Disability Settlement: Disability Insurer Caves In and Settles Rare Blood Disorder Disability Case
A large national disability insurance company denied our client’s Long Term Disability benefits after he was forced to stop working due to a rare blood disorder. His condition left him unable to be in close proximity with others. Our client literally could not leave his house for more than short periods of time, because he was susceptible to infection, and the smallest infection could spell life or death for him.
His job duties required him to work in a busy office that housed over 600 employees. He could not work from home, and had no way to limit his encounters with others. Can you imagine how he could do his job if his doctors were ordering him not to leave his house? Apparently, the disability insurance company could.
The LTD company had a private investigator conduct surveillance on our client. Of course, they barely got any! The private eye conducted a whopping 7 minutes of surveillance over the course of 4 days. Why? Because our client could not leave the house! The surveillance literally confirmed what our client was reporting as his limitations. However, because he had not been prescribed a life support system like the “boy in the plastic bubble,” the disability insurer ignored his limitations and denied his benefits.
Our client went looking for a disability lawyer, and when our experienced ERISA disability attorneys got involved in the claim, we found out that the LTD adjuster had searched the country trying to find a doctor who would give an opinion that our client was not disabled. The disability claim rep literally contacted over 20 potential compulsory medical examiners. She finally selected one to do an exam.
Amazingly, the doctor hand-picked by the insurance company actually agreed with our client’s doctor’s restrictions! The LTD insurance company then had the gall to ask their doctor to change his favorable opinion. They wanted their doctor to leave out his opinions about our client’s restrictions, and only comment on his sitting, standing, and lifting capabilities. Of course, those were not the reason why our client was disabled.
As part of our thorough ERISA claim investigation, we found the smoking gun emails between the LTD claim representative and the vendor that hired their doctor asking that the opinion be changed. We appealed the denial for our client, using that evidence and other information we found in our ERISA investigation which showed the disability company was violating its fiduciary duty by denying the claim. The disability insurer actually went looking for a second doctor to review the file. That doctor also agreed with our client’s doctors. Despite two of the insurer’s doctors explaining that our client could not work, the LTD adjuster handling the appeal upheld its disability denial.
Our team of ERISA disability insurance attorneys filed a lawsuit on behalf of our severely disabled client. Through the work of extensive written motions, a battle over discovery in which the insurance company fought having to produce documents, and after months of negotiations, Disability Attorneys John V. Tucker and Amy Ray were able to get the disability insurance company to make a substantial settlement offer that was accepted by our client.
RESULT: Substantial Confidential Settlement.