Tech Support Rep Wins Standard LTD Insurance Appeal for Back Disorders
Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.
After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review of her medical records. The physician reviewer concluded that the medical records did not support a diagnosis of lumbar radiculopathy and that although she suffers with lower extremity radiating pain and paresthesia the imaging did not show ongoing nerve root compression or severe canal stenosis. They also noted all of her “normal” examinations by her physicians.
The physician reviewer noted that the records supported diagnoses of lumbar spondylosis, lumbar disc herniation, lumbar pain, and post laminectomy syndrome but that she would be capable of work activity with limitations and restrictions. Standard also cited a determination by its vocational consultant that with the restrictions and limitations suggested by the peer review physician that she could work in her own occupation.
Following submission of her appeal, the Standard overturned the decision after submission of records from her physical therapist and pain management physician evidencing that her conditions have progressively worsened and significantly impact her quality of life.
Also, submitted with her appeal was a recent physician report from her orthopedic spine specialist documenting radicular pain and back pain preventing return to full time work due to inability to sit, stand and walk for prolonged periods of time.
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Standard Reviews
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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 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 >
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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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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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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 >
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Standard's sudden denial was inexplicable
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Standard has keep me jumping through hoops for years
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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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Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review ... Read More >
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