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Standard overturns decision to deny disabled Project Manager long-term disability insurance benefits after first Appeal

In addition to health insurance and other employee benefits his employer provided long-term disability insurance through Standard Insurance Company, based out of Portland, Oregon.

In 2010, Terry was forced to file a long-term disability claim with Standard Insurance Company (“Standard”) informing him that due to his debilitating disease he was no longer able to perform with reasonable continuity the Material Duties of his Own Occupation.

Soon after filing his disability claim Standard informed Terry that his claim was approved, which came as no surprise to him given the extent of his health issues.

Standard Terminates Long-term Disability Claim After 24 Months Claiming that the Disability was Due, In Part, to a Mental Disorder

The primary cause of Terry’s disability was and always had been type 2 diabetes and peripheral neuropathy. His pain had become so severe and had caused him to give up a successful career it was no surprise that Terry also began suffering acute depression symptoms related to the worsening of his physical state. Terry had also been diagnosed with bipolar disorder and anxiety, which complicated matters.

After paying his long-term disability claim for 24 months Standard informed Terry that it would no longer pay benefits beyond the 24 month period on account of his disability being “caused or contributed” to by a mental disorder. It was true that Terry suffered from mental illness, however, he had not claimed that depression nor any other mental illness was the sole or primary cause of his disability. Notwithstanding, Standard proceeded with the termination of Terry’s long-term disability claim on the grounds that his disability was caused or contributed to by a mental disorder. As part of their basis for denial, Standard cited the opinion of a hired medical consultant. That medical consultant attempted to minimize the extent of Terry’s physical disabilities while accentuating his mental disorders.

Following Submission of ERISA Administrative Appeal by Attorney Cesar Gavidia Standard Overturns Decision to Limit Long-term Disability Claim to 24 months

In response to Standard’s decision to terminate Terry’s long-term disability claim after 24 months, Attorney Cesar Gavidia and his appeal team began compiling the necessary evidence and implementing their plan of attack. Terry’s appeal served not only to detail and uncover all of the flaws and errors in Standard’s decision, but also to ensure a strong administrative record in the event that Standard decided to uphold its decision and the case were to proceed to federal court litigation.

Fortunately, a more expeditious and just result occurred. After receiving the appeal submitted by Attorney Gavidia and his appeal team, Standard overturned its decision and began paying benefits specifically for Terry’s type 2 diabetes, peripheral diabetic neuropathy and other physical complications.

Terry continues to receive monthly long-term disability insurance benefits from Standard while Attorney Gavidia continues to assist him with the ongoing and seemingly never-ending requests for health and status updates from Terry and his attending physicians.

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Standard Reviews

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Standard

Standard insurance just dropped me with no communication with me.

Reviewed by D Larson on October 4th 2023 Verified Policyholder | June 2019 date of disability

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 >

Reply

Sent on October 4th 2023 by Attorney Gregory Dell

I am sorry to hear about your experience. Do you currently have a denial letter from them that you can email to me?

Standard

Standard is one of, if not the worse, company in the industry now

Reviewed by Anonymous Erisa Victim on December 5th 2019 Verified Policyholder

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'

Reviewed by S.B. on August 22nd 2019 Verified Policyholder

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 >

Reply

Sent on August 22nd 2019 by Attorney Jay Symonds

S.B., this sounds extremely unusual and unreasonable, I suggest you contact our office and speak with one of the attorneys to address the specific questions you have re... read more >

Standard

I waited 5 weeks just to be told I can't receive benefits

Reviewed by Marissa on June 11th 2019 Verified Policyholder

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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Sent on June 11th 2019 by Attorney Gregory Dell

Marissa, I am sorry to hear of your diagnosis and the troubles Standard is giving you. Please contact our office at once for a free consultation. We would love to speak... read more >

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

Reviewed by Gena on December 10th 2017 Verified Policyholder

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

Reviewed by Linda on September 13th 2017 Verified Policyholder

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

Reviewed by Donna on July 26th 2017 Verified Policyholder

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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Sent on July 26th 2017 by Attorney Stephen Jessup

Donna, please contact our office with a copy of the denial letter so we can discuss in detail how we may be able to assist you in appealing the denial.

Standard

Mental health LTD should be covered under the Mental Health Parity Act

Reviewed by Kim V. on February 10th 2017 Verified Policyholder

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 >

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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?

Answered on September 21st 2023 by Attorney Gregory Dell

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.

Answered on May 31st 2023 by Attorney Gregory Dell

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?

Answered on December 8th 2020 by Attorney Alex Palamara

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?

Answered on September 11th 2020 by Attorney Alex Palamara

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?

Answered on July 10th 2020 by Attorney Steven Dell

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?

Answered on May 10th 2018 by Attorney Alex Palamara

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?

Answered on March 30th 2018 by Attorney Rachel Alters

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?

Answered on December 1st 2017 by Attorney Stephen Jessup

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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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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Reviews from Our Clients

S.S.

I am a physician in my 30s who was practicing in my hospital based medical specialty until my Multiple Sclerosis diagnosis began to severely limit my physical ability to work.

My husband and I were obviously in distress at these very unwanted life changes and frankly overwhelmed with the possibility of a long and traumatizing legal battle ahead of us. We knew we were legally entitled to benefits through the separate private individual and employer based ERISA disability insurance policies we had, but even cursory research and discussion with colleagues made it clear that insurance companies will strategize with their own legal teams to find ways to not pay out benefits. We found many before us who had fallen unwittingly into legal pitfalls that prevented them from ultimately obtaining benefits. We realized we needed to seek legal counseling.

