Our office is proud to announce another one of many recent successful appeals submitted to insurance companies in which long-term disability benefits were reinstated. On this Prudential disability denial, we represent a gentleman suffering from numerous medical conditions, including Meniere’s disease, Benign Paroxysmal Positional Vertigo, Syndromic Sensorineural Hearing Loss and Oscillopsia.
Mr. H had been receiving long-term disability benefits from Prudential for just under two years when Prudential terminated his benefits as it determined he was now capable of performing the duties of not only his but any occupation, even though his claim was still in the own occupation period. In attempting to justify the termination of benefits, Prudential ignored the opinions of Mr. H’s treating physicians and rendered its decision based in part on the opinions of its own in-house reviewing physicians, who arbitrarily determined restrictions and limitations without considering the medical evidence.
In addition, Unum also based its decision to terminate on a surveillance video that we successfully argued, through expert testimonials, was not relevant to the determination of his functional abilities.
Mr. H contacted our firm for assistance in preparing an ERISA long-term disability appeal. We obtained substantial evidence in support of his disability claim, including opinion letters from his treatment providers and numerous testimonial letters from family, friends and previous co-workers, attesting to his limited ability to function and hold down full time employment. After reviewing the appeal, the adverse benefits determination was overturned, and Mr. H’s long-term disability benefits were reinstated. Our office will continue to oversee this claim for Mr. H with a goal of preventing a future denial of benefits.
If you need assistance in submitting a thorough, well-prepared ERISA disability appeal, or require assistance with a claim under your private long-term disability insurance policy, please contact McDermott Law.