• Prudential Long Term Disability Denial Reversed for IT Professional with CancerPrudential Long Term Disability Denial Reversed for IT Professional with Cancer

Team lead by Attorney Cesar Gavidia Forces Prudential to Overturn Long-term Disability Denial on Appeal for IT Support Technician Diagnosed with Cancer

Jared was an IT Support Technician before small cell carcinoma in his middle ear caused fatigue, weakness, headaches, dizziness and head pains forcing him to submit a leave from work request and file a long-term disability claim with his employer’s LTD insurer, The Prudential Insurance Company of America (“Prudential”).

Clinical Specialist for Prudential Reviews Medical Records and Finds that Restrictions and Limitations Would Not Prevent Performance of Work Activities.

Aside from the significant emotional and physical issues that arise from a cancer diagnosis, the location of Jared’s cancer in his middle ear produced particularly impairing problems. Fatigue and weakness caused him to tire easily, headaches produced distracting pain causing him to lose focus, dizziness and head pains were equally distracting and made it impossible to focus on the information displayed on his multiple computer screens.

Prudential verified that Jared’s “Usual Occupation” was that of an IT Support Technician and that his job required installing and supporting desktop/laptop hardware and software, computers, office printers and maintaining personal computers. Prudential identified Jared’s usual occupation as being a “light occupation” requiring exerting up to 20 lbs. of force occasionally, and/or up to 10lbs. frequently, and/or a negligible amount of force constantly to lift, carry, push, pull or otherwise move objects.

Following submission of his long-term disability claim, Prudential found that Jared was indeed disabled from engaging in his usual occupation as an IT Support Technician and approved payment of his long-term disability benefit. After approving and paying Jared’s disability claim for approximately 10 months Prudential terminated Jared’s disability claim on the basis that its clinical consultant, whom it did not identify as a nurse or a physician, found that he did not have any ongoing limitations or restrictions from work activities.

Evidence Heavy Appeal Succeeds in Overturning Prudential’s Denial of Long-term Disability Benefits

The Appeal addressed a number of inconsistencies and inaccuracies in Prudential’s denial letter, starting with the fact that Prudential had approved Jared’s disability claim on the basis that his symptoms, which included dizziness, weakness, inability to carry a gallon of milk, inability to stand/walk for longer than 5 – 10 minutes, hearing loss in left ear, hand / leg numbness and difficulty swallowing, had not changed in the nine months since he had been approved. In addition, the Appeal addressed that Prudential had required Jared apply for social security disability benefits so that it could reduce his monthly long-term disability benefit payments, to only baselessly deny his claim after Social Security Disability promptly found a basis to approve him on his initial application. Attorney Gavidia and his team argued that Prudential failed to give the Social Security Disability approval any weight which violated ERISA.

The Appeal also included evidence and opinions from Jared’s treating physician which supported that he was unable to work in his usual occupation as an IT Support Technician. One particularly concerning piece of evidence included a statement from Jared’s treating physician disputing that Prudential had ever contacted him or even attempted to contact him, despite Prudential statement that it had attempted to contact his treating physician.

Within 3 weeks of submitting Jared’s Appeal Prudential notified Attorney Gavidia that it was overturning its decision, paying all back benefits owed and approving Jared for ongoing monthly benefits as long as he continues to meet the definition under the policy. Attorney Gavidia and his team continue to manage the proof of loss requests on a monthly basis and monitor Prudential’s handling of Jared’s claim.

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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   *****

Craig (California)

Cesar and Michal helped me through my case against Prudential. That only touches the surface. I suffered a bad injury which made me a challenge as I often didn’t recall what was said and to whom.

Cesar took the leap of faith to help me but he didn’t treat me like a client but more as if I was part of your family. I don’t know how you were able to get transform the team to have such a great attitude but by far I must say I am treated well from the moment I called, retained your firm it helped me through the minute I faced IME’s. Cesar demonstrates empathy and cares for his clients. I know that I made the right decision to select your firm and am fortunate that firms such as yours are around to help go up against big companies.

I truly am happy to send you a note to advise of my complete satisfaction.

The first and most important matter you have at hand is to take care of your health and let your retained lawyers handle the information needed to not only be approved for long term disability but also to make sure that your claim is managed for the duration of your disability. The disability is a matter that may last a lifetime.

A thorough online yelp review was held prior to conversations with Cesar Gavidia Esq. and Michal Mizrahi from the firm of Dell & Schaefer. I decided to retain them to handle my disability claim. The law-firm has an elaborate web page that demonstrates their ability to go up against all the largest insurance with a stellar track record.

The ERISA law is complex and if you decide to battle the insurance company without representation the odds will be stacked against you. An insurance company has one goal alone and that is to generate profits. The representation of Cesar Gavidia Esq. and Michal Mizrahi were responsible for the successful appeal and approval of my case.

An insurance company typically will deny or delay the claim as the penalty for denial or delay is non-existent. In my case, I was prepared with retained council Cesar Gavidia Esq and Michal Mizrahi who prepared and submitted the ERISA appeal. The document was complete and included information to demonstrate that I was disabled and overturned a previous denial from Prudential.

I’m not only happy to say that I picked the right firm but that I have developed a trusting relationship with combination of Cesar Gavidia Esq. and Michal Mizrahi from the firm of Dell & Schaefer.

Cesar Gavidia Esq. or Michal Mizrahi will pick up calls and take the time to explain what is being done by the insurance company or return the call in a timely basis if they were busy. This was after I had signed to be represented.

I never met Cesar Gavidia Esq. or Michal Mizrahi in person but I consider them my friends versus just attorneys that have been hired.

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