We found Dell Disability Lawyers through their YouTube channel where their partners have videos discussing the legal intricacies and latest developments in private disability law. I was impressed by their dedication to the field and reached out through their website to request a free consultation.

We were delighted to hear that Mr. Steven Dell himself would be willing to take our case and felt assured that we would be represented by the best of the best.

We have not been disappointed in our expectation and have, in fact, been consistently very impressed. Steven Dell is clearly both knowledgeable and wise about dealing with these issues but more importantly, has shown kindness and impeccable honesty at each step of the way.

Merlin has demonstrated a very high capacity for organizing and handling the endless myriad of documents and communications between us and the insurance companies. She has also been very compassionate, accessible and forthcoming in dealing with our many anxiety fueled emails and telephone calls to her and we are very grateful for her involvement.

For over 7 months, we have been working closely with Steven Dell and Merlin Bryan from Dell Disability Lawyers as they have guided us through the process of review and initial application for benefits from our two insurance policies (Hartford and Ameritas).

We are happy to announce we just received approval of claim from the Hartford insurance company.

At this time we are still working with this firm as we await the final decisions from Ameritas policy that we are hopeful will have a similar outcome.

As anyone with a chronic and progressive illness can tell you, time becomes a very precious commodity. Through their representation, Dell Disability Lawyers has allowed us to focus the majority of our time enjoying the time and function I have left while resting assured that our disability case laid in competent and caring hands.

The truth is that no amount of money can make up for what we have lost, but it is a huge comfort to have a team like Dell Disability Lawyers at our sides to help us ensure we will be able to continue to care for ourselves and our families.

We highly recommend Dell Disability Lawyers, Mr. Steven Dell and Ms. Merlin Bryan to handle your disability insurance claim.

Thank you Steven, thank you Merlin!

We will certainly plan on leaving another review for completeness once we have our final decision from Ameritas.

Paula B.

I have been working with Dell Disability Lawyers for the past 5 years concerning my disability as it pertained to my employer. I have been more than pleased with them the entire time. They have always kept me informed of any paperwork needing completed or any changes coming ahead. Nothing has been a surprise. I would recommend them to you to help with your disability case if you’re trying to dip into the policy you’ve been paying for.

Michael M.

I am a physician who has been disabled for over 10 years. During this time I have been represented by Cesar Gavidia and his assistant, Danielle Lauria. Their representation on my behalf has allowed me to concentrate on dealing with my disability/disease process and all associated complications and not having to deal with all the things that are necessary in a disability insurance claim. Based on my personal experience from many years of practicing medicine I would consider their work product, insight and effort in the disability insurance claim procedures to be superior. I would recommnend them, which I have done, with my highest level of confidence. In short, you will be well served with this practice.

Dan P.

I had to retire from my career due to a bad back that restricted me from performing my duties. I had LTD insurance and after a few years of receiving monthly benefits from this insurance company, they notified me that my benefits were terminated stating that I don’t qualify due to my duties not fitting into some “national job description” and a nurse had deemed me eligible to go back to work. It’s a crushing feeling to have this told to you over the phone with hardly any information given. Luckily, I came across Dell Disability Lawyers and spoke with Attorney Palamara who calmed me down and stated they would take my case. Within a couple of months my benefits were restored, and I had piece of mind. I cannot thank Attorney Palamara and the staff at Dell Disability Lawyers enough for their professionalism, no nonsense approach, personal and timely communication and quick ability to litigate my case.

Jen S.

I wanted to thank Mr. Symonds and his legal assistant Sonia for their professionalism, guidance and dedication towards my LTD insurance claim. Going through the denial process on my own was going to get me sicker and I knew it was time for help right away. I reached out to Dell Disability Lawyers for assistance and not too long after my call, I was connected with Sonia. Soon after that, I was talking about my case with Mr. Symonds. After a long and tedious process with the LTD insurer, we won the case. The wait can absolutely be lengthy, but in the end, it was all very much worth the fight. Thank you both so much for all that you have done for me! I also want to thank those who assisted in keeping me updated, as needed. Highly recommended for anyone who is going through the brutal process of an LTD denial.

Carl G.

I would like to thank Dell Disability Lawyers for taking care of my case and help me get the insurance coverage that I was rightfully in need of. Specially, I would like to thank Attorney Alexander Palamara and right-hand legal assistant, Sonia Nogueira, who made this process less stressful. They answered all my questions and kept me informed every step of the way.

Don’t get me wrong. They never promised or told me that I was going to win my case, as no one can guarantee that for you. What they did do, was letting me know that they were working hard for me and to keep positive. Something that I recommend everyone to do is to subscribe to their YouTube channel. That will give you an idea on how they operate and why they (for most of their cases) win their cases.

Since I was awarded disability, I am still having surgeries and thanks to them, I’ve been able to cover all those expenses.

Warm regards to everyone at Dell Disability Lawyers!

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I’m so very Grateful and Thankful for the team at Dell Disability Lawyers. They worked tirelessly to get the best outcome for me. I’m so glad that I found them!!

Carole S.

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Awesome team. Jay and his team, Sonia and Francesca, truly care. This team is very professional and quick to respond. Jay always provided answers in detail to my questions. I strongly recommend Jay Symonds.

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