The Tenth Circuit Court of Appeals held Reliance Standard Life Insurance Company’s termination of long-term disability benefits based on surveillance of the claimant was proper and reasonable.
Background
Dana Gielessen was a physical therapist assistant (“PTA”). Through her employment, she was covered under a long-term disability policy. In April 2016, she took leave from work to undergo cochlear implant surgery. She would never recover.
Following her surgery, Ms. Gielessen began to experience significant problems with her balance. Unable to work as a PTA, she filed a claim for long-term disability (“LTD”) benefits with Reliance Standard.
In May 2017, Reliance Standard approved Ms. Gielessen’s claim for benefits finding she was disabled from her job as a PTA. Then, in October of 2018, Reliance approved Ms. Gielessen’s any-occupation benefits – it recognized she couldn’t even perform desk work due to her balance issues.
While on claim and receiving disability benefits, Reliance Standard ordered surveillance of Ms. Gielessen. Surveillance is a common tactic used by insurance companies to catch claimants engaging in activity inconsistent with their reported activity levels.
The surveillance showed Ms. Gielessen doing the following:
- Walking her dog with a widened gait but without an assistive device (like a cane)
- Walking up two steps onto the front porch of a home without an assistive device
Based on these videos, Reliance Standard terminated Ms. Gielessen’s benefits concluding she “had no limitations with balance, walking, or bending and you do not need assistance with these activities.”
Ms. Gielessen appealed the termination of her benefits and submitted evidence to Reliance Standard pushing back against the surveillance. Still, Reliance Standard denied her appeal based on a medical record review completed by its paid reviewing physician.
Lawsuit against Reliance Standard
Ms. Gielessen sued Reliance Standard. The trial court ruled for Reliance Standard. So, Ms. Gielessen appealed to the Tenth Circuit Court of Appeals.
The court held that the only relevant evidence to address was the surveillance videos used to terminate benefits. In other words, the court solely analyzed whether Reliance Standard was justified in terminating benefits based on the surveillance.
The court was persuaded by the videos and found that Ms. Gielessen can walk briskly and steadily for at least twenty minutes – bringing into question whether her balance impairments truly resulted in her disability. The court found Reliance Standard properly relied on the videos and ruled against Ms. Gielessen.
This is a cautionary tale. You should be aware that your insurance company may be watching you to try and catch you doing things you claim not to be able to. Despite this case, there are many cases out there where courts have stated that surveillance of someone doing minimal activity does not mean they are capable of full-time work.
Our attorneys are familiar with all major disability insurance companies and their attempts to use surveillance as a means to deny benefits. We know how to fight back against this surveillance and can help you with your claim for benefits.
Lawyers with Expertise in Disability Insurance and Life Insurance Claims
Because we specialize in long-term disability and life insurance claims, our clients get the benefit of:
- Having an attorney who is an expert in ERISA claims and appeals.
- Having an attorney who has experience with every major disability and life insurance company.
- Being backed by a law firm with a proven track record of winning tough disability and life insurance lawsuits.
Choose Dabdoub Law Firm to get experienced lawyers on your side.
We can help with:
- Submitting and managing disability insurance and life insurance claims.
- Appealing long-term disability denials and lower court decisions.
- Negotiating lump-sum settlements and life insurance payouts.
- Filing a lawsuit against your employer and/or disability or life insurance company.
Call (800) 969-0488 to request a free consultation with a disability attorney.
