A Man in Pain
Mr. X's ongoing disability has severely impacted his daily life. Imagine waking up each day, knowing that even the simplest tasks will be a monumental challenge. That's the reality Mr. X faces due to his debilitating condition. His maximum Residual Functional Capacity (RFC) falls significantly low, meaning he struggles with even basic activities like sitting, standing, and walking.
For Mr. X, every attempt to carry out simple actions is fraught with difficulty. After testing, his FCE findings were clear and detailed. They showed that his maximum sitting tolerance is only occasional, and his ability to stand and walk is infrequent at best. This disability severely limits his capacity to perform any job listed in the Department of Labor's Dictionary of Occupational Titles (DOT). Mr. X is unable to engage in gainful employment.
Mr. X's overall functional capacity was assessed through grip strength testing. His gripping strength was found to be significantly below normal for a man of his age. The norms for a 46-year-old male are 111 on the dominant hand (DH) and 107 on the non-dominant hand (NDH). Mr. X's gripping strength peaked at only 84 pounds on the right and 78 pounds on the left, a material difference from the norms. This discrepancy, ranging from 24% to 27%, is consistent with the recommendation to restrict Mr. X to only frequent upper extremity grasping activity. It also aligns with his overall weakness in functional lifting.
The repeated testing during the FCE confirmed the accuracy of these measures, lending credibility to Mr. X's condition.
Mr. X's disability has dramatically altered his life. It prevents him from performing any gainful occupation, and the detailed findings of the FCE provide a clear and compelling account of his ongoing struggles.
An Unfounded Decision
Despite the overwhelming evidence of Mr. X's struggles, Prudential sent a notification stating that "... it appears you will no longer be eligible for benefits as of November 1, 2023." This decision came as a shock and frustration to Mr. X, especially considering his well-documented and severe limitations.
This is not the first time Prudential has wrongly and unreasonably denied Mr. X's Long-Term Disability (LTD) claim. Notably, this is the second instance where the insurer questioned his eligibility despite all the substantial proof provided.
A Law Firm Steps In
At this critical juncture, Dabdoub Law Firm stepped in to provide Mr. X with the legal assistance he desperately needed. Recognizing the gravity of his situation, the firm meticulously gathered and presented substantial evidence of Mr. X's continued struggles. They compiled comprehensive medical records, expert testimonies, and detailed accounts of Mr. X's limitations, all aimed at countering Prudential's unreasonable denial of his benefits.
Understanding the complexities of Mr. X's condition and the importance of providing accurate and persuasive documentation, the law firm left no stone unturned. Their dedicated effort underscored the severity of Mr. X's disability and the insufficiencies in Prudential's assessment process.
With the irrefutable, the firm presented Mr. X's case clearly and compellingly, addressing every detail of his condition and its impact on his daily life. This robust presentation forced Prudential to reevaluate its decision.
Ultimately, the firm’s intervention proved decisive in helping Mr. X regain the benefits he needs to manage his condition and live with a measure of dignity. This relentless advocacy restored Mr. X's benefits, and it highlights the need for insurance companies to approach claims with fairness and thoroughness. This truth is especially clear when dealing with individuals whose lives are profoundly affected by their disabilities.
Disability Insurance Companies Have Lawyers. Shouldn’t You?
Because this law firm was created to focus on disability insurance, we have developed an expertise in this complex area of the law.
Our expertise in long-term disability claims means our clients have the backing of a law firm that has attorneys who:
- are experts in disability claims;
- fought all major disability insurance companies and know their tactics;
- a track record of success;
- won major disability lawsuits that created good law; and
- recovered millions of dollars in disability benefits.
All our lawyers commit every day of their legal career to helping people get disability benefits from MetLife, UNUM, Prudential, Northwestern Mutual, Hartford, CIGNA, and others.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help. We help clients nationwide.
Call to get experienced disability lawyers on your side with:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; and/or
- Filing a lawsuit against your disability insurance company.
If you are facing unfair decisions from an insurer, Dabdoub Law Firm can help you, too. Consultations are free, so contact us online or call our office at (800) 969-0488 today.
