Successful Appeal Against Prudential Gets Breast Cancer Survivor Back on Claim for LTD Benefits

Nearly ten years after initially beating breast cancer, our client was distraught to hear that she had a reoccurrence of the disease in 2015. She quickly underwent a left mastectomy, chemotherapy and radiation therapy, followed by a course of lymphedema therapy. In 2016, she had expander placement but unfortunately she suffered from a non-healing wound in her left chest from the expander that had to eventually be removed in 2017. Continued chemo treatment in 2017 and other issues left her with a severely impacted left upper extremity and peripheral neuropathy, as well as severe restrictions and limitations.

Thankfully, her employer, Saint Clare’s Health System/Catholic Health Services, provided coverage for their employees under a long term disability insurance policy with Prudential. Shortly after leaving work in February of 2015, our client made a claim for Long Term Disability (LTD) Benefits and Prudential initially agreed to award benefits which began in August of 2015. Benefits continued all the way through the end of February of 2018.

Unfortunately for our client, by way of a denial letter dated March 26, 2018, Prudential stated that based upon a review by its clinical team, it found that while she had medically supported restrictions and limitations, these would no longer preclude her from performing full time sedentary work. Knowing there was no way she could return to work of any kind due to her pain, fatigue, concentration issues, etc., our client found Dell & Schaefer and requested that they assist her with an appeal.

Appeal by Attorney Palamara

After receiving the denial letter, the former employee of Saint Clare’s Health System/Catholic Health Services spoke with Attorney Alexander Palamara. From the initial phone call, Attorney Palamara realized the gravity of the situation and the harm being done to the claimant. He knew that benefits needed to be reinstated as quickly as possible as they were certainly justified in this situation.

A review of the medical records and the claim file that Prudential provided confirmed the Attorney’s thoughts that this denial was flat out wrong. Prior to filing the appeal, Attorney Palamara reached out to a few of the treating providers to build an even stronger case for the appeal. Each of the providers was more than willing to give written support for this claim.

A timely appeal was filed to challenge Prudential’s denial letter. This appeal first noted that two of Prudential’s own reviewers had previously concluded that our client was completely disabled from any gainful occupation. The Appeal then heavily criticized the new reviews that Prudential was relying upon to now deny the claim. The appeal also showed that Prudential was unreasonably selecting certain medical records to support its decision while clearly ignoring objective documentation showing that her issues remained. The appeal also laid out strong support from the treating providers and overwhelming objective evidence that should not have been and could no longer be ignored.

Claim is Re-Approved:

On January 4, 2019, we received word that Prudential had completed its review and decided to reinstate benefits. The re-approval was a nice holiday surprise for our client who was relieved to be back on claim. While she knows that the fight for her benefits will continue until she is able to return to work, she knows that the people at Dell & Schaefer will do whatever it takes to keep her on claim.

If you have been denied disability benefits by Prudential or any other disability insurance company, please do not hesitate to contact Attorney Alexander Palamara at Dell & Schafer for a free consultation.

Learn how to file a winning Prudential disability appeal.

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FAQ

Do you help Prudential claimants nationwide?

We represent Prudential 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 Prudential disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Prudential. 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 Prudential.

How do you help Prudential claimants?

Our lawyers help individuals that have either purchased a Prudential 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 Prudential:

  • 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, 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   *****

Anna P. (Iowa)

Mr. Jessup was able to secure approval for my benefits beyond the 2 year mark. This is a critical time as the evidence must show that you can’t work any occupation. By engaging him before the two year mark we were able to avoid a lapse in claims or erisa appeal.

Mr. Jessup was very professional, kind, flexible, and ultimately got results. The assistant on our case was Michal and she was amazing throughout the case. Very professional, quick to respond to questions, organized, and proactive.

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