February 2014 Archives

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 Center to represent her in litigation.

Win In Smith V. Hartford

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.

Back Problems? It May Be More Than You Think

The pain may be so constant that you have learned how to forget about it. Until you drop something on the floor. All of a sudden, bending over becomes a painful and frustrating ordeal. You felt this pain a while ago, but you have disregarded it until it dulled into a chronic ache. All of these may be a sign of disc problems.

Improper Delegation Leads Preferential Review and Settlement

Melissa Gardner 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.

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Erisa Law Center

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