Cluster Headaches Long Term Disability Claim Paid by Liberty Life
Our client, a general manager of a large restaurant franchise began to suffer from cluster headaches. Cluster headaches are more intense than migraines but do not last as long as migraines. When he suffered a cluster headache he was unable to do anything due to intense pain. He applied for Long Term Disability (LTD) benefits from Liberty Life Assurance Company (one of the Liberty Mutual companies), and Liberty denied his disability claim.
Liberty Life denied LTD benefits stating that there was no proof that our client’s pain was as intense as he claimed. Liberty also took the position that there were no objective findings to prove he was having the cluster headaches.
In its denial letter, Liberty Life;s disability claim handler wrote that Liberty actually spoke to one of his treating doctors who they claimed had said that our client was able to work.
Not only did Liberty deny the LTD claim, but it also denied our client’s waiver of life insurance premium benefit due to his disability. This is a benefit where the disabled worker is able to keep life insurance coverage bought through the employer at no cost as the life insurance company waives the need for premium payment. Faced with these denials, he called John Tucker and our team of disability attorneys for help.
Bill Demas, one of our experienced disability attorneys investigated the case, and found evidence that Liberty Life had misquoted our client’s treating doctor. There was actually a letter from the treating doctor telling Liberty it was wrong. The doctor had never said that our client could work! He went on to tell them all the problems and limitations of our client, that he felt the issues were real and that our client could not work. That letter was in Liberty Life’s file when then denied our client, their employees literally just chose to ignore it!
Our team prepared an appeal that highlighted the doctor’s letter, as well as several hundred pages of other evidence that was obtained from various sources proving that our client’s condition was real, the limitations were real and that he was unable to work.
Not only did Liberty Life reverse its denial of the LTD benefits, but it also reversed its decision on the life insurance premium waiver claim. Our client was paid past due LTD benefits, and put back on claim, along with reinstating his life insurance policy and continuing to waive any premium payments.