Standard Overturns Denial of Disability Benefits to Chiropractor

As any chiropractor or anyone who has been to a chiropractor knows – chiropractic medicine is very physically intensive work. The wear and tear a chiropractor can endure over the course of a career often resembles what many patients seek treatment with a chiropractor for. Such was the case with our client, who after 20 years of practice began to succumb to chronic neck pain due to cervical herniations, cervical radiculitis and multiple shoulder problems to include a rotator cuff tear, labral tear, degenerative changes to the AC joint and decreased range of motion. No longer able to meet the physical demands of his occupation as a chiropractor he filed his claim for long term disability benefits with Standard Insurance Company through the policy he had purchased from the Nebraska Chiropractic Physician’s Association (NCPA).

The Denial of Benefits

After many years of faithfully paying his premiums it came as a surprise to our client when Standard notified him that claim was being denied. Concerned by assertions made by Standard as to the nature of his policy and the contents of his denial letter he contacted our Office and spoke with Attorney Stephen Jessup.

In denying our client’s claim for benefits Standard relied on an independent file review conducted by a doctor that never physically examined our client or spoke with any of his treatment providers. Despite years of consistent treatment with medical doctors, chiropractors and objective medical evidence by way of MRIs, Standard’s doctor noted that there was insufficient medical information to support any restrictions and limitations and that our client should be able to return to work full time as a Chiropractor.

Additionally, review of the pertinent information indicated that Standard was erroneously trying to apply ERISA standards to what was an ERISA exempt policy. Attorney Jessup explained how this misapplication could negatively impact our client and how the appeal should be approached in order to protect our client in the event of future litigation.

The Appeal

As Standard was treating our client’s claim as an ERISA based denial of benefits Attorney Jessup remained silent as to the incorrectness of same and moved to quickly secure a complete copy of the claim file from Standard. Upon receipt and review Attorney Jessup discovered that the vocational review conducted by Standard was incomplete and failed to take into account multiple aspects of our client’s occupation as a sole practitioner chiropractor. Furthermore, the review of the medical review evidenced a systematic attempt to downplay our client’s weekly chiropractic treatment and an attempt to require objective medical evidence that does not exist to support our client’s subjective complaints of paint.

After receipt and review of all treatment and medical records Attorney Jessup arranged for additional diagnostic testing, to include a functional capacity examination, in order to better support and bolster the already lengthy history of medical restrictions. With the additional supportive medical information obtained, Attorney Jessup coordinated with our client’s providers to obtain additional supportive letters and forms.

In submitting the appeal Attorney Jessup attacked Standard’s position that the policy was governed by ERISA, as well as undermined both the vocational and medical reviews Standard conducted. Faced with an overwhelming amount of medical evidence and legal argument Standard was left with little choice but to admit its mistake and approve our client’s claim for long term disability benefits.

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FAQ

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, GoToMeeting.com 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   *****

Patricia E.

After fighting with UNUM for over a year over whether I was disabled (I had been determined to be disabled by the Federal Government and had a letter stating such), I finally decided to hire an attorney. Being skeptical and wary of money grubbing lawyers, I researched various firms over 2 months, interviewing prospective attorneys over the phone. I selected Dell & Schaefer based on their website, case success statistics, and the speed at which they returned my calls and emails.

My experience in working with Rachel Alters and her assistant Michal Mizrahi is nothing short of outstanding. They responded quickly to phone calls and emails and were mindful of my concerns and information needs. Even when Ms. Alters was out of the office for personal reasons, she would make sure that my questions were answered thoroughly in a timely manner. I cannot say enough good things about Michal. She anticipated my needs and was proactive in keeping me informed as my case progressed.

In the end, Rachel and Michal were successful at reaching a good settlement for me with UNUM and I am very satisfied.

Resolving disputes with insurance companies is always stressful and unpleasant. I strongly suggest that if you find yourself in that place, that you seriously consider Dell and Schaefer, and if possible, Rachel Alters. She made what could have been a horrible situation not only bearable but brought to a successful conclusion in a timely manner. I am clear that I would never had had such a positive outcome without their help and expertise.

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