Liberty Mutual Reverses Parkinson’s Disease Disability Denial
Our client, a warehouse worker had Parkinson’s Disease and developed increasing symptoms over time. Her tremor became very significant, and her stamina was hampered by ever-increasing fatigue. Her employer had a Long Term Disability benefit plan, and he finally got to the point that he had to file a claim for LTD benefits. She did not realize it until she filed the disability claim, but her employer purchased a group disability policy from Liberty Life Assurance Company, a Liberty Mutual company.
Liberty Approved Claim for Two Years Based on “Own Occupation” Disability
When she applied for LTD benefits, Liberty Life recognized the severity of her condition and paid her claim. Under her employer’s group disability plan, employees qualify for disability during the first 2 years of disability if they cannot perform the duties of their own occupation. This type of disability definition is often called “own occupation: or “own occ” disability.
Liberty Cut Off LTD Benefits after Two Years Under “Any Occupation” Definition of Disability
After paying Long Term Disability for 24 months to our client, Liberty Life decided she could return to work in a different job. Liberty terminated her disability benefits. Liberty’s decision letter stated that after 24 months, the group disability policy’s test for disability was not whether our client could do her job, but instead it was whether she could do any job in the national economy. This type of definition is called an “any occ” or “any occupation” test for disability. Liberty’s disability claim handlers decided that our client was able to work in an occupation.
How Liberty Decided Our Client Could Work in an Occupation Was the Problem
Even though Liberty Mutual determined that our client was still unable to do her pwn job, Liberty Mutual’s “Vocational Expert” gave an opinion that our client was able to perform “some job” in national economy. One problem was that a generic decision saying someone could do “some” work, does not give a disabled plan participant the chance to appeal a specific determination about a job.
A second problem for Liberty that our firm attacked was that Liberty’s termination of her LTD benefits occurred even though Social Security granted our client’s application for Social Security Disability. Social Security found that there were no jobs she could engage in on a sustained basis (meaning she could not do any job full-time, or even on a significant part-time basis). She had been receiving Social Security Disability benefits for over a year. Additionally, Liberty Life’s policy allowed it to reduce its LTD benefit payment by the amount of SSD benefits our client was receiving. Liberty took advantage of the SSD benefit for this offset (reduction), yet Liberty ignored Social Security’s findings that our client could not engage in any occupation.
Attacking Liberty Life’s Termination Decision
Our client hired us after she received her denial. Our team of experienced ERISA disability attorneys immediately obtained and reviewed almost 1,000 pages of documents sent by the disability insurance company Liberty Mutual. Our analysis showed that our clients’ neurologist had not documented some aspects of Parkinson’s Disease that would have helped to demonstrate that she was disabled from any occupation. Worse, Liberty did not gather information that it should have, including these specifics from the physician treating the Parkinson’s.
Our appeal added medical information to Liberty Life’s file, but more importantly we helped to document our clients vocational limitation. Those restrictions and limitations included the way her Parkinson’s symptoms impacted her:
- use her hands and arms;
- fatigue / energy; and
- the need to take frequent breaks.
Another key factor that we developed evidence about was the unpredictability of her symptoms. Our client’s symptoms are never static – they do not stay the same every moment of every day. She cannot predict how she will feel or what symptoms will be worst each day when she wakes up.
The proof (evidence) we put together was submitted as part of an appeal with lengthy legal argument. After considering the LTD appeal, Liberty Life reversed its original decision to cut off benefits. Liberty started paying monthly Long Term Disability benefits and has continued to pay those benefits.