A Woman in Need
A recent client of ours had a long history of working in the disability field. Working out of Flint, Michigan, she moved her way up to being a team leader for her company. She was aware of the signs when her own health issues kept her from performing her duties.
Unfortunately, many health issues hit her at once. She suffered from osteoarthritis, lumbar spondylosis, scoliosis, and more. These issues caused chronic pain, sleep apnea, hypertension, and worse.
Our client tried to work from home and even attempted to do her job in a prone, lying position. Nothing helped. Her illnesses were obstructing her functionality, and presently, there are few indications that she will fully recover.
Our client allowed herself to be seen by several medical experts, and the opinions were unanimous. Doctors concluded that her condition would force her to be “off-task” at least 25% of the time. She would be expected to miss at least four days of work each month to manage her ailments. The professionals agreed that our client was not faking her issues. Her pain was as bad as reported. Most importantly, her body simply wouldn’t allow her to work a sedentary job, which her occupation requires.
Naturally, she applied for long-term disability (LTD) from her insurer, Mutual of Omaha. Inexplicably, the company turned her down.
An Unjust Denial
As our firm began investigating her claims, it became clear that her insurer ignored the clear evidence of her disability. According to her FCE (functional capacity evaluation), our client “put forth full effort” in her treatment. There simply was no reason to believe she had brought any of the pain upon herself.
Mutual of Omaha was given three independent evaluations of our client's condition, each backing up the other. Moreover, our client provided medical records and other supporting evidence to prove her claim.
None of this mattered to the insurer. Instead, they relied on the opinions of their reviewers, people on their payroll. Our firm concluded that the insurer’s doctor selectively reviewed the records, made one brief phone call to her, and denied the validity of her claim. To us, it was clear that the insurance company cherry-picked the information it wanted and made its decisions from there.
A Firm Defending the Law
To combat this clearly unfair denial, our team went to work. Many laws are written broadly, and it is often necessary to rely on prior rulings to support your position. Pouring through prior LTD decisions, we found example after example that proved the insurer’s denial was unjust.
For instance, a 2004 ruling states that an FCE is “the best means of assessing an individual’s functional level.” These are the very assessments that the insurer ignored. Our team also uncovered decisions that show “bare conclusions are not a rationale” for LTD denial. A company that denies LTD must provide reasonable evidence to do so. Mutual of Omaha did none of this, issuing a simple denial by mail with little rationale.
Based on what we saw, it appeared that the insurer would be satisfied only if our client was completely bedridden. As we discovered, this is not a standard that can be reasonably upheld.
Help From a Lawyer with Expertise in Disability Insurance
Disability insurance law is complex, which is why you should hire an experienced disability attorney to handle your claim. Because all disability lawyers at this law firm focus on disability insurance claims, we have expertise in disability insurance law.
That means we have:
- Experience with every major disability insurance company.
- A proven track record of success in major disability lawsuits.
- Recovered millions of dollars in disability benefits for our clients.
Further, we never charge fees or costs unless our clients get paid.
Dabdoub Law Firm can help at any stage of your disability insurance claim, including:
- Submitting your disability insurance claim,
- Appealing a long-term disability denial,
- Negotiating your lump-sum settlement, or
- Filing a lawsuit against your disability insurance company.
Federal law applies to most disability insurance claims, so our lawyers can represent clients across the country. No matter where you are located, we can help.
Call us at (800) 969-0488 or contact us online to speak with an experienced disability attorney. Consultations are free.
