Suffering from multiple medical conditions and unable to function in a daily job, a health care professional and her Texas disability lawyer filed a lawsuit against Reliastar Life Insurance Company to force the insurer to pay disability benefits as contracted in an employee welfare benefit plan.
Cynthia O., a “RN Bariatric Clinical Coordinator,” stopped working on January 29, 2009 due to “fibromyositis, fibromyalgia, chronic fatigue syndrome, depression, agoraphobia and panic disorder.” In addition, the medications that Cynthia was prescribed to cope with the symptoms of her maladies cause cognitive functioning problems and sedation effects.
Claimant and her disability lawyer file lawsuit per ERISA
Fully qualifying as a totally disabled per the terms of her employee benefits disability plan, Cynthia should be receiving her entitled disability benefits from Reliastar, but has been denied her benefits. According to the complaint that Cynthia’s lawyer filed on August 25, 2011 in the United States District Court for the Southern District of Texas Houston Division, the insurer violated Cynthia’s disability plan provisions and ERISA (the Employee Retirement Income Security Act of 1974) by denying Cynthia her rightly deserved disability benefits.
Basis of disability benefits case
In the complaint Cynthia’s disability lawyer notes that Reliastar has wrongfully denied Cynthia her disability benefits because:
- Cynthia is totally disabled and cannot perform her job duties;
- The insurer failed to “afford proper weight to the evidence in the administrative record showing that [Cynthia] is totally disabled;
- Reliastar did not apply the definition of disability as laid out in the plan that Cynthia was a beneficiary of;
- Reliastar’s denial of Cynthia’s disability claim is “unreasonable, arbitrary, and capricious”; and
- Reliastar’s has “violated its contractual obligation to furnish disability benefits to” Cynthia.
Background of Reliastar claimant’s pursuit of disability benefits
Cynthia is 57 years old and was previously employed by St. Joseph Health System. Due to degenerative and traumatic injuries, Cynthia ceased working at St. Joseph as a RN Bariatric Clinical Coordinator on January 29, 2009, filed a claim for short term disability benefits with Reliastar and was denied disability benefits. Cynthia was further denied long term disability benefits from the insurance provider and after using all her administrative remedies, providing ample medical records that verify her disabled condition as well as evidence of her Social Security Administration favorable disability decision, Cynthia was forced to engage a disability attorney to take her case to a Texas District Court.
Claimant’s demands of Reliastar
In their complaint Cynthia and her lawyer accuse the insurer of wrongfully denying Cynthia her disability benefits in spite of medical evidence proving her disabled condition and ask the District Court to:
- Grant Cynthia declaratory relief by finding declaring that she is entitled to injunctive relief in the form of short term and long term disability benefits from Reliastar;
- Order the insurer to reimburse Cynthia for attorney’s fees while pursuing her lawsuit; and
- Award Cynthia “such other relief as may be just and appropriate.”