MetLife Cites Incorrect Insurance Rule to Terminate Florida Woman’s LTD Benefits

Our client, a Delray Beach, Florida woman, was receiving disability benefits through MetLife for her spinal stenosis. The medical condition can manifest severe back pain, random muscle spasms, nerve sensitivity, and various other issues. With no positive change in her condition, MetLife terminated her benefits early, saying its Limited Disability Benefit provision applied. However, upon review from our disability lawyers at Dabdoub Law Firm, it became apparent that the provision did not apply to spinal stenosis and that the termination was therefore erroneous. In a direct response letter, we pointed out the error and MetLife agreed to reinstate our client’s benefits, including retroactive benefits that would have been accrued had the termination never occurred.

Details of the Erroneous LTD Benefits Termination Case

Spinal stenosis is a neuropathological condition that can cause severe disability, making any form of gainful and regular employment impossible. MetLife’s Limited Disability Benefit provision limits long-term disability benefits given to people with certain neuromuscular, musculoskeletal, and soft tissue disorders. An exception to this limitation, though, applies to spinal cord damage, such as those experienced due to spinal stenosis.

When our client began suffering from the disabling conditions caused by spinal stenosis, MetLife approved her disability benefits. Through this approval, the insurer acknowledged the severity of her condition and just how much it did disable her. In MetLife’s own descriptions, our client is capable of completing “less than sedentary” work, which is to say she cannot even perform light work while seated and with limited motion.

She underwent several spinal surgeries to try to correct or alleviate her symptoms. Unfortunately, progress has not been seen by her treating doctors. It was also noted that epidural injections and medications were ineffective.

To this end, her disabling conditions persist to this day, yet MetLife still terminated her benefits early. It explained that spinal stenosis is limited by the Limited Disability Benefit provision. However, as described above, it is not.

Dabdoub Law Firm countered the early termination of her benefits with an appeal. We explained as clearly as possible to MetLife that its own rules did not exclude spinal stenosis due to the definition of the condition. We were also certain to underline the fact that our client’s medical conditions had not improved, so there would be no reason to terminate her benefits under any other circumstances, either. After receiving our appeal, MetLife agreed to reinstate her benefits with a retroactive application for the benefits she lost due to the wrongful termination.

Our Lawyers Specialize in Disability Insurance Claims

Because Dabdoub Law Firm has always focused only on disability insurance cases, our lawyers are considered by many as experts in legal representation for disability insurance benefits clients.

That means our disability lawyers have:

  1. Won several major disability lawsuits that help make better law for disability claimants;
  2. Experience fighting every major insurance company, such as UNUM, Hartford, MetLife, CIGNA, Prudential, and more.
  3. Successfully represented hundreds of clients and won millions of dollars in disability benefits.

Because federal law applies to most disability insurance claims, we can help clients across the country.

Disability insurance companies have lawyers. You should, too. Call Dabdoub Law Firm to get experienced disability lawyers on your side.

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