MetLife Overturns Prior Disability Denial in Support of Appeal

Ms. A, a highly educated professional woman, was involved in two separate car accidents (one in 1992 and one in 2002) and was later bucked off a horse in 2009.  Over time, the effects from these different injuries compounded and progressed, eventually causing severe pain that is now nearly constant.  Ms. A currently suffers from cervical post laminectomy syndrome, cervical facet arthropathy, radicular pain, myofascial pain syndrome, chronic pain syndrome, chronic neck pain, degenerative disc disease, and fibromyalgia.

Despite all efforts to avoid leaving her career, Ms. A ceased working due to her health conditions.  Given her inability to continue performing her required work duties, she applied for Long-Term Disability (“LTD”) benefits under her Metropolitan Life Insurance Company (“MetLife”) policy.  Despite clear opinions from medical providers regarding her inability to fully function, MetLife denied Ms. A’s claim.  In denying these benefits, MetLife claimed that she did not meet the required definition of “Disability/Disabled” under the usual occupation provision.

The disability attorneys and paralegals of McDermott Law, LLC, who handle ERISA governed as well as non-ERISA disability claims, assisted Ms. A in submitting an appeal of MetLife’s adverse benefit determination.

We pulled together and provided MetLife with substantial medical, vocational and other evidence in support of her claim.

MetLife correctly determined that Ms. A did in fact meet the definition of disability, reversed its prior decision, and Ms. A’s benefits were approved.  A lawsuit was avoided.

This client is currently on claim and receiving LTD benefits from MetLife as was promised by the policy of insurance.  The team at McDermott Law, LLC will continue to oversee her claim with a goal of preventing a future denial of benefits by MetLife.

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