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.

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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, 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   *****

Dawn P.

I had to quit working after 8 years of dealing with chronic pain from 2 bulging and torn discs from an injury and failey back surgery. I was approved for Long term disability through my employer benefits, with Unum. They covered me with payments for one year, and suddenly sent a letter that their doctors disagreed with my surgeon and pain management doctors, and they felt I could go back to work full time. I hired a local attorney, trying to save some money, but I don’t think he had much experience dealing with big LTD companies such as Unum. He filed terrible appeals on my behalf with little to no effort on his part of building a good case for me. After a year of dealing with his condescending attitude and loosing my final appeal, I decided to call up Dell & Schaefer. I had contacted them a year prior when searching for an attorney. Cesar was willing to take my case and felt I had a good one. But I didn’t want to pay the percentage he was asking for if we won back then. The old saying, “you get what you pay for”, proved to be true in this case and I regretted not hiring him from the beginning!

Once I did hire him, and thank goodness he was still willing to take my case even though he was dealing with defending poor appeals by my previous lawyer, things got moving along for me. Because of his years of experience dealing with Unum, and his record of wins against them, within 6 months we had a settlement I could live with! The stress I suffered before Cesar and weight on my shoulders was gone! Cesar is a kind, caring, attorney who will fight for your rights! His assistant Michal always talked to me when I called in with questions or to check up on my case and never made me feel bad for calling. It was nothing like the previous relationship I had with my other attorney and his staff, who avoided me. Cesar explains the process well and keeps you updated on your options throughout the process. He was worth every penny!

I am grateful for their representation and would recommend anyone with an ERISA case to call him!

***** 5 stars based on 165 reviews

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