Our client, a 57 year old Senior Vice President of distribution and manufacturing for a large company located in Illinois, became disabled due to brachial plexopathy, non union of humeral fracture, cervical radiculopathy and carpal tunnel syndrome.
The long-term disability plan was managed by Trustmark Insurance, and the company was self-insured. After the company filed a claim for bankruptcy protection, Met Life became financially responsible for the claim, responsible for handling the claim and the payment of benefits.
After several years of qualifying for benefits under both the original company plan and under Met Life, a paper review was conducted by Met Life. It was determined that she continued to be totally disabled from any occupation and benefits continued to be paid.
Several months later, another paper review of her file was conducted, this time by Reliable Review Services (RSS), a company that does paper reviews for many disability insurance companies. The review from RSS determined that our client was now able to perform full time sedentary work based upon a labor market survey. Her administrative appeal was reviewed by Met Life and subsequently denied.
The Law Office of Justin Frankel was retained to represent her claim, and we filed a lawsuit in the United States District Court. We demonstrated that this review was completely inaccurate and that our client was no more able to work in any occupation at the time of the RSS review as she was when she was first found to be disabled.
Met Life reinstated her benefits and paid her the claims that had been denied.
In a time when companies file for bankruptcy with increasing frequency, employees are right to be concerned about changes in disability insurance coverage. However, when mistakes are made, an aggressive approach to litigation is necessary to fight for benefits.
If your disability insurance claim has been terminated after a review, call us today to learn how we can help.
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