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MetLife Misinterprets Client’s Condition and High-Level Occupation to Deny Benefits

Our client was thriving in her high-level career as a senior-level sales strategist in Albany, NY when her health took a sharp turn without warning. She developed a severe fever, and doctors discovered an infection present throughout her entire body due to liver failure. Notably, our client had no significant history with alcohol nor any way to anticipate her sudden illness. In the hospital, our client’s condition was so bad that her doctors recommended she contact her children for a final goodbye.

Miraculously, our client pulled through. Once her condition stabilized, she was diagnosed with cirrhosis of the liver, fatty liver disease, hepatitis C, and Hashimoto’s disease. Since her initial hospitalization, our client has been in and out of the hospital more than a dozen times to treat infections caused by her failing liver. She has also experienced severe fatigue and cognitive impairment, which have rendered her unable to fulfill the duties of her occupation.

Rather than suffer through physical and cognitive symptoms and fail to complete important assignments, our client made the difficult decision to stop working and file for long-term disability benefits under her insurance policy with MetLife.

Based on the insurance company’s response, MetLife denied her claim without so much as reading her story. Fortunately, Dabdoub Law Firm was able to recover benefits upon appeal.

Overlooking the Most Important Information – Cognitive Impairments

In its denial letter, MetLife immediately made a mistake, misidentifying our client as a sales or marketing manager instead of a senior-level sales strategist. As an attorney and a high-level strategic employee, our client has a more demanding job. This fact is important.

MetLife’s second – and most significant – mistake was its complete disregard of our client’s cognitive impairments. Though our client’s physical disability is serious enough to warrant long-term disability benefits, her cognitive impairments are the main medical condition keeping her away from her job. Previously our client read and interpreted long, complex documents. Now, she can hardly remember 5 pages at a time, gets confused easily, and simply does not have the mental stamina to fulfill the duties of her previous occupation.

Our client’s primary care physician (PCP) has noted fatigue, abdominal swelling, wrist pain, overall weakness, leg cramps, lethargy, reduced cognition, a decline in memory, decreased mental stamina, and intermittent confusion. The PCP classified our client’s disability as primarily cognitive and stated that she is “unable to work in any capacity,” likely permanently.

Documents from our client’s PCP alone are enough to approve her claim for long-term disability benefits. Through various hospital visits, yet another doctor identified cognitive impairments that diminish our client’s ability to focus and concentrate. Further, our client underwent a functional capacity evaluation to prove her physical and cognitive impairments, as well as an independent neuropsychological evaluation.

Dabdoub Law Firm Gives MetLife a Chance to Improve the Situation

Based on all the medical evidence described above, and the opinions of those who evaluated her, our client will never be able to return to her demanding career.

Although this fact is beyond devastating, MetLife has a chance to make our client’s life better as she battles her medical conditions. In fact, MetLife promised to support our client in this exact scenario.

All MetLife had to do was conduct a full and fair review of our client’s case. Instead, it overlooked her cognitive impairments and tried to write her off.

Dabdoub Law Firm simply pointed out the error of MetLife’s ways and gave the insurance company a chance to make the right decision – and to avoid litigation.

MetLife approved our client’s long-term disability benefits and paid retroactive benefits in full.

Disability Insurance Companies Have Lawyers. Shouldn’t You?

Because Dabdoub Law Firm was created to focus on disability insurance, we have developed an expertise in this complex area of the law.

Our expertise in long-term disability claims means our clients have the backing of a law firm with attorneys who:

  1. Are experts in disability claims.
  2. Have fought all major disability insurance companies and know their tactics.
  3. Boast a track record of success.
  4. Win major disability lawsuits and improve the law for claimants.
  5. Have recovered millions of dollars in disability benefits.

All our lawyers commit every day of their legal careers to helping people get disability benefits from UNUM, MetLife, Prudential, Northwestern Mutual, Hartford, CIGNA, and others.

Federal law applies to most disability insurance claims, so our disability attorneys do not have to be located in your state to help. We help clients nationwide.

Get in touch to get experienced disability lawyers on your side while you:

Call us at (800) 969-0488 or contact us online for a free consultation with a disability attorney.