MetLife (Metropolitan Life Insurance Company) had to seemingly ignore a veritable stack of medical evidence that proved disability when it decided to terminate a woman’s long-term disability benefits early. In a case led by Attorney Geannina Burgos, Dabdoub Law Firm was able to challenge the early termination, insisting that the insurance company take a careful and full look at her medical history and all the statements of her treating physicians. The termination was reversed.
Details of the Sicca Sjogren Syndrome Case
When she was only 30 years old, our client had to stop climbing the corporate ladder because symptoms of Sicca Sjogren Syndrome, a rare chronic autoimmune disorder, were becoming too painful. Each day, she suffered from chronic fatigue and cognitive impairment that made even sedentary work impossible. MetLife’s physician-consultant Dr. Angelica Shepard reviewed her LTD claim, recognized her disability, and approved the benefits without interruption. Yet later, the insurance company would abruptly reverse its own decision and end those benefits early.
Upon the first review of the case, Attorney Burgos found report after report and page after page of medical evidence that pointed to our client’s disability:
- An independent neuropsychological evaluation (INE) determined that she had problems with fine motor coordination, executive functioning, memory and recall, speed and language functioning, and more.
- Another doctor performed a Neuropsychological File Review (NFR) to scrutinize the results of the INE and concluded that the original evaluation was accurate and comprehensive; furthermore, the author of the NFR elaborated on its findings by saying that our client has a “constellation of cognitive deficits [that] greatly interfere with meeting the time and productivity demands of any form of employment for the foreseeable future.”
- Even a functional capacity evaluation (FCE) that included physical therapy tests concluded that our client “does not appear to exhibit functional capabilities consistent with that required to perform any work on a full-time bases [sic] at the sedentary category.”
The medical evidence of disability continues, though.
- Another independent occupational therapist reviewed the FCE and agreed with its findings.
- Also, an independent double-board certified internal medicine and infectious disease specialist performed an evaluation of our client’s records and concluded that our client has a “poor prognosis for improvement.”
- An independent board-certified rheumatologist also agreed that our client’s Sjogren’s disease complications are legitimate and disabling.
With so much medical evidence available to show her disability, how did MetLife determine she was fit to start work again? The insurance company’s reasoning is bizarre, and perhaps it did not properly review the medical evidence. Attorney Burgos used direct language to inform MetLife that it could either approve the LTD benefits again or meet the reputable trial lawyers of Dabdoub Law Firm in court. We are proud to say that the long term disability claim was approved and benefits were once again paid.
Lawyers with Expertise in Disability Insurance Claims
This law firm has always focused only on disability insurance law. Because we specialize in long-term disability, our clients get the benefit of:
- Having an attorney who is an expert in long-term disability claims;
- Having an attorney who has experience with every major disability insurance company; and
- Being backed by a law firm that has a proven track record of winning tough disability lawsuits.
Call the Dabdoub Law Firm to get experienced disability lawyers on your side. We can help with:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
The firm represents clients nationwide with disability claims governed by federal law, even if we are not located in your state.
Call (800) 969-0488 or contact us online to speak with an experienced disability attorney. Pay no fees or costs unless you get paid.