Reliance Standard overturned its previous denial of long term disability benefits for Texas Retail Store Manager

Our client, Mr. S, formerly worked as a Store Manager for a large national retail chain. In August 2016 Mr. S suffered from multiple Transient Ischemic Attacks (“TIAs”) or mini-strokes which left him with debilitating physical and cognitive impairments. Mr. S made several attempts to return to work failed but continued to suffer slurred speech, headaches, pressure in the back of his head and memory loss, had difficulty training employees and kept repeating himself. Finally, as a result of these conditions and the restrictions and limitations associated with them, Mr. S stopped working completely in April 2017 and, thereafter, failed to regain his premorbid cognitive level of functioning which was crucial to his continued success in his high intellectual career as a Store Manager.

Reliance Standard found Mr. S to be totally disabled and approved his STD claim through the 180 day maximum benefit period which ended in January 2017. With the expiration of the STD benefits Mr. S’s claim was submitted for continued payment under Reliance Standard’s LTD Policy, with the same definition of disability.  After paying his LTD benefits for two years as a result of his physical and cognitive impairments; by letter in January 2019, Mr. S was informed that his LTD benefits were denied because Reliance Standard had determined that “[b]ased on the documentation provided, it appears that your Total Disability is caused by or contributed to by a Mental Nervous Disorder” even though Mr. S had no history of, nor had he received treatment for an alleged mental illness associated with his disabling neurological conditions. After receiving the denial, Mr. S contacted Dell & Schaefer and discussed his case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Reliance Standard’s denial letter and in the evidence it relied on and agreed to prepare and submit Mr. S’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Reliance Standard’s short-comings and reasons for denial, with a special focus on Reliance Standard’s incorrect application of the Policy’s Mental Nervous Disorder provision, which caps disability payments at 24 months even if an individual continues to be disabled. The appeal first confirmed that Mr. S’s initial claim and Reliance Standard’s subsequent approval were based on cognitive disorders, slurred speech, ocular pain, memory loss, and headaches all associated with his strokes. It wasn’t until 18-months into his claim that a nurse consultant, without review by a physician specializing in vascular neurology, unilaterally reclassified his condition as “depression.”  The appeal next clearly established that Mr. S continued to be disabled and unable to perform his own occupation as a Store Manager due to his extensive chronic headaches and significant cognitive impairment. Mr. S’s treating neurologist confirmed this in her multiple objective assessments over the years. On appeal Reliance Standard requested that Mr. S undergo a Neuropsychological Independent Medical Examination (“IME”). After assuring that the appropriate safeguards were in place to protect the independence and credibility of the IME process, Mr. S attended the IME. The results of the IME confirmed that Mr. S suffered from disabling Vascular Neurocognitive Disorder, which also put him at greater risk for Neurodegenerative Disease.

Just over nine weeks after filing his appeal, and after reviewing hundreds of pages of exhibits and medical records as well as conducting an IME, Reliance Standard overturned its decision to terminate benefits, paid full LTD back benefits and reinstated Mr. S’s LTD benefits. Attorney Symonds continues to represent our client to best ensure that Reliance Standard will not terminate his benefits again. Feel free to call our disability attorneys for a free consultation regarding any matter relevant to your disability claim.

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FAQ

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, GoToMeeting.com 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.

Reviews

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.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

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