After appeal filed by Attorney Jay Symonds, Sun Life overturned its previous denial of long term disability benefits for Florida ICU Nurse

Our client, Ms. A, formerly worked as a Nurse in the Intensive Care Unit. In September 2014 a number of medical issues, including chronic pain, fibromyalgia, chronic fatigue, neuropathy, bilateral hip pain, bilateral hip bursitis and bilateral knee osteoarthritis forced Ms. A to stop working and submit her claim for disability benefits, first under her employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. Both benefits were funded and administered by Sun Life. Under her employer’s disability policy, after 24 months she would be considered totally disabled if she was unable to perform the main duties of “any occupation” for which she was qualified by education, training and experience and with additional consideration of her functional limitations and transferable skills.

After paying Ms. A for 24 months under the Policy’s “own occupation” definition of disability, Sun Life denied continued LTD benefits on the basis that she allegedly no longer met the policy definition of disability. Specifically, Sun Life stated that “the medical evidence does not support that [Ms. A] would be precluded from performing the Material and Substantial Duties of any Gainful Occupation.” After receiving the denial, Ms. A contacted Dell & Schaefer and discussed her case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Sun Life’s denial letter and in the evidence it relied on and agreed to prepare and submit Ms. A’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Sun Life’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of Sun Life’s denial and significant inconsistencies with its medical reviewer’s findings. In particular, the appeal addressed several inconsistencies and misinterpretations of medical information submitted by Ms. A’s primary treatment provider and the extent to which Ms. A was functionally limited. The appeal also questioned the findings of an Employability Assessment/Transferable Skills Analysis conducted by Sun Life based on misinterpretation of the APS submitted as well as the failure to evaluate whether Ms. A could perform a sedentary occupation with “reasonable continuity,” which the medical record confirmed she could not.

Just over two months later, and after reviewing the appeal and hundreds of pages of exhibits and medical records, Sun Life overturned its decision to terminate benefits and negotiated a reasonable settlement of Ms. A’s long-term disability benefits claim.


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Sun Life Reviews
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Sun Life

Unscrupulous Tactics

Reviewed by Misseekayy on December 19th 2023   Verified Policyholder | May 2023 date of disability
Sunlife uses unscrupulous tactics in order to prevent payment of claims. They wait until it is close to the 30 day mark and then they ask for another form of information o... read more >
Sun Life

What a mess

Reviewed by Unknown on September 12th 2023   Verified Policyholder | July 2020 date of disability
This place has no idea what day it even is. First they attach my claim to my previous claim in which was a new claim. They messed up and denied me then made me wait yet ag... read more >
Reply
Sent on September 12th 2023 by Attorney Gregory Dell

I am sorry to hear what you are experiencing. Make sure you deal with Sunlife writing and follow up every day. If you would like assistance please contact us.

Sun Life

They leave you unable to fight

Reviewed by Kara on May 1st 2023   Verified Policyholder | July 2014 date of disability
I received LTD from Sunlife since 2014 until 2021. I still tried fighting in 2022. Somewhere they changed my claim from physical to mental but nothing in my medical histor... read more >
Reply
Sent on May 1st 2023 by Attorney Gregory Dell

Kara:
Thank you for submitting a review about your experience with Sun Life. If you appealed your denial, then you may still have time to file a lawsuit to obtain... read more >

Sun Life

Sun Life is a real pain

Reviewed by Chris K. on May 20th 2022   Verified Policyholder
Sun Life is a real pain. I just want them to buyout my long term disability policy, but they keep playing around and around. I just to be left alone and given my lump sum ... read more >
Reply
Sent on May 20th 2022 by Attorney Rachel Alters

Chris, you can contact me at Rachel@diattorney.com and we can set up a call to discuss your buy out options.

Sun Life

Everytime SunLife receives my information they ask for another 7 to 10 business days

Reviewed by Joe M on May 31st 2021   Verified Policyholder
Told Sunlife I’m getting an attorney since my claim was filed April 16, 2021, still pending a decision and everytime they ask for more information and they receive it, t... read more >
Reply
Sent on May 31st 2021 by Attorney Jay Symonds

Joe, I assume this is a short term disability claim pursuant to a group policy issued to your employer. If so, the relevant federal claims regulations allow the carrier... read more >

Sun Life

I have lost everything due to non payment of my claim.

Reviewed by Lester H. on November 2nd 2020   Verified Policyholder
I have lost everything due to non payment of my claim.
Sun Life

SunLife said if I don't apply for SSI they will lower my payments

Reviewed by Jeffrey R. on July 26th 2020   Verified Policyholder
Sun Life is trying to get me to apply for ssi. Have long term disability though them been on it for 9 months. Live in PA. Telling to apply or they are lowering my payments... read more >
Reply
Sent on July 26th 2020 by Attorney Rachel Alters

Jeffrey, you are required under the policy to apply for Ssdi. If you don’t they will take an estimated offset and decrease you benefit by that amount.

