Prudential’s summary judgment ruling is reversed twice by the 7th Circuit US Court of Appeals

Hugo Diaz, a computer programmer for Bank One, stopped working on January 31, 2002 due to chronic back pain, and underwent a lumbar fusion surgery on February 4, 2002. Mr. Diaz’s job was classified as sedentary and required him to be sitting for 90% of the time. On July 22, 2002, Diaz filed his application for long-term disability and on August 27, 2002 Prudential denied Mr. Diaz’s claim on the basis that his inability to perform his job was not consistent with the medical evidence presented. After filing his initial application and submitting two Appeals of his denial to Prudential, Mr. Diaz received his final denial on April 16, 2003.

Mr. Diaz’s long-term disability policy defined disability during the first 24 months as: “You are disabled when Prudential determines that you are unable to perform the substantial and material duties of your regular occupation due to your sickness or injury; and you have a 20% or more loss in your indexed monthly earnings due to that sickness or injury.

Mr. Diaz filed a lawsuit in the district court on April 22, 2003 and on May 12, 2004 a summary judgment was granted in favor Prudential. The Appellate Court reversed the summary judgment because the district court applied the wrong standard of review. The district court reviewed the case again and granted another summary judgment in favor of Prudential. Finally on August 23, 2007, the Appellate court once again reversed the entry of Summary Judgment for Prudential and ruled that a summary judgment in favor of Prudential can not stand. In reversing Prudential’s summary judgment for the second time, the Appellate Court stated, “The district court failed to consider the difference between a person’s being able to engage in sporadic activities and her being able to work eight hours a day five consecutive days of the week. In doing so, it ignored the dispute of material fact about Mr. Diaz’s capacity to do the latter.” The court also noted that the district court failed to consider the opinions of Mr. Diaz’s personal physician, neurologist, and pain management specialist.

Practice note: This case is very interesting because the Appellate court acknowleged that district court judges can be confused about the manner in which they are suppose to review an insurance companies denial of long-term disability benefits. The court stated, “Some of the confusion in this area may be attributable to the common phrase “de novo review” used in connection with ERISA cases. In fact, in these cases the district courts are not reviewing anything; they are making an independent decision about the employee’s entitlement to benefits. In the administrative arena, the court normally will be required to defer to the agency’s findings of fact; when de novo consideration is appropriate in an ERISA case, in contrast, the court can and must come to an independent decision on both the legal and factual issues that form the basis of the claim. What happened before the Plan administrator or ERISA fiduciary is irrelevant.”

Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

View videos, articles, resolved cases and claimant reviews about your specific disability insurance company.

Leave a comment or ask us a question


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.


Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Speak With An Attorney Now

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