A Delaware Court ruled that MetLife wrongly terminated disability benefits for someone suffering from Chronic Fatigue Syndrome (“CFS”) and Fibromyalgia. A former Vice President of at Bank of America, Ms. Seeman, went out on disability due to CFS and Fibromyalgia.
Initially, the Court found in favor of Ms. Seeman, but could not conclude whether her physical conditions rendered her disabled under the any occupation standard for disability. The case was sent back to MetLife to conduct a review of her claim.
Dabdoub Law Firm helps people around the country who are battling CFS and/or fibromyalgia collect disability benefits they deserve to be paid. If you have a disability claim that is being delayed approval or denied, give us a call to hear how we help.
MetLife’s Disability Denial
MetLife had three independent physician consultants do a paper review. This is when they reviewed all the medical records and documentation in the file without actually examining the claimant. All three physicians concluded that Ms. Seeman was not disabled. They claimed her medical evidence and documentation did not support restrictions and limitations that would prevent Ms. Seeman from working.
Also, MetLife’s vocational experts did not take into consideration Ms. Seeman’s levels of fatigue, loss of concentration, or other relevant factors of her conditions.
Proving CFS and Fibromyalgia Disability
CFS and Fibromyalgia can be difficult to prove. Neither condition can be objectively tested. These conditions are based on subjective complaints, but the treating physician is the best physician to know whether someone is disabled form these conditions.
Ms. Seeman provided evidence of fatigue, trigger points tests for fibromyalgia, and inability to walk, sit or stand for extended periods. MetLife appeared to ignore all this. Her doctors supported her inability to work due to fatigue, pain, loss of consciousness and other effects of her conditions.
MetLife’s consultants found her medical records did not support a disability based on CFS. Specifically, MetLife found that there was no objective evidence of her condition.
MetLife Wrongfully Terminated Benefits
The court found it is an abuse of discretion for an insurance carrier to require objective testing when no such testing is available. It found MetLife cherry picked the medical records and ignored the employability assessments. It noted that one of the physician consultants mischaracterized the opinion of her treating doctor. Picking and choosing parts of the record is self-serving and thus unreasonable.
Having an Experienced Disability Attorney Matters
Because disability insurance law is complicated, it is important to get legal help from a lawyer who focuses on disability law.
As a law firm built to focus disability insurance, all our lawyers spend every day working to get our clients disability benefits from insurance companies.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
If your claim for long term disability benefits was denied or being delayed by an insurance company, call us to speak with a disability insurance attorney.
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