A Maryland federal court found it was unreasonable for Reliance Standard to terminate disability benefits for a Senior Systems Engineer who suffered from Long-Haul COVID.
Background
Christine Ward became disabled in 2021 after contracting COVID-19 and experiencing long-haul symptoms. Ms. Ward’s long-COVID syndrome symptoms caused her to stop working in her position as a senior systems engineer at the MITRE Corporation.
Ms. Ward’s work involved high-level information technology-related systems to Medicaid and Medicare as well as the Department of Defense. Ms. Ward received short-term disability benefits and was initially approved for long-term disability benefits.
In support of her disability claim, Ms. Ward provided a variety of medical evidence including a neuropsychological exam, office visit notes from various specialists including speech pathologists and a physical medicine and rehabilitation doctor, among others.
During this time, the Social Security Administration (“SSA”) also approved her disability benefits in March 2022 retroactive to her date of disability, citing to Ms. Ward’s neurocognitive disorders and determining she was limited to “simple work.”
Reliance Standard, however, terminated Ms. Ward’s long-term disability benefits effective October 2022 claiming Ms. Ward’s condition had improved. Ms. Ward appealed the termination, which Reliance Standard denied. Reliance Standard based its termination and its appeal denial on paper record reviews by its medical consultants. In other words, they never had her examined in person.
Ms. Ward was left with no choice but to file a lawsuit for her LTD benefits against Reliance Standard.
The Court’s Review of the Evidence
The court engaged in a thorough review of all the evidence. It first started with a review of Ms. Ward’s medical condition and records. Reliance Standard made several arguments about the evidence that, it believed, showed her condition had improved.
For example, Reliance Standard argued that Ms. Ward
(1) had no strong clinical evidence of functional impairment,
(2) reported improvement in her symptoms, and
(3) went on a three-week long international trip, which showed her ability to function.
The court rejected all those arguments. It noted that overall, Ms. Ward’s records showed that she still continued to have symptoms of fatigue, brain fog, and trouble concentrating—albeit variable.
None of Ms. Ward’s records showed sustained improvement. The Court also noted that international travel was not inconsistent with disability.
Thus, based on an overall review of the medical evidence, the court found that Reliance Standard was wrong and unreasonable to terminate Ms. Ward’s long-term disability benefits.
This case is a good example of how insurance companies can flip the switch after approving a disability claim despite no evidence of change or improvement. Having a long term disability insurance lawyer who understands the law and how disability insurance companies operate is helpful in fighting back against these insurers.
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