After Two Appeals, Standard Approves Short & Long Term Disability Benefits for Nurse
Prior to filing for disability, our client was a Registered Nurse employed as a Senior Case Manager for United Healthcare. Our client was a dedicated employee who enjoyed her work until chronic pain, frequent headaches, and resulting cognitive dysfunction forced her to stop working in July of 2018. Fortunately, her employer provided disability insurance coverage under two policies: UnitedHealth Group’s self-funded Short Term Disability Policy and a Group LTD Policy which was administered and insured by The Standard Insurance Co. Initially, our client was found to be totally disabled under the terms of the STD policy but not for the maximum benefit period. Following the filing of an appeal by Attorney Palamara, her benefits for short term disability were reinstated and paid through the maximum benefit period which ended in January of 2019.
While her STD appeal was pending, our client filed for LTD benefits under the governing LTD Policy with the Standard. Unfortunately, despite being awarded her maximum Short Term benefits following the STD appeal by Attorney Palamara, The Standard denied her claim for long term disability benefits. In the LTD denial letter, The Standard claimed her illnesses did not preclude her from performing her nursing duties, and as a result, the Standard felt that she did not meet the Definition of Disability.
The Standard’s decision to deny benefits rested almost exclusively on a paper review and opinion by a physician consultant, who never examined or met with our client. The physician consultant noted inconsistencies regarding our client’s functional abilities and disregarded much of the relevant medical information concerning her multiple chronic impairments. Citing the physician consultant’s review, Standard concluded that the medical evidence did not contain any objective findings to support restriction and limitations and that our client could return to her past work as a Nurse Case Manager.
Appeal by Attorney Palamara
After receiving the denial letter for the long term disability claim, Attorney Palamara quickly reviewed the denial letter and knew that Standard did an improper job of reviewing her claim. After ordering the claim file and all medical records from the treating providers, it was quickly seen that Standard and its reviewing consultant overlooked ample objective evidence of her chronic pain and disabling conditions.
First and foremost, Standard and its physician consultant did not examine our client to have an opportunity to observe her decreased sensation, as well as her impaired grip and motor strength. It also did not interview our client to ascertain or quantify the extent of her chronic pain complaints. Attorney Palamara also highlighted a multitude of additional functional restrictions that were supported by the medical records but not considered by Standard.
LTD Claim Approval
On July 24, 2020, we received word from Standard that it was approving our client’s Long Term Disability Claim. In its correspondence, The Standard advised that its Administrative Review Unit completed its review of the claim and determined that it was reasonable to conclude that our client continues to satisfy the applicable definition of disability. Shortly thereafter, our client received a sizable benefit check for nearly a year and a half of benefits and remains on claim at the present time. Although our client is relieved to be finally on claim, she knows that the fight will continue as her policy’s definition of disability changes after 24 months of benefits. At that point, we will have to prove to Standard that she is “unable to perform with reasonably continuity the Material Duties of Any Occupation.” Thus, Attorney Palamara will continue to work on this claim to continue to prove to Standard that our client remains disabled and satisfies the requirements of the policy.
If you have been denied disability benefits by Standard or any other disability insurance company, please do not hesitate to contact Attorney Alexander Palamara at Dell & Schafer for a free consultation.
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Standard Reviews
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Showing 8 of 650 Reviews
Standard
Standard insurance just dropped me with no communication with me.
I was put on Standard insurance by my employer in 2019. I was told by them when I was first on disability that I would be on this for the rest of my life. After 2 years of... read more >
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Standard
Standard is one of, if not the worse, company in the industry now
The Standard changed after the company was acquired by Japanese based Meiji Yasuda Life Insurance Company in 2016 and subsequently being delisted from the US stock exchang... read more >
Standard
Standard is one of, if not the worse, company in the industry Standard hasn't approved or denied my claim in over a year. They keep promising to look at it 'next week'
My husband is covered by a Standard STD/LTD non-ERISA plan. He has a very rare neuromuscular disorder and was hospitalized in intensive care, was off work for 6 weeks (wai... read more >
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Standard
I waited 5 weeks just to be told I can't receive benefits
After working overtime and stressing behind my job for the past 5 years, it resulted in me being diagnosed with retinopathy hypertension, at the age of 29, on 12/10/2018. ... read more >
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Standard
The Standard will threaten to withhold your pay until you sign every document that they send you. The worst part is when they consider back payment for SSDI benefits
First of all, the worst thing that could ever happen to a hard-working person is a permanent disability. Fighting to secure payment is hard enough when you are well. Let a... read more >
Standard
Standard's sudden denial was inexplicable
I was placed on disability by my doctor with a diagnosis of Cognitive Impairment (supported by both a neurologist and a neuropsychologist) which severely affects my abilit... read more >
Standard
Standard has keep me jumping through hoops for years
I have been on LTD with The Standard since September 2011. The have had me jumping through hoops for all these years. Very rude if I call and ask a question. They say they... read more >
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Standard
Mental health LTD should be covered under the Mental Health Parity Act
My company contracted with Standard for our short and long term disability policies. In Jan 2014 I was on STD, which turned into LTD with a waiting period, which was tough... read more >
Answered Questions by Our Lawyers
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Showing 8 of 28 Answered Questions
Q: Do I have to pay back LTD after receiving SSDI?
A: Hello. In most group disability policies there is offset language which states you must pay back any LTD that ... Read More >
Q: Non-taxable benefits have become taxable.
A: I am sorry to hear what you are going through. We have seen you exact fact pattern with tax on ssdi when you w... Read More >
Q: How do I ensure Standard makes a timely decision with regard to my claim?
A: Matthew, we are sorry to hear that you are having difficulty with your claim. While the insurance company does... Read More >
Q: Why can my employer hold my disability check after The Standard sends it to them? Can I file a grievance with them?
A: Lucas, it sounds like your claim for STD benefits is under a policy that is self-funded by your employer. Thus... Read More >
Q: Should I contact you before submitting my application for a private disability benefit?
A: It is in your best interest to contact us as early as possible if you think you are going to need to file a lo... Read More >
Q: Is there any case law in which a state government employee LTD plan decided to drop the 24 month mental health limitation? Has there been any success against a state government and Standard using ADA Title I (employee) and 3 (insurance company) from a discrimination basis?
A: Marie, thank you for your compliments on our website. We strive very hard to get as much information out there... Read More >
Q: How can Standard deny my claim and expect me to work when I am disabled?
A: Debbie, unfortunately this situation occurs often as there are two different departments reviewing your claim ... Read More >
Q: I'm waiting to hear back about my appeal. Should I hire an attorney?
A: Pam, if an appeal has already been submitted there may be very little an attorney could do at this point until... Read More >
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After Two Appeals The Standard Insurance Approves Short & Long Term Disability Benefits for Nurse
Prior to filing for disability, our client was a Registered Nurse employed as a Senior Case Manager for United Healthcare. Our client was a dedicated employee who enjoyed her work until chronic pain, frequent headaches, and resulting cognitive dysfunction forced her to stop working in July of 2018. Fortunately, her employer provided disability insurance coverage under two policies: UnitedHealth Group’s ... Read More >
Standard Approves Disability Benefits to Attorney with Fibromyalgia
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Standard overturns decision to deny disabled Project Manager long-term disability insurance benefits after first Appeal
Terry had worked as a project manager for a large national health group earning over $85,000 annually, until type 2 diabetes left him disabled and suffering from peripheral diabetic neuropathy, severe chronic pain, fatigue and depression.In addition to health insurance and other employee benefits his employer provided long-term disability insurance through Standard Insurance Company, based out of Portland,... Read More >
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