Comorbid conditions are when multiple medical conditions exist at the same time. They are usually not related to each other. Comorbid conditions can make it difficult to prove disability when filing for long term disability insurance benefits. Our client was employed for many years as a manager in a retail store. She had a long term disability insurance policy through her employer with Liberty Life Assurance Company.
She filed for disability insurance benefits in 2013. She was approved and received the benefits for about 3 years. When Liberty Life terminated her disability benefits, our law firm filed an appeal. However, Liberty Life took more time than allowed under ERISA law for deciding an appeal. We then filed a lawsuit in federal court. Because of the lawsuit, Liberty Life decided to pay her long term disability benefits.
Each medical condition she suffered had its own symptoms and required medication. The result of this left her permanently disabled. Our client’s treating physicians have consistently said that she is permanently disabled to due to her comorbid conditions. The laundry list of medical issues include fibromyalgia, chronic pain syndrome, migraines, heart disease and anxiety/depression. One of the more debilitating issues is the migraines. She suffers from about 15 migraine headaches a month. And because of her chronic pain syndrome she can only sit, stand, or walk for 2 hours out of an 8 hour workday. All together, these medical conditions make it impossible for her to a reliable employee.
In the appeal, we argued that our client continues to be permanently disabled from a sedentary occupation due to her comorbid conditions. We provided proof from her doctors indicating the doctor’s recommend less that sedentary restrictions and limitations. This case was difficult because Liberty had extensive medical records which they believed showed that the issues were more mental than physical. In other words, her symptoms were in her head and not real diagnosable medical conditions.
Additionally, Liberty relied upon video surveillance they took of our client. Of the 19 days they watched her, she only left her house on 9 of them. We argued that just because she left her house does not prove she is able to work. Our client never suggested to Liberty that she was bedridden or so severely disabled she cannot move from her home. However, there is a difference between being able to run an errand and being able to consistently work an 8 hour day. Our client, like most disabled people, has some good days. On those good days, she is able to do normal activities such a grocery shop.
Under ERISA, Liberty had 45 days to make a decision, but could take one extension of another 45 days. They did not meet that deadline. We were forced to file a lawsuit against Liberty Life for disability benefits under ERISA. Because of the lawsuit, Liberty returned a favorable decision by reinstating our client’s long term disability benefits.
Because each client’s case is unique and has different facts, results similar to those in other clients’ cases are not guaranteed.
