Sun Life denies disability insurance benefits to Alabama man with heart problems
An disability lawyer recently filed a civil complaint on behalf of Philip Linville in United States District Court for the Northern District of Alabama in the Northeastern Division against Sun Life Assurance Company of Canada (Sun Life). Sun Life denied Mr. Linville’s claim for long-term disability benefit payments and is allegedly in violation of the terms of the group long-term disability plan held between Sun Life and Mr. Linville’s employer – Cherokee Nitrogen Company, a subsidiary of LSB, Inc. The long-term disability plan under which Mr. Linville was a participant is governed by the Employee Retirement Income Security Act of 1974 (ERISA).
Mr. Linville worked his last day for Cherokee Nitrogen Company on June 22, 2009 as a result of his being completely and totally disabled due to a number of disabling conditions which include, but are not limited to, hypertension, chest pain, dyspnea, aortic aneurysm, palpitations, and shortness of breath.
On September 9, 2009, Mr. Linville filed a claim for long-term disability benefit payments with Sun Life. Mr. Linville also obtained a written statement from his treating physician to support Mr. Linville’s disability benefits claim and submitted the treating physician’s statement to Sun Life on September 30, 2009.
Sun Life responded to Mr. Linville on December 8, 2009 stating the medical documentation he provided did not support a claim for long-term disability benefits, thus denying his claim. Later that month on December 28, 2009, Mr. Linville filed an appeal with Sun Life as a response to Sun Life denying long-term disability benefits to him.
Sun Life received Mr. Linville’s appeal and requested more information from Mr. Linville to substantiate his long-term disability benefit claim. Mr. Linville complied with Sun Life’s request on January 28, 2010 by providing Sun Life with further documentation to support his appeal.
However, Sun Life upheld their original decision to deny Mr. Linville long-term disability benefit payments on June 15, 2010. Sun Life advised Mr. Linville of his right to file a civil suit under ERISA since all of his administrative remedies have been exhausted.
Mr. Linville and his Alabama disability lawyer allege that Sun Life relied on information received from their own medical experts to determine Mr. Linville’s supposed lack of supporting documentation that would preclude him from working at his own or any occupation. According to Sun Life’s medical experts - as alleged by Mr. Linville - Mr. Linville could perform “light work.” Furthermore, Mr. Linville alleges that Sun Life “tried to pressure at least one medical personnel into changing his mind regarding Plaintiff’s disability status to perform “light work.” Such an assessment made by Sun Life’s medical reviewers, according to Mr. Linville, is at odds with the statement from his treating physician and other supporting medical documentation that Mr. Linville provided to Sun Life in September of 2009 and again in January of 2010. Mr. Linville’s treating physician stated that Mr. Linville “could not work at all and was disabled from any occupation.”
Therefore, in accordance with the definition of “disabled” listed in the group long-term disability plan held by Mr. Linville through Sun Life and the supporting medical documentation from Mr. Linville’s treating physician, Mr. Linville is bringing action against Sun Life for denying his long-term disability benefit claim.
For his relief, Mr. Linville is asking the court for the following:
- to compel Sun Life to pay him long-term disability benefits retroactive to the time he became completely and totally disabled along with future disability benefit payments;
- attorney’s fees and court costs;
- any other relief permitted under ERISA pursuant to 29 U.S.C. 1001.