Reliance Standard Denies LTD Benefits 4 times in 24 Months for 64 Year Old Insurance Agent with Peripheral Neuropathy

This case is crazy because Reliance Standard denied long term disability benefits four times in a 24 month period and forced the claimant to file four separate appeals. Our client was an insurance agent for Florida Farm Bureau Insurance Companies. In 2017 and 2018 he was forced to reduce his work hours due to pain and complications caused by peripheral neuropathy. Despite his modified work schedule he struggled to effectively perform his duties due to chronic pain.

He was forced to stop working and file a disability claim under his employer’s group long-term disability policy with Reliance Standard Insurance Company. After filing his claim Reliance denied it claiming that he did not work the required 30 hours per week in order to maintain coverage under the policy, despite that his reduction in hours at work was due to his inability to work full time on account of his peripheral neuropathy.

He appealed the decision and following a review of his medical records and other information Reliance approved his claim for total disability. The approval did not last long, since 5 months later Reliance Standard terminated the claim on the basis of a physician review that concluded restrictions and limitations of any kind were not supported. This was the same physician reviewer that 5 months earlier had opined that EMG / NCS objectively confirmed his neuropathy status and his ongoing symptoms and impairment, and that he had a poor prognosis.

We appealed the decision and prevailed after submitting additional records and evidence from the client’s pain management doctor that his main was chronic and had to be maintained with long term opiate medication. Shortly after Reliance Standard overturned its decision and once again approved the client’s claim.

Three months later Reliance Standard once again terminated the disability claim. This time it determined that our client was previously disabled from his own sedentary occupation as an insurance agent, however was capable of engaging in any gainful occupation.

We again appealed the decision. In the appeal we identified notes from Reliance Standard’s own medical consultant who found less than a year earlier that the client was precluded from engaging in any sustained work function on a frequent and constant basis due to peripheral neuropathy. Also submitted was evidence from the social security administration that it found our client to be totally disabled from any occupation.

We recently have been notified that Reliance Standard has once again overturned its own wrongful decision. Our client is now 64 years old and nearly at the end of the maximum pay period of the policy.