Stephen Jessup revealed that Prudential was not properly classifying or recognizing the true nature of his pre-disability occupation with his employer. Therefore, Prudential was not reviewing his medical condition as it related to his ability to perform the duties of his occupation.

Dell and Schaefer attacked Prudential on this fact, submitting an initial appeal in January of 2009 that detailed the duties of his occupation and how, in light of these duties, his coronary artery disease prevented him from being physically unable to perform those duties. Prudential reviewed the initial appeal and within three weeks sent a second denial letter.

Review of Prudential’s second denial letter clearly indicated that Prudential did not even take into consideration the information submitted in the first appeal regarding our client’s occupation and again cited no medical evidence to support disability. A second appeal was filed in late July 2009, which once again illustrated how Prudential was improperly reviewing our client’s claim for benefits in violation of ERISA.

Attorneys Dell and Schaefer argued that although objective tests such as EKG’s indicated no abnormalities, the practice of medicine is not an exacting science, and that the only truth in our client’s medical history is that he repeatedly “passed” testing, and experienced a heart attack upon returning to work not once, but twice.

Following the submission of the second appeal, Prudential took the full 45 days to review his claim, and even requested an extension of an additional 45 days. During this period Prudential requested our client undergo an Independent Medical Examination, where once again diagnostic testing appeared normal, but his performance on other tests indicated the severity of his impairment.

Faced with the reality of our client’s medical history, and the fact they had improperly reviewed his claim for benefits, Prudential reversed their decision to terminate our client’s benefits and paid all past due disability benefits. Fortunately our client was able to prevail without the need to file a lawsuit.

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   *****

John M.

I have been a client of Stephen Jessup since early last year and have to say he’s an amazing attorney whose direct approach and attention to detail are second to none. My case presents a difficult challenge in that we have to manage my LTD policy, workers compensation, and SSDI all together. Attorney Jessup has been able to guide me through all the intricacies of all three and has gone out of his way to do so, even in dealing with workers compensation and SSDI, although he is not required to do so. He doesn’t embellish or overstate what he can do for you. I have never had an email go unanswered or an attorney conference call cancelled. His compassion and understanding about your situation and condition are genuine. He listens to all your concerns and never will respond with empty rhetoric or lip service. And let’s not forget Anneli De Cardenas, who is definitely a big part of Dell & Schaefer. She has been terrific to deal with and has been very empathetic regarding my case.

Dealing with the insurance company by yourself is not only stressful but also not recommended; since Dell & Schaefer have started managing my LTD policy, I have felt a tremendous sense of relief because they are always on the ball and I trust that they are handling it effectively. I have the utmost gratitude to Stephen Jessup and Dell & Schafer for everything they have done for my case.

***** 5 stars based on 202 reviews

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