California Court Finds United of Omaha Applied Wrong Standard When Denying Widow Her Late Husband's Disability Benefits from Liver Cancer
A Court in California found United of Omaha applied the wrong standard when denying widow her late husband’s disability benefits. Matthew Lyttle was a former vice president of a chemical company who went out on long-term disability as a result of his cancer diagnosis. The court ordered United of Omaha to pay Lyttle’s widow LTD benefits from the time Lyttle stopped working until his death, plus three months of life insurance benefits.
Our law firm helps people like Ms. Lyttle every day. Our lawyers have tons of experience fighting all major disability insurance companies. We have won several major disability lawsuits.
Mr. Lyttle’s Long-Term Disability Case
Matthew Lyttle was diagnosed with liver cancer in September of 2011. By 2014, it was confirmed that the cancer had spread to other parts of his body. That year, Lyttle used nearly 200 hours of combined sick leave and vacation time from his work as a vice president of a chemistry company. Lyttle suffered from severe flare ups of hand-foot syndrome attributed to his on-and-off use of medication. In 2016, Lyttle filed for long-term disability benefits.
During its review of his claim, United of Omaha had a nurse conduct a paper-based review of Lyttle’s records. Claiming there was no significant change medical from Lyttle’s last day of work through the review date, the nurse reviewer concluded he could return to the workforce full-time. In addition to also having a physician conduct a paper-based review of Lyttle’s records, United of Omaha had Lyttle undergo an independent medical evaluation (IME) to determine his cognitive function. The IME doctor opined Lyttle had significant limitations in his cognitive functioning that would prevent him from his occupation. Despite this, United of Omaha denied Lyttle’s claim and rejected his appeal.
United of Omaha’s Policy Language
The court reviewed Lyttle’s case de novo - or without giving deference to Mutual of Omaha’s decision but rather simply reviewing whether or he met the definition of disability in the policy. The court found United of Omaha should have ask whether Lyttle could continue with his demanding job with reasonable continuity as required under the insurance policy. Instead, United of Omaha asked whether there had been a change in his medical condition from when he was still working compared to when he went out on medical leave. The court also found United of Omaha failed to consider Lyttle used significant amounts of his sick and vacation time in 2015 as well as his failure to improve medically.
Hiring an Experienced Disability Lawyer is Critical
Most people, like Mr. Lyttle receive disability insurance through their job. These claims are generally governed by ERISA. This is a very complex law which generally favors the insurance companies.
Most disability policies give the insurance company discretion, meaning a judge must rule in favor of the insurance company unless it was entirely unreasonable in denying benefits. Merely proving you are disabled is not enough. This is a difficult standard to meet. In Mr. Lyttle’s case, the court reviewed the matter de novo because California law bans discretionary clauses in disability insurance policies.
It is important you hire an experienced long-term disability lawyer.
Dabdoub Law Firm was built to be a disability insurance law firm. Because all our disability lawyers focus on disability insurance claims, the firm has significant experience with every major disability insurance company and has won important disability lawsuits.
The firm can help at any stage of your long term disability claim, including:
- submitting a disability insurance claim;
- appealing a long-term disability denial; or
- filing a lawsuit against your disability insurance company.
Hiring an experienced disability attorney is important. Because federal law applies to most disability insurance claims, our lawyers do not have to be located in your state.
Call for a free consultation with an experienced disability attorney.