Sedgwick And AT&T Disability Denial Scheme Exposed In ERISA Lawsuit
On May 14, 2012, the U.S. District Court for the Northern District of California issued an order on a very hot topic for ERISA Disability Lawsuits. The issue concerns how much “Discovery” a denied person is able to obtain from the Disability Insurance Company while litigating a case.
Frequently, the lawyers for the disability insurance companies claim that the Plaintiffs should be allowed no discovery other than access to the administrative claim file. This old argument was turned on its head in 2008 when the U.S. Supreme Court ruled in Metropolitan Life Ins. Co. v. Glenn that limited discovery was allowed in ERISA cases. The recent ruling from the Northern District of California in John Doe v. AT&T Western Disability Benefits Program illustrates how courts are beginning to allow such discovery in today’s ERISA disability denial cases.
To first understand how this ruling and other recent rulings will affect our clients and others similarly situated it is important to understand what exactly discovery is. Very simply, “Discovery” is a pre-trial tool in which each party can obtain evidence from the opposing party using devices such as requests for the production of documents, requests for admissions, and requests that the opposing side answers interrogatories (written questions). The documents and answers provided to the questions posed in discovery can lead to evidence that can favor the plaintiff when the case goes before the Judge for trial.
In most ERISA disability cases, the Plaintiff / Claimant’s discovery request is restricted only to “unearth the existence of possible conflicts of interests under which the defendant may operate or of procedural errors that may have undermined the fairness of the plaintiff’s hearing.” What exactly the Plaintiff is allowed to ask for under these restrictions was the question that was answered in this recent California disability claim.
The Case involved a former employee of AT&T, Inc. who brought suit challenging his Short Term Disability Benefits denial under the AT&T Western Disability Benefits Program. The Disability Attorney representing the plaintiff desired answers and documents to determine if the defendant had a “conflict of interest.” For instance, the Plaintiff requested the number of claims and appeals in 2009 and 2010 that NMR (the “independent” company who provided the physicians who conducted the medical review of the medical documentation) had provided medical reviews for, as well as the total numbers that resulted with NMR approving and denying disability claims/appeals. The Plaintiff also requested the total amount of money that had been paid to the 3rd party administrator Sedgwick Claims Management as well as NMR in 2009 and 2010 for services related to the Disability Plan’s Administration. Finally, the Plaintiff sought any documents relating to the Plaintiff’s claim or appeal that was received or created by the Defendant, Sedgwick or NMR. Sedgwick has been hired by AT&T to administer all of the short term and long term disability insurance claims. Unfortunately the policy language in the AT&T policy is terrible and Sedgwick is notorious for denying numerous claims.
The Court found that each of these requests were relevant because it could show a stingy claims granting history as well as an economic interest in denying claims by AT&T, Sedgwick and NMR. The Court also found that the interrogatories posed must be answered as the Federal Rules of Civil Procedure “mandates that a party responds to interrogatories with “the information available to it.'” Likewise, the Court also found that the Federal Rules also requires that “a party produce relevant, non-privileged documents in its “possession, custody, or control.'” AT&T attempted to argue that some of these documents were not available to it or were not in its possession, custody or control. The Court, however, disagreed and pointed to the Agreement/Contract between AT&T and Sedgwick (and Sedgwick’s subcontractors) that granted “control” and “ownership rights over such information and documents” to AT&T.
While the outcome of this ruling is specific to the facts of this case, this ruling, like many others that have recently been issued by other courts, show that the Courts are slowly promoting the idea that discovery is reasonable in ERISA Disability Denial Cases.
Resources to Help You Win Disability Benefits
Get Your Sedgwick Disability Application Approved
Prevent a Sedgwick Disability Benefit Denial
Negotiate a Sedgwick Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Sedgewich is the worst-immediate denial of all requests for treatment. Rubber stamps DENIED ALL RFA’s
Attorney Alexander Palamara of Dell Disability Lawyers gets LTD Benefits Reinstated for former Walmart Manager who is now found disabled from Any Occupation
Court Orders Sedgwick to Pay Disability Benefits to Claimant with Carpel Tunnel Syndrome Even though the Employer Offered Her Accommodations
Reviews from Our Clients
Very satisfied with the work of this team. Took well care of my case and took all the necessary time to be responsive and attentive when I had questions. Guided me through recovery and returning to normalcy. All thanks to Jason & Tabitha, thank you!
I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
It’s unfortunate when disability insurance companies come after older disabled policyholders just to help their bottom line. It can be a living nightmare the damage they can do to a family. Dell Disability Lawyers are polite, understanding and knowledgeable. They call you back and answer any question you have no matter how unimportant it can be. The amount of stress they took off of myself and family was incalculable. I recommend them highly to take care of any disability case whether it be filing for benefits or reversing a claim decision. They are outstanding.
I could not have been happier or more appreciative of the hard work they performed on my behalf. I was well briefed on my case and it was closed in a timely manner with a financially successful resolution.
Mr. Symonds and Sonia as well as everyone else we have worked with throughout this process have been very helpful, professional and caring to our situation. We are very thankful to have this great team on our side.
Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
I was denied long term disability benefits from The Hartford after being on it for years. I found Dell Disability Lawyers after doing research online. In a matter of days they responded and explained to me everything that would be done. Dell Disability Lawyers were able to settle my suit against The Hartford very quickly and responded to me quickly. I would definitely recommend this team of lawyers for anyone that is fighting for their disability insurance.
I have had nothing but a great experience with Dell Disability Law Firm. Mr. Alex Palamara and his team went above and beyond my expectations. They will respond to emails and phone calls in a timely manner. Thank you once again for taking my case.
This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.