Syncope is the medical term used to describe fainting or passing out. A syncopal event often comes on with no warning, is short in duration and recovery is often spontaneous. For our client, a Construction Project Manager responsible for driving to work sites and then navigating the site, an event could spell disastrous. Even more frustrating than suffering from recurrent syncope events is not having a clear understanding as to the cause of same or knowing when an attack would occur. This was the reality our client faced, a reality that eventually left him with no choice but to file for long term disability benefits under his employer’s disability policy with Reliance Standard.
Long Term Disability
Our client’s initial claim for benefits was approved by Reliance Standard after a nurse case manager determined our client only had a physical ability to perform sedentary level work and that he was to avoid driving due to his medical condition. Unfortunately for our client the approval of benefits did not last long. Within a couple weeks of approving long term disability benefits Reliance Standard issued a denial of benefits based upon a vocational review conducted after long term disability benefits had initially been approved.
Following the denial of his disability benefit our client contacted Attorneys Dell & Schaefer and spoke with Attorney Stephen Jessup. Attorney Jessup obtained a copy of our client’s claim file from Reliance Standard and what he found was nothing short of a purposeful attempt to deny our client’s long term disability benefit. In reviewing the claim file what was most disturbing was the fact that Reliance Standard’s nurse case manager still supported disability in light of the restrictions of a sedentary physical demand level and no driving. From a medical standpoint nothing had changed in our client’s medical condition, but now the records that were used to approve our client’s claim for disability benefits were now being used to deny it. But how?
Attorney Jessup discovered that the vocational review conducted by Reliance Standard incorrectly categorized our client’s occupational duties as simply a “Project Manager,” which was classified as solely a sedentary demand occupation – a physical demand level that Reliance Standard’s nurse case manager had opined our client could perform at. As noted above the situation was made even more suspicious by the fact that the vocational review of client’s occupation did not occur until AFTER benefits had been approved. Attorney Jessup felt that Reliance Standard purposefully performed the vocational review after the medical review in a calculated effort to deny our client’s benefit.
In submitting the appeal Attorney Jessup systematically attacked the vocational review and provided extensive documentation as to the nature of our client’s occupation as a Construction Project Manager, which required the ability to drive to job sites and once there safely navigate and inspect the site. Additionally, Attorney Jessup obtained updated medical records and statements in support of disability from our client’s doctors, which clearly indicated the danger our client faced and risks associated with a return to his former occupation.
Following the submission of the appeal, Reliance Standard ultimately overturned its denial of benefits, reinstated the claim and forwarded all back benefits owed. Attorney Jessup continues to monitor our client’s claim to prevent any further future wrongdoing by Reliance Standard.
Fight for your rights to disability insurance benefits
If your claim for short or long term disability insurance benefits have been denied please feel free to contact our office to discuss how we may be able to assist you in securing the benefits that rightfully belong to you.
Read more about Stephen Jessup here and about Syncope disability claims here. You can also read more about Reliance Standard disability claims on this page.