Symetra Reinstates LTD Benefits for Former Vice President of Grady Management, Inc. who suffered from multiple Strokes

Prior to becoming disabled, our client had worked at Grady Management, Inc., a well-respected full service real estate firm in Maryland, since April of 1978. For 37+ years, our client worked for Grady and worked his way up to become the Vice President of Priority Engineering Services. Obviously his work at Grady was more than a job, it was his life. Unfortunately for our client, serious medical conditions interrupted his continued employment and he was forced to stop working in June of 2015.

What caused him to stop working was the fact that our client suffers from hypercoagulopathy disorder which is a disease that is characterized by an increased tendency of the blood to form clots. Other diagnoses include deep vein thrombosis, pulmonary embolisms and he has even suffered from multiple cerebrovascular accidents (strokes). These issues have left him suffering from short term memory loss and impaired cognitive functioning, among other issues.

After 37+ years, our client was forced to stop working. Fortunately, Grady Management provided its employees with coverage under a Long Term Disability Insurance policy and fortunately that policy was with Symetra Life Insurance Company. After leaving work and applying for benefits, Symetra initially approved his claim and in fact paid his claim for a little over two years. Unfortunately, continued benefits were denied by way of a denial letter dated November 1, 2017.

Symetra’s Denial Letter

Symetra’s Policy with Grady Management contained typical policy language that included what is known as the “change in definition of disability.” In this policy (like most group insurance policies with all insurance providers), in order to initially receive benefits a claimant must prove that he or she is prevented “from performing with reasonably continuity the material and substantial duties of your regular occupation…” However, after benefits are paid for 24 months, what it means to be disabled changes. After 24 months of benefits, the claimant then must prove that he/she is prevented “from performing with reasonable continuity the material and substantial duties of any gainful occupation.” As it is clearly tougher to prove that one cannot perform “any gainful occupation”, this is the time period when most insurance companies deny previously approved claims.

This situation was not unique. Armed with the new definition of disability and armed with the opinion of an “Independent Physician Consultant” who performed a review of the medical records, Symetra determined that as of November 1, 2017, the claimant was not disabled from any gainful occupation. Specifically, Symetra stated that he did “not have any restrictions or limitations and that (he had) a full work capacity.” Symetra even stated that there was “no objective physical impairment preventing you from performing any occupation.”

Knowing that Symetra’s conclusions were wrong and knowing that he had no ability to perform any gainful occupation, the claimant knew he needed assistance to fight this denial and he found Attorney Alexander Palamara of the Dell & Schaefer law firm.

Appeal by Attorney Palamara

After reviewing the denial letter, the claim file and all of the medical records, it was clear to Attorney Palamara that there was no way this honorable man who worked for 37+ years for the same company could possibly perform any gainful occupation. Attorney Palamara reached out to numerous treating physicians and each of them could not have been more supportive of the fact that their patient should be deemed completely disabled no matter what the definition of disability should be. Our appeal focused not only on the significant and overwhelming volume of objective evidence that showed each of his diagnoses and their accompanying symptoms and complications, our appeal also utilized the support of the treating physicians who wrote statements that said that our client “has had a history of mini strokes and multiple medical problems that affect his memory and cognition.” The treating doctors opined that “due to his cognitive impairment (our patient) is totally disabled.”

Claim Re-Approval

Thankfully, on the 90th day after the appeal was filed, Symetra reached out to our firm and notified us that our client’s claim was reapproved and that all retroactive benefits would paid as well as ongoing monthly benefits. While our client is happy to be back on claim and getting the benefits he deserves, he knows that the fight will continue. He also knows that Attorney Alexander Palamara will do whatever it takes to keep him on claim. If you have been denied disability benefits by Symetra 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 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.

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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.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

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