In Lori Smith v. Hartford Life & Accident, 2013 U.S. Dist. LEXIS 13868 (N.D. Cal., January 30, 2013) we successfully represented Ms. Smith in a claim for life insurance waiver of premium benefits. Smith was a bank executive who became disabled by co-morbid conditions as a result of several surgeries on her hands and depression because she could no longer work. Initially, Hartford approved disability benefits and life insurance waiver of premium ("WOP") benefits, but then it terminated both LTD and WOP benefits. After the termination of benefits Smith was awarded Social Security disability benefits. We appealed both denials simultaneously. The LTD appeal asked whether Smith could perform her "own occupation"; the WOP appeal asked whether she could perform "any occupation." Hartford granted the LTD appeal, but denied the WOP appeal. We successfully sued to reinstate Smith's waiver of premium benefit.
A Texas-sized victory
Kathleen Bernardo was employed at American Airline as Manager of Airport services. She was diagnosed with aplastic amenia (low blood cell counts) and treated with cyclosporine, an immunosuppressant drug. She applied for long term disability from the plan which was administered by MetLife. The plan paid benefits for about one year and a half and then terminated benefits. Ms. Bernardo filed two administrative appeals herself. The appeals were denied. At that point she hired the ERISA Law Group to represent her in litigation.
Improper delegation leads preferential review and settlement
Melissa Garner was an employee of an AT&T subsidiary, working as a Marketing Support Specialist. Her job consisted primarily of communicating with customers via telephone and coordinating the provision of various user- related services. She began experiencing aching-type back pain, sought medical treatment, and was diagnosed with degenerative disc disease at L3-L4, L4-L5, L5-S1 and central and annual tears at L3-L4, L5-S1 discs. Ultimately, her doctors recommend surgery, but her medical carrier would not approve it, claiming that the surgery was experimental. In the meantime, Ms. Gardner's claim for disability benefits was denied by AT&T's third party administrator, Sedgwick Claims Management Services.
Bogus surveillance doesn't defeat nurse's claim
The ERISA Law Group represented Deborah Maher in her long term disability claim against her employer, Massachusetts General Hospital. Ms. Maher worked in the Boston area as a Registered Nurse. She developed chronic abdominal pain and related symptoms which her physicians contributed to chronic pancreatitis, pain syndrome, and fibromyalgia. She was prescribed substantial amounts of narcotic pain medications to control the pain. After receiving long term disability benefits for several years the plan administrator, Liberty Life Insurance Company of Boston, terminated her benefits. After Ms. Maher's first appeal was denied by Liberty, she hired us to submit a second appeal on her behalf.
New discovery rules established in the 10th Circuit
The ERISA Law Group represented Aileen Murphy in her long term disability claim against MetLife. Ms. Murphy worked as a Tax Firm Director for Deloitte & Touche, a position which entailed travel, significant interaction and coordination with others, negotiations with the IRS, and advising clients in complex tax matters. She became disabled by co-morbid conditions: a psychiatric condition and a pain condition as a result of severe back problem. The combination of her conditions together with her medications caused fatigue, balance and vision problems, memory and cognitive problems, as well as chronic pain. Her claim for long term disability benefits was denied. She submitted her own appeal, which was also denied. We filed suit on her behalf in district court and propounded discovery regarding MetLife relationship with the doctors who provided reports for MetLife and Ms. Murphy's claim.