Sun Life

I don't understand SunLife's overpayment letter

Reviewed by Gina L. on July 15th 2020   Verified Policyholder
My name is Gina and I have been collecting LTD from my previous employer through Sun Life for almost 2 years. I am currently easing back into the work force and I work a p... read more >
Reply
Sent on July 15th 2020 by Attorney Rachel Alters

Gina: I suggest you contact our office and speak with one of the attorneys to discuss the specific questions you have. At that point you can send along the letter.

Answered Questions by Our Lawyers
(29)
Showing 8 of 29 Answered Questions

Q: Can SunLife offset dependent social security benefits received on account of my wife's disability?

Answered on May 8th 2020 by Attorney Stephen Jessup
A: Dominick, unfortunately, employer provided disability policies contain language that allows for the offset of ... Read More >

Q: Does SunLife have a required time to make a decision? Can they request medical records that have nothing to do with my illness?

Answered on February 19th 2019 by Attorney Gregory Dell
A: Megan, in an ERISA governed claim Sun Life would have 45 days to make a decision and have the option of taking... Read More >

Q: What happens if a policy doesn't mention something I believe I had and paid for (COLA)?

Answered on July 14th 2018 by Attorney Rachel Alters
A: Rachael, if the policy does not mention a COLA then that usually means that the insurance company does not off... Read More >

Q: Can SunLife deny me on the basis on a preexisting condition?

Answered on June 15th 2018 by Attorney Alex Palamara
A: Scott, the policy governing your claim will define what is a pre-existing condition. If you were having sympto... Read More >

Q: Can I sue SunLife if I signed a Settlement & Release Agreement?

Answered on June 4th 2018 by Attorney Jay Symonds
A: RB, if you signed a Settlement & Release Agreement you are bound by those terms and would have waived your rig... Read More >

Q: Can I still get my short term disability benefits if I'm terminated?

Answered on January 26th 2018 by Attorney Stephen Jessup
A: C. Freeman, even if you are terminated you would still have legal rights under your policies. Your rights unde... Read More >

Q: Can I sue SunLife for pain and suffering?

Answered on January 12th 2018 by Attorney Stephen Jessup
A: Jim, under ERISA governed policies there are no actions for pain and suffering, only unpaid benefits. Read More >
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If you're covered by a long term disability policy offered by Canadian-based carrier Sun Life, you may never have expected to have to submit a claim for disability insurance benefits. At Dell & Schaefer, we've handled thousands of these claims and are familiar with the tactics Sun Life and other disability insurance carriers use to try to avoid paying disabi... Read More >

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How Do You Fight a Long-Term Disability Denial?

Getting a denial letter from your disability insurance company is one of the ultimate insults. You are sick and not able to work, yet your disability insurance company is telling you to return to work. The disability insurance company has denied your disability benefit claim and is basically calling you a liar. When receiving a disability denial letter or a ph... Read More >

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Sun Life Wrongfully Denies Disability After Paying For 23 Months

We represent a 57 year-old claimant who’s occupation was selling commercial vehicles for many years.  Her job was very physical as it required her to climb in and out of semi-trucks multiple times a day as well as operate them which was very strenuous. She went out of work in due to ongoing and severe debilitating right hip, low back, and bilateral knee pain... Read More >

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Our client, Ms. L, formerly worked as a Technology Teacher for a public high school in Massachusetts. For many years Ms. L suffered from chronic debilitating effects of multiple physical conditions and ailments, including most notably severe degenerative joint disease and osteoarthritis, which left her with debilitating physical pain and occupational impairments. Ms. L was unwilling to give up his career and w... Read More >

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Sun Life overturned previous denial of LTD for California Diagnostics Manager

Our client, Ms. G, formerly worked as a Diagnostics Manager for a regional Healthcare System. In October 2016 a number of medical issues, including Stage IV Ovarian Cancer Neoplastic Fatigue, Major Depressive Disorder, Language Disorder and Cognitive Impairment forced Ms. G to stop working and submit her claim for disability benefits under her employer’s long-term disability (LTD) policy, which was funded an... Read More >

Unum and Sun Life approve disability benefits to OB/GYN

Our client, a well-established and experienced, OB-GYN, who had run a successful medical practice before becoming part of a hospital system, began to experience orthopedic problems that are common to doctors whose practices requires a substantial amount of surgical and clinical procedures. Like many surgeons, she attempted to find ways to minimize discomfort in an effort to be able to continue her surgical dut... Read More >

