Prudential approves an appeal after terminating our client’s long-term disability benefits based on surveillance of the wrong person. We filed an appeal on behalf of our client whose disability benefits had been wrongly terminated. He was on claim and receiving benefits for about 14 years when Prudential conducted a review which lead to the termination of benefits.
Our client worked as a cleaner in Connecticut which required upper body motion, incling use of both his right and left arms. Due to his medical conditions he is limited in the use of his left and right arms which prevented him from working as a cleaner.
Our client suffers from osteoarthritis and poliomythis of the shoulder. He also has degenerative disc disease. All of his conditions affect his upper body and make it difficult for him to function. He has limited range in motion, weakness, and pain. For 14 years, Prudential agreed he was entitled to disability benefits, but still decided to send him to an independent medical examination (IME) with a doctor and conducted surveillance.
The IME lasted about five minutes where the doctor did a very brief examination of the claimant. The doctor determined that he was not functionally limited and was able to work. The surveillance footage showed a man driving a car, carrying paint buckets (which may have been empty), and walking up and down stairs. It appeared at one point during the video that he may have been working as a painter. Based on this, Prudential terminated his disability benefits.
We filed the initial appeal and provided additional medical evidence showing he is still disabled. However, Prudential still stood by their decision and denied the appeal. It came to our attention after we filed our initial appeal that the surveillance footage was of a different man. It was not our client. We then filed a second voluntary appeal and provided proof it was not him in the video. We also provided more medical evidence showing his condition worsened and demanded Prudential immediately approve his disability benefits.
After receiving our second appeal, Prudential overturned their termination and reinstated our client’s benefits.
