Long-Term Disability Success: Reinstating Benefits After a “Any Occupation” Termination

Our client, an Internist at a major New York hospital, had dedicated her career to caring for patients with skill and compassion. Over time, however, she developed multiple degenerative spinal conditions that left her in constant, debilitating pain. Despite her best efforts, she could no longer mask her physical limitations during patient interactions. Her physicians ultimately advised her to stop working—for her own safety and for the safety of those under her care.

Our Client Retained The Law Office of Justin Frankel’s Disability Attorney

Recognizing the seriousness of her situation, she sought out a leading disability insurance law firm to review and manage her coverage, which included individual disability policies with Northwestern Mutual and Unum, as well as a group policy through her employer with First Reliance Standard.

During her consultation with Attorney Justin Frankel, he thoroughly explained the nuances of each policy and answered all of her questions. Confident in his expertise, she retained Attorney Frankel to manage and file her disability claims. Attorney Frankel and team immediately began assembling the medical and vocational evidence necessary to support her claims, carefully tailoring their approach to her specific conditions and the demanding nature of her work as a physician.

Insurers Acknowledge Total Disability

Shortly after filing, Northwestern Mutual, Unum, and First Reliance Standard each approved her long‑term disability claims, acknowledging that she was totally disabled and unable to continue practicing medicine.

Two years later, however, First Reliance Standard terminated her benefits as she transitioned into the “any occupation” phase of her claim, despite the fact that both Northwestern Mutual and Unum continued to recognize her inability to return to work in any capacity. Determined to challenge this unjust decision, Attorney Frankel developed a comprehensive and aggressive appeal strategy.

Challenging the Termination With Medical and Vocational Proof

As part of the appeal, our client underwent additional diagnostic testing to directly refute First Reliance Standard’s conclusions. We collaborated closely with her treating physicians to prepare detailed narrative reports documenting the progressive nature of her spinal conditions and clearly outlining her functional limitations. We also retained a vocational expert to conduct an in‑depth assessment, which objectively confirmed that she was incapable of performing any occupation.

Responding to an Unfavorable IME Report

After the appeal was submitted, First Reliance Standard demanded that she attend an “independent” medical evaluation (IME). The firm agreed only after securing strict conditions, including the right to submit information to the examiner, to respond to any resulting report, and to have a witness present during the evaluation.

When the IME report arrived, it was unfavorable and starkly contradicted the observations of the witness who attended the examination. Because we had preserved our right to respond, we immediately dismantled the IME findings through a detailed affidavit from the witness, exposing the inaccuracies and inconsistencies in the insurer’s report.

Successful Appeal Restores Long-Term Disability Benefits

Our strategy proved decisive. First Reliance Standard reversed its termination and reinstated her benefits. Today, our client continues to receive monthly disability payments from First Reliance Standard, Northwestern Mutual, and Unum. Most importantly, she now has the security and peace of mind she deserves, allowing her to focus on her health without the fear of financial instability.