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MetLife Approves Disability Insurance Benefits for Sufferer of Multiple Orthopedic Ailments

November 5, 2012

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Our firm was recently successful in obtaining long-term disability benefits for a client insured by MetLife. Ms. R suffered from acute back pain which included cervical spondylosis, cervicalgia, and migraines. She also suffered from various sleep problems, which only made her spinal pain worse. After determining she was unable to perform the duties of her own occupation, Ms. R ceased working and submitted a claim for long-term disability benefits to MetLife. After reviewing medical documentation, MetLife concurred she was unable to work and approved her claim. After receiving benefits for only five months, MetLife cut her off, alleging she no longer met its definition of disability. Her disability benefits were cut off when she needed them most. MetLife provided no basis for its termination, other than a written report prepared by its in-house physician.

Ms. R contacted our firm seeking assistance in filing an appeal of MetLife’s adverse benefits determination, which is required of all claims governed by the Employee Retirement Income Security Act (“ERISA”). We obtained pursued several pieces of documentation, including a Functional Capacity Evaluation, supporting letters from her treating physician and other relevant evidence supporting her claim. Our appeal resulted in MetLife reversing its prior decision to terminate benefits. Her monthly disability benefits have now been restored without the need of a lawsuit.

Ms. R contacted the Law Office of Shawn E. McDermott to assist in the filing of his appeal of denied benefits, to ensure the proper presentation of his claim ot the insurance company. Attorney Heather Petitmermet and Legal Assistant Emily Fourcroy worked on her claim, gathering and analyzing information they knew would be needed by the insurance companies in order to establish his claim for benefits. These efforts paid off rather quickly for our client.

Categories: Colorado, Disability, ERISA Claims, Insurance

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