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 help Reliance Standard claimants nationwide?

We represent Reliance Standard clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Reliance Standard disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Reliance Standard. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Reliance Standard.

How do you help Reliance Standard claimants?

Our lawyers help individuals that have either purchased a Reliance Standard long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Reliance Standard:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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.

Dell & Schaefer Client Reviews   *****

Kelly B. (Nevada)

I had been on long term disability for over 10 years, with Aetna disability company. I had 3 heart surgeries in that time and some other pretty serious medical issues. I was very ill, during that time, seeing my physicians regularly and in and out of the hospital. It was very stressful keeping up with the vast amounts of paperwork, physicians attending statements, and communicating full time with the disability company.

One time, right before my open heart surgery, they stopped paying my claim for 4 months, for absolutely no reason. I did get that straightened out, eventually, but we were almost homeless, in the process. I decided to consider a buy out, on my disability claim and I wanted to use a large, reputable attorney’s firm, to handle this negotiation and contract. I called and talked to an attorney named Rachel Alters, who worked for Attorneys Dell & Schaefer. They had a very large attorneys practice and I was very comfortable using them.

She was very professional, but also really compassionate, about everything I had been through. I felt like she would really be someone I could trust. It turned out the gentleman she ended up talking to, from Aetna, was someone she knew from dealing with them in the past. This made everything go so much easier, I think, but either way, Rachel is wonderful! I would recommend her very highly, to anyone. She has my five star recommendation!

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