Standard Insurance Company reverses disability insurance denial for a disabled lawyer
Author: Attorney Rachel Alters
Disability Insurance Lawyers Dell & Schaefer prevailed in an ERISA appeal filed on behalf of their client when The Standard Insurance Company wrongfully denied her long term disability benefits. The client was suffering multiple gastro-intestinal conditions, chronic intractable abdominal pain, visceral hypersensitivity syndrome, nausea, vomiting secondary to a neuroma, migraines, fibromyalgia, severe weight loss, fatigue, syncope, and secondary diagnoses of anxiety, post traumatic stress disorder, major depressive disorder, panic disorder with agoraphobia, inability to concentrate and memory loss, all of which prevented her from performing the material duties of her occupation as an attorney. The claimant had been hospitalized for approximately three months, continued to be disabled after her protracted hospital stay, yet The Standard claimed that she was capable of performing her job duties as an attorney, 40 hours a week, since she failed to go to the doctor for approximately six weeks following her hospital discharge.
According to The Standard, the claimant was no longer disabled on July 20, 2009 (days after she was discharged from the hospital) and her failure to return to work within 30 days from July 20, 2009 exceeded the Allowable Period of Temporary Recovery during the Benefit Waiting Period.” Therefore, she was no longer covered under the policy when she “again became disabled on September 10, 2009.”
The claimant’s treating physicians all clearly stated that she was unable to return to work after her hospitalization due to frequent vomiting, severe abdominal pain, fatigue as well as cognitive impairment and depression, however, The Standard ignored their medical opinions claiming that she failed to seek treatment therefore she had recovered completely and was able to work 40 hours a week without physical or cognitive limitation.
The claimant was so ill she could hardly leave her home other than to attend doctors’ appointments, spending most of her day in bed or on the couch being cared for by her family. Attorneys Gregory Dell and Rachel Alters filed an appeal on behalf of our client in January of 2011. In our appeal we were able to show that the claimant was disabled and unable to perform the material and substantial duties of her occupation. This was evidenced by a the opinions of her treating physicians, her voluminous medical records and a day in the life video depicting how the clamant spent her day frequently vomiting and unable to care for herself. She clearly could not go to work in an office setting as an attorney 40 hours a week.
In March of 2011, The Standard informed our client that her disability benefits would be approved as they determined that she was disabled and unable to perform the material duties of her occupation. Our law firm continues to handle our client’s disability claim on a monthly basis.