A U.S. District Court in Atlanta, Georgia, found Greater Georgia Life Insurance Company (“GGL”) was wrong in terminating the long-term disability benefits of a former truck driver.
Mr. Madison suffered from chronic knee pain which prevented him from being able to drive a truck. Thus, he filed a claim for disability benefits with GGL. His benefits were initially approved and paid until GGL terminated such benefits in January of 2015. Based on its review of the facts, the court held that GGL had abused its discretion in terminating Mr. Madison’s benefits and ordered GGL to issue unpaid benefits and pay Mr. Madison’s attorney’s fees.
This firm has always focused only on disability insurance law. We have helped many people suffering from chronic pain. Cases based on chronic pain can be difficult due to the subjective nature of pain and fatigue. But, as seen in this case, courts are beginning to recognize chronic pain can lead to a disability. Our long term disability lawyers can help you find the evidence you need to have a chance against the insurance companies.
The Court’s Review of Mr. Madison’s Claim
The court here had a good understanding of the medical records. Its knowledge of the facts helped Mr. Madison win his case.
The court ultimately ruled in Mr. Madison’s favor for the following reasons:
- The medical records from his treating physicians confirmed physical impairments and limitations
- A functional capacity evaluation (FCE) provided objective medical evidence that Mr. Madison’s injury made him unable to work as a truck drive
- GGL was unjustified in relying on its own medical reviews
The court noted that in Mr. Madison’s many visits to his physicians, his doctor regularly observed physical symptoms impairing his ability to work as a truck driver. The court also pointed to MRI findings as supportive of Mr. Madison’s disability.
The court was most persuaded by the findings of a FCE. An FCE is a test performed by a physical therapist to determine a person’s physical abilities. Here, the court found that the FCE confirmed Mr. Madison could not safely perform the material duties of his job. The court strongly disagreed with GGL’s argument that FCEs are not reliable. In fact, it cited and agreed with another court’s opinion that FCEs have been described as “the best means of assessing an individual’s function level.”
Finally, the court was not persuaded by GGL’s reliance on three medical reviews performed at GGL’s request. The court found that the reviewing physicians were not provided with all the medical evidence. Thus, it held that reliance on such selective reviews by doctors unfamiliar with Mr. Madison and the dismissal of clear medical evidence of disability was unreasonable. Accordingly, the court ruled for Mr. Madison.
Our Disability Attorneys Can Help You
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.
We understand what evidence is needed to give you the best chance against the insurance companies. This is particularly true for claims involving subjective complaints such as chronic pain, chronic fatigue, migraines, etc.
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.