Standard Denies Long-term Benefits to California Teacher with Chronic Lyme Disease

Even though the California teacher suffered from Chronic Lyme Disease and numerous other conditions,Standard Insurance Company (“Standard”) still denied her claim for long-term disability (“LTD”) benefits.

Background

Ms. Entz suffered from various medical issues since she was a child, worsening as she got older. Despite the numerous medical conditions, Ms. Entz started feeling particularly ill in 2013.

After almost two years of doctor visits and testing, Ms. Entz was diagnosed with Chronic Lyme Disease. Even with the diagnosis, numerous other conditions and symptoms persisted, from arthritis to hypothyroidism to gastrointestinal issues. Three of her treating doctors believed she was disabled and unable to work.

The Claim and Denial

Ms. Entz filed her claim for long-term disability in August 2015. She listed Lyme Disease and “multi-system failures” as the reason for her disability. Her doctor corroborated the diagnosis and also listed several other diagnoses and conditions that were reasons Ms. Entz was unable to work.

However, Standard denied her claim because there was not enough medical evidence to support that Ms. Entz suffered from a specific illness. In addition, Standard did not accept Lyme Disease as a valid diagnosis.

Court’s Review of Ms. Entz’s Claim

Standard argued that the diagnosis of Lyme Disease, or Chronic Lyme Disease, was medically questionable. However, the trial court quickly rejected this argument.

Rather, the court stated Ms. Entz’s symptoms should be looked at in the context of her entire medical history. Standard’s sole focus on whether there was a test to conclusively establish Lyme Disease while ignoring her numerous symptoms was improper. Instead, Ms. Entz’s disability should have been assessed in light of her capacity to work as a teacher given her symptoms.

Looking at Ms. Entz’s medical file as a whole, the trial court determined Ms. Entz was totally disabled and entitled to benefits under the terms of the policy.

Help from a Lawyer with Expertise in Disability Insurance

This law firm was built to be a disability insurance law firm.

That focus means:

Our disability lawyers can help you with:

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. Pay no fees or costs unless you get paid.

Categories:

Let Dabdoub Law Firm Fight for the Disability Benefits
You Rightfully Deserve.

    • Please enter your name.
    • This isn't a valid phone number.
      Please enter your phone number.
    • This isn't a valid email address.
      Please enter your email address.
    • Please enter your age.
    • Please enter your occupation.
    • Please enter your disability insurance Company.
    • Please make a selection.
    • Please make a selection.
    • Please enter a message.
Request a Free Case Evaluation