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, 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.

Questions About Hiring Us

Do you help Standard claimants nationwide?

We represent Standard clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Standard disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Standard. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Standard.

How do you help Standard claimants?

Our lawyers help individuals that have either purchased a Standard long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Standard:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Louis P., MD

My chronic health problems had progressed to the point that it was impossible for me to continue practicing my specialty as an obstetrician and gynecologist. With my physician’s support and excellent own occupation professional disability insurance policies I began the application process solo and with confidence that approval would be easy. After several months of endless and confusing demands for documents, files, records and reports by the insurance carriers I was in a panic over the realization that I was in over my head and that my entire financial future could be ruined by mistakes on my part during the application process.

Having seen ads by Dell & Schaefer, I contacted them on-line with a summary of my situation. A phone call was received from Gregory Dell within hours of submitting the on-line inquiry. His competence and knowledge was immediately apparent and reassuring. After a thorough discussion of my case I could not copy the files fast enough to get them to his office and in his capable hands. End of the story is that the results were much better than I could have imagined. Money is not one of my problems.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us