Prudential reverses denial on second appeal & pays $175,000 in past due disability benefits to OBGYN

Medical Condition and Occupational Duties
Our Client, an OBGYN (hereinafter referred to as “Dr. OBGYN”), was employed by a hospital when he began to experience anxiety and depression following the filing of a malpractice lawsuit. Our client began drinking alcohol on a daily basis and was subsequently hospitalized for three months as a result of alcoholism, anxiety, depression and suicidal thoughts. Prior to claiming disability Dr. OBGYN’s substantial and material duties involved the delivery of babies, gynecological surgeries and on-call requirements.

Procedural History

Our Client’s disability plan was provided as an employee benefit from his employer, which meant that his disability plan was governed by ERISA. As a result of having a disability plan governed by ERISA, our client was required to exhaust his administrative remedies and file two written appeals with Prudential before he could he file a lawsuit. Attorneys Dell & Schaefer was retained on this case following Dr. OBGYN’s initial denial of benefits by Prudential.

In Prudential’s initial denial letter they claimed that Dr. OBGYN was disabled during the three month period of time that he was hospitalized, but that he was capable of returning to work immediately following his hospital discharge. Prudential’s opinions were reached based upon a paper review of Dr. OBGYN’s medical records by a doctor employed by Prudential doctor. Prudential denied the first appeal on the basis that Dr. OBGYN was only disabled when he was drinking and therefore he should be capable of working. Prudential completely ignored the fact that a substance abuse disorder is a disabling condition. Prudential never examined Dr. OBGYN in order to evaluate his medical condition.

Through a coordinated effort between our law firm and Dr. OBGYN’s treating doctors, we were able to present Prudential with additional medical information in support of the claim for long-term disability benefits. The additional medical information and our extensive second appeal letter were submitted to Prudential in a timely manner. Within 45 days of receiving the second appeal letter, Prudential reversed their previous two denials and determined that Dr. OBGYN was eligible for disability benefits. Since Dr. OBGYN suffered from a mental nervous and substance abuse disorder, the disability policy limited him to two years of disability benefits. Dr. OBGYN was awarded more than $175,000 in past due disability benefits.

This Prudential ERISA appeal was handled by Attorney Gregory Dell.

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   *****

Wendy H. (Maryland)

Words cannot express the gratitude I have for Rachel and her team. I felt like she listened, gave me her advice, and supported my decisions. The process was seamless and I did not feel that I was being bombarded with “task” as her team handled as aspects of my case. I am very pleased with the honest feedback and communication through the process. I would definitely recommend Rachel and her team at Dell & Schaefer law firm.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us