Guardian Disregards Chronic Back Pain in Unreasonable LTD Reversal

Before suffering a back injury, our client enjoyed her job as a claims adjuster in Hagerstown, Maryland, and never could have imagined filing for long-term disability (LTD) benefits. Unfortunately, her chronic and severe back pain became unbearable and forced her to stop working. Although she was reluctant to apply for LTD benefits, The Guardian Life Insurance Company of America (Guardian) approved her claim and encouraged her to apply for Social Security benefits, as well. The Social Security Administration (SSA) approved our client’s claim, and Guardian continued to pay LTD benefits for 5 years.

Over time, our client’s condition has not improved, but this did not stop Guardian from terminating her benefits due to the skewed results of a functional capacity evaluation (FCE) and surveillance footage.

Our client had no choice but to contact Dabdoub Law Firm for assistance.

Understanding Chronic Back Pain

Chronic back issues do not simply go away after 5 years. Instead, they tend to get worse over time and as individuals age. Our client undergoes exhaustive treatment to manage her back pain. Despite trying surgery, physical therapy, aqua therapy, prescription medications, nerve blocks, nerve ablation, and spinal cord stimulation, our client’s condition has only worsened. Her medical records show this, and all her doctors, agree but Guardian chose not to evaluate the evidence in our client’s case fairly.

Guardian chose not to listen to our client’s pain management specialist but to perform a flawed FCE and conduct surveillance. Neither of Guardian’s actions disproved our client’s disability.

An Erroneous FCE and Unremarkable Surveillance

In a functional capacity evaluation, our client could lift, carry, push, and pull certain amounts. Nevertheless, she experienced extreme pain and discomfort while performing these tasks. Guardian focused on the former fact, entirely ignoring the latter. The company also ignored the doctor’s findings that our client is not currently functioning at a sedentary level and does not have the ability to work an 8-hour day. Sitting for more than 10 minutes, walking more than 20 minutes, or lifting more than 15 pounds increases our client’s pain. She went into the test with a pain level of 4 and emerged with a pain level of 7, despite taking a Percocet prior to the examination.

For additional “evidence,” Guardian conducted a 4-day period of surveillance. Their footage