10 Severe Comorbid Conditions Cause Man's Disability, MetLife Still Denies Benefits
Our client, an engineer from Catskill, New York, was diagnosed with cervical disc disorder, lumbar radiculopathy, myalgia, carpal tunnel syndrome, diabetes, memory loss, and several other disabling health conditions. Surprisingly, MetLife not only said our client was not eligible for long-term disability (LTD) and 401(k) benefits, but the insurer also said he was entirely capable of returning to work. In response to their unreasonable denial, Dabdoub Law Firm jumped into action to file an appeal. With the presentation and explanation of extensive medical records that prove disability, we were able to successfully convince MetLife to approve his LTD benefits without needing to go to trial.
Details of the 10+ Disabling Conditions Case
When someone is suffering from multiple health conditions at once, they are called comorbid conditions. It is not uncommon for someone to have three or four comorbid and related conditions. In this case, though, our client was diagnosed with at least 10 comorbid conditions, and any number of them would reasonably be considered disabling enough to continue his work as an engineer for IBM.
Throughout the years, he has seen several doctors and medical specialists to try to help alleviate the chronic pain he suffers as a result of his comorbid conditions. Our client’s primary care physician determined he could not work an 8-hour day, 40-hour week, even in a sedentary position. A neurologist concluded our client was unable to “sit still for long periods of time due to pain” associated with his back and spinal conditions. A pain management specialist also concluded that our client could not work any longer as an engineer due to his disabilities.
Ultimately, the primary care physician determined these limitations for our client:
- Sitting for 30 minutes per 8-hour day (intermittently)
- Standing for 10 minutes per 8-hour day (intermittently)
- Walking for 10 minutes per 8-hour day (intermittently)
- Never able to twist/bend/stoop, reach above shoulder level, or reach front and side at desk level
- Never able to lift any weight
Despite a multitude of medical professionals agreeing that our client could not even stand for more than 10 minutes a day, MetLife denied his LTD benefits. Our casework uncovered that MetLife had sent papers to a registered nurse with no specialized training in neurology, pain management, etc., asking her to assess our client’s disability. It was through her cursory review, founded on a lack of critical training, that our client’s LTD benefits were denied. The nurse never even had the chance to meet or talk to our client, yet she decided he was not disabled.
Our appeal focused on the extensive medical records that proved our client’s disability, as well as challenging of MetLife’s denial reviewal methods. Handling such an important, life-changing decision in such a lackadaisical, unofficial way was simply inexplicable. We are proud to report, though, MetLife conceded upon reception of our appeal, and our client has been given LTD benefits as needed.
Help from a Lawyer with Expertise in Disability Insurance
Disability insurance law is complex. Hiring an experienced disability attorney is important. Because all disability lawyers at Dabdoub Law Firm focus on disability insurance claims, we have unrivaled expertise in disability insurance law.
Our focus on disability law means we have:
- Experience with every major disability insurance company;
- A proven track record of success by winning major disability lawsuits; and
- Recovered millions of dollars in disability benefits for clients.
And, we never charge fees or costs unless our clients get paid.
We can help at any stage of your disability insurance claim, including:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Because federal ERISA law applies to most disability insurance claims, our lawyers are able to represent clients across the country.
Call (800) 969-0488 to speak with an experienced disability attorney. Consultations are free.