Alabama Court Rules in Favor of Manager Suffering From Chronic Pain Syndrome

An Alabama court rules in favor of a manager at BellSouth suffering from chronic pain syndrome and thoracic disc disease. The court held that the claimant submitted substantial proof of her disability through medical tests and examination completed by her pain doctors.

In this case, the employer, BellSouth, self funded its disability plan. This means disability benefits are paid out from the employer’s own assets. BellSouth outsourced the administration of its plan to a third party company called Broadspire.

Background

Suzanne Lee worked for BellSouth, mainly in managerial roles. She started missing work in 2005 due to chronic pain. She filed for short term and long term disability through BellSouth, which Broadspire handled.

Ms. Lee submitted medical records, letters and questionnaires from her many treating doctors, MRI’s and CAT scans that supported her chronic pain and thoracic disc disease diagnosis and symptoms. She even underwent surgery for her thoracic disc disease. She had epidural steroid injections for the pain and took different kinds of pain medications.There was a wide variety of medical evidence showing chronic pain symptoms.

Ms. Lee even attempted to do a functional capacity evaluation (“FCE”) but the test was unable to assess her functional abilities due to her reports of pain. She did have some functional testing that showed decreased muscle strength. Despite all that, Broadspire denied her claims and appeals for short term and long term disability benefits.

The Court finds there is substantial evidence of pain supporting disability

Obviously, there is no test for pain. It cannot be measured by a machine or in blood work. The way to demonstrate pain in a disability case is through things like:

  • Medical records
  • Abnormal physical examination findings
  • Abnormal findings on scans such as MRI or CT
  • Medical reports by doctors
  • Functional testing demonstrating muscle strength and ability

The Court found that Ms. Lee’s medical evidence supported disability. The Court noted that Broadspire ignored objective evidence from numerous treating providers and mischaracterized the evidence.

This kind of behavior is common in disability claim reviews. Insurance companies or claim reviewers often undermine or undervalue medical evidence, abnormal physical exam findings, testing and doctor’s opinions. Even more, they use their own medical reviewers to discredit or misconstrued the medical evidence.

The disability insurance attorneys at Dabdoub Law firm handle chronic pain cases often. Just because there is no formal test to prove pain does not it cannot be proven. Our goal as attorneys is to maximize the medical evidence available and use the treating doctors to explain and bolster those records. Sometimes, outside testing is necessary and helpful. We make that call with the client based on the available information.

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