Facing Denied Long-Term Disability Benefits by United of Omaha/Mutual of Omaha?
If your long-term disability (LTD) benefits have been denied or terminated by United of Omaha/Mutual of Omaha, you might be wondering what steps to take next. The ERISA Law Center is here to assist you.
Understanding ERISA and Non-ERISA Claims
Most disability benefit claims are governed by ERISA. Some disability benefit claims, those based on government plans and some church plans, are not governed by ERISA. Either way, the ERISA Law Center can help you. We regularly represent persons who have been denied both ERISA and non-ERISA disability benefits by United of Omaha/Mutual of Omaha.
Common Patterns in United of Omaha/Mutual of Omaha’s Long-Term Disability Benefit Denials
Incomplete Documentation
Long-term disability benefit claims denied by United of Omaha/Mutual of Omaha often follow a common pattern. Sometimes United of Omaha/Mutual of Omaha denies disability benefits because you or your doctors did not complete and submit the forms or medical records they requested. You can often fix that problem yourself by completing the forms, seeing your doctor, and getting your doctor to do complete forms, and provide medical records.
Limited Medical Record Review
Sometimes United of Omaha/Mutual of Omaha denies LTD claims without paying any benefits or after paying only short-term disability benefits. A common practice in such denials is that United of Omaha/Mutual of Omaha only obtains a few months of your medical records and does not get records from all of your doctors. Then its in-house doctors and nurses “cherry pick” those records, resulting in a denial of your benefits. You can sometimes correct that problem yourself by submitting all of your medical records and having one or more of your doctors provide letters explaining why you cannot work.
Changes in the Definition of Disability
In most United of Omaha/Mutual of Omaha disability policies, the definition of “disabled” changes after you receive 24 months of benefits. For the first 24 months, you are entitled to benefits if you are unable to do your own occupation. After 24 months, you are entitled to benefits only if you cannot do any occupation. United of Omaha/Mutual of Omaha will often terminate disability benefits with just a few months of “own occupation” benefits to be paid. Another common pattern is that United of Omaha/Mutual of Omaha terminates benefits after paying all the “own occupation” definition of disability benefits.
Long-Term Disability Denials Based on Similar Job Capability
Often United of Omaha/Mutual of Omaha will deny or terminate long-term disability benefits during the “own occupation” definition of disabled not because it claims you can do your own job but because United of Omaha/Mutual of Omaha claims you can do a similar job. Most United of Omaha/Mutual of Omaha policies define “your occupation” not as what you actually do for your employer but what people doing similar jobs generally.
Transition to “Any Occupation” Definition
Most United of Omaha/Mutual of Omaha disability policies have a change of definition to the “any occupation” definition after you receive 24 months of benefits. Often United of Omaha/Mutual of Omaha terminates benefits at the end of 24 months, claiming you can do some other job. Often the jobs United of Omaha/Mutual of Omaha claims you can do are make-believe. Often the wages United of Omaha/Mutual of Omaha claims you can earn are also make-believe. But, United of Omaha/Mutual of Omaha has a report from a vocational expert – employed by United of Omaha/Mutual of Omaha who says you can perform these jobs and earn these wages.
The Appeal Process
When United of Omaha/Mutual of Omaha denies or terminates long-term disability benefits, it invites you to request a review and file an “appeal.” Typically, after the appeal is submitted, United of Omaha/Mutual of Omaha obtains new medical or vocational reports and invites you to review those new reports and comment on them. When you only have a few months left of benefits under the own occupation standard and it denies those benefits, it forces you to do a full appeal and to comment on its new medical and vocational reviews for just a few months’ benefits – and then typically denies benefits again when the definition of disabled changes to the any occupation definition.
Long-Term Disability Denials and Surveillance Tactics
Sometimes United of Omaha/Mutual of Omaha pays disability benefits for the entire own occupation period and then for many years under the any occupation definition of disabled. Sometimes you can go for years without United of Omaha/Mutual of Omaha ever requesting new medical records – just an annual statement from you and your doctor that you continue to be disabled. But then United of Omaha/Mutual of Omaha terminates your LTD benefits even though you have never gotten better.
United of Omaha/Mutual of Omaha uses a variety of medical professionals – nurses and doctors it employs and nurses and doctors employed by others to review your records. These nurses and doctors often “cherry pick” your medical records – picking bits and pieces out of context to support the conclusion that you are capable of working.
Sometimes United of Omaha/Mutual of Omaha will require that you attend a “independent medical examination” or a “functional capacity evaluation.” Often United of Omaha/Mutual of Omaha secretly surveils you while you are going to and from these examinations and on the days before and after these examinations – and then claim that because you can walk to your car, drive your car, and maybe fill it with gasoline, you are capable of working.
Lack of Consistent Claims Practices
United of Omaha has represented that while it has a claims manual, it hasn’t used it in more than five years. This means that, in effect, there are no rules or practices which its claims and appeals personnel are required to follow. That demonstrates that United of Omaha decides claims for long-term disability benefits in an erratic an unfair manner. Historically, United of Omaha used inside doctors to make final decisions on appeals, which meant that those appeals were almost always or always denied. New ERISA regulations applicable to almost all claims probably should stop that, although may not.
Your Rights and Legal Support For Denied LTD Claims
The law – whether ERISA or if not an ERISA claim, state law – gives you the right to fight back to recover your long-term disability benefits. The ERISA Law Center can help you. We know the law. We know United of Omaha/Mutual of Omaha’s common practices. We know what evidence you need to demonstrate either to United of Omaha/Mutual of Omaha or in court if your internal appeal is not granted to recover your disability benefits.
Don’t Face Denied LTD Benefits Alone: Let Us Advocate For You
If you are facing a denial of your long-term disability benefits, don’t navigate this complex process alone. Contact the ERISA Law Center today at 559-549-6490 or by filling out our online form. Our experienced long-term disability lawyers are ready to help you fight for the benefits you deserve. Call us now for a consultation.