After appeal filed by Attorney Jay Symonds, Sun Life overturned its previous denial of long term disability benefits for Florida ICU Nurse

Our client, Ms. A, formerly worked as a Nurse in the Intensive Care Unit. In September 2014 a number of medical issues, including chronic pain, fibromyalgia, chronic fatigue, neuropathy, bilateral hip pain, bilateral hip bursitis and bilateral knee osteoarthritis forced Ms. A to stop working and submit her claim for disability benefits, first under her employer’s short-term disability (STD) policy and then c... Read More >

Sun Life Approves Disability Benefits to Surgical Services Director

Prior to filing for disability our client worked as a Surgical Services Director for a large hospital system. Her occupation came with an incredible amount of responsibilities relating to the efficient and safe operation of the surgical department of a hospital- requiring her to not only have to be mentally alert, but also physically available on a moment’s notice throughout the hospital. This was a tall ord... Read More >

Sun Life ignored its own medical expert's opinions supporting registered nurse's inability to work in a sedentary occupation due to severe rheumatoid arthritis

Sun Life reinstated LTD benefits after Dell Disability Lawyers appealed wrongful termination of LTD benefits of registered nurse suffering from rheumatoid arthritis demonstrating Sun Life ignored the overwhelming volume of objective evidence supporting the claim for total disability including their own peer review physician's opinions that the claimant could not perform sedentary work.At the time of the on... Read More >
Disability Lawsuit Stories
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Can Sun Life deduct Veterans' Benefits from a monthly disability insurance benefit payment?

The case of Marco Martinez v. Sun Life Assurance Company of Canada (Sun Life) provides guidance in determining whether Sun Life, can deduct Veterans' Benefits from its monthly disability insurance benefit payment to the Plaintiff. In this case, Plaintiff, who was covered under a disability insurance policy issued by his employer and governed by ERISA, began receivin... Read More >

California Court Reverses Sunlife Disability Denial for Woman with Fibromyalgia

In this video, disability insurance attorneys Rachel Alters and Gregory Dell discuss a California Federal Court decision in which a Sunlife disability insurance denial was reversed. Rachel Alters discusses the court’s frustration with Sunlife and finding that Sunlife abused their discretion by denying long term disability benefits after paying for multiple yea... Read More >

Court Remands Sun Life to Consider Social Security's Decision to Award Plaintiff Disability Benefits

In Green v. Sun Life Assurance Co., the issue concerned whether or not the claimant was continuously disabled during the 180-day required elimination period in order to qualify for disability benefits. The plan administrator, Sun Life Assurance Co., was aware that the claimant had been awarded disability benefits by the Social Security Administration (SSA), but failed to review the SSA file or the determinatio... Read More >

Sun Life's Video Surveillance Backfires & is Ordered to Pay Disability Benefits

In the case of Solnin v. Sun Life and Health Insurance Company, et al., the plaintiff, an assistant bank manager, injured her back at work and was initially granted short term disability benefits under her employee benefit plan. The case has an extensive procedural history of Sun Life terminating benefits, adminstrative appeals and at least one previous court case.In this action, in its attempt to discredi... Read More >

Court Rules That Sun Life Did Not Properly Review a Mental Nervous Disability Claim

In this video nationwide disability insurance attorney Stephen Jessup discusses a recent Sun Life long term disability claim in which the court finds that Sun Life failed to conduct a proper evaluation. The claimant that filed for long term disability benefits had a mental nervous disorder.... Read More >

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We get many calls involving claims denied based upon exclusions for losses or disabilities resulting from certain excluded conditions. Common excluded losses are those resulting from pre-existing conditions, suicide or attempted suicide, acts of war, or criminal acts.In a recent case out of Kansas, a federal court was faced with determining whether there was a sufficient causal nexus to deny a claim based ... Read More >

Court Awards Attorney's Fees After Disability Insurance Claim is Remanded Back to Sun Life

When suing an insurance company to recover disability benefits in an ERISA case, the three most likely outcomes by the court are; (1) awarding past benefits, (2) sending the claim back to the insurance company for further review (remand), or (3) finding in favor of the insurance company. The first and second outcomes are a win for the Plaintiff after which the court has discretion to award attorney's fees and ... Read More >

Accountant Punished by SunLife for Working Part-Time During Tax Season

Most long-term disability policies require a claimant not only be unable to perform the material and substantial duties of his or her occupation due to sickness or injury, but they must also be earning less than 80% of their pre-disability income if they are working on a full-time or part-time basis while disabled. If a claimant has applied for disability benefits due to the inability to work in a full-time ca... Read More >

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Get Your Disability Application Approved

Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.

Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the little guy against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

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Who are Dell Disability Lawyers?

We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

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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 insurance 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 phone, email, fax, or video conferencing sessions. 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 insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers 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.

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