Having exhausted all her disability insurance appeals and her patience, Torey Robinson filed a lawsuit in the United States District Court for the Southern District of Texas, Houston Division against Prudential Insurance Company in an effort to collect her back and future disability benefits as stipulated in her Prudential Insurance policy. With no more ERISA disability administrative remedies to pursue, Robinson felt she had no other choice but to file a lawsuit to collect her disability benefits and let the Court decide the merits of her claim for disability benefits.
Robinson, a former sales analyst for U.S. FoodService, Inc. filed her Prudential disability claim per her employee disability policy to rightfully receive her disability benefits due to multiple documented medical conditions that preclude Robinson from carrying out her occupational duties, or any work for that matter. Her complaint enumerates that she suffers from thoracic and lumbar neuritis and radiculitis, lumbar facet disease (spondylosis without myelopathy, chronic pain syndrome, lumbrosacral degeneration and intervertebral degenerative disc disease. Consequently, she takes a number of prescription medications to control her pain, many of which produce side effects that also interfere with her ability to work. These side effects include sedation effects and cognitive difficulties. The combinations of her conditions and the medications she must take to function have rendered Robinson disabled to work on a consistent basis for any meaningful amount of time.
Robinson’s Disability Benefit Claim
Robinson ceased working on September 5, 2008 and applied for short term disability, which she was granted. She later filed for long term disability benefits through her Prudential Plan; and, while she was initially granted long term benefits on February 5, 2009, on July 17, 2009, Prudential sent Robinson a letter denying her further benefits stating that she was not considered to be unable to perform her “own occupation” and thus did not qualify for long term disability. Robinson appealed Prudential’s denial through the ERISA administrative process and requested a review of her claim, providing Prudential with properly documented paperwork that verified that she is totally disabled. Prudential responded as before that no disability benefits would be granted on February 18, 2010. Robinson again appealed in August of 2010, providing additional medical documentation of her condition and was denied benefits again on November 12, 2010. Robinson’s disability attorney stated in the complaint that Prudential “discounted the opinions of Plaintiff’s treating physicians, among others, and the documented limitations from which Plaintiff suffers including the effects of Plaintiff’s impairments on her ability to engage in work activities.”
Robinson’s Lawsuit Against Prudential
In essence, Robinson and her disability lawyer claim that Prudential terminated Robinson’s long term disability benefits under ERISA 29 U.S.C. § 1132. They reiterate that Robinson is totally disabled, that Prudential did not properly look at the evidence of her disability when making their decision, that they are being “unreasonable, arbitrary and capricious,” and that they have not fulfilled their obligation to provide Robinson with disability benefits under the terms of her insurance policy.
Robinson is asking the United States District Court for the Southern District of Texas, Houston Division to rule that Prudential must provide her with past-due short term and long term disability benefits under her plan as well as award her attorney fees and any other remedies the Court sees fit.