An employee of 3M Company as a Key Account Manager for 30 years, the claimant was shocked to find out that his security net disability insurance plan was not so secure when Sedgwick Claims Management failed to meet its obligations to provide him disability benefits should he become disabled while working at 3M Company. With no other options available to resolve his issue with 3M Company and Sedgwick, the claimant engaged the services of a disability attorney and filed a lawsuit against 3M and Sedgwick, alleging ERISA violations, on May 27, 2011 in the United States District Court of Minnesota.
The claimant’s Disabling Condition Documented
Diagnosed in March 2010 with “pain in his right foot and great toe; insomnia; numbness and tingling in his right hand, fingers and arm; hallux limitus, right foot; osteoarthritis of his right foot; right first MTP DJD; status post chilectomy, right great toe; and irregular heartbeat” and in ensuing months, “depression NOS; anxiety NOS; generalized anxiety disorder; and panic disorder” as well as a “history of cervical spine surgeries,” the claimant had had enough after a foot surgery in April of 2010. Consequently, upon the advice of his treating physicians and their documented opinion that the claimant is unable to “perform all material duties of his regular occupation, or of any other reasonable and appropriate occupation,” the claimant ceased work and applied to Sedgwick for his short and long term disability benefits.
The claimant’s Disability Benefits Payments Terminated
Initially, the claimant did receive his short term disability benefits payments from Sedgwick. However, after three months of receiving those benefits, the insurer terminated the claimant’s benefits effective June 21, 2010. In his Complaint the claimant and his disability attorney allege that Sedgwick terminated his disability benefits in violation of the terms of his policy and asked for a copy of the plan. In violation of ERISA 29 CFR § 2560.503-1, Sedgwick provided the claimant with only a Summary Plan Description instead of the complete Plan that is required by law. And even though the claimant wasn’t privy to the complete requirements of an appeal with the insurer, he filed an internal appeal of his short term disability benefits which were denied again and again.
The claimant, still with limited access to his disability policy’s procedures and requirements requested his long term disability benefits and was denied without any reason given for the denial by Sedgwick.
The claimant And His Disability Attorney File A Complaint In District Court As A Last Resort
Consequently, the claimant and his disability attorney allege that Sedgwick “failed to provide a full and fair review” of the claimant’s claim and did not give the claimant a reason for the denial as is required by ERISA, 29 U.S.C. § 1133. The claimant seeks a judgment against 3M and Sedgwick for “the of his short term disability benefits remaining under the 3M Short Term disability Policy… his rights to future long term disability benefits… interest on accrued benefits, and attorneys’ fees, costs” and other expenses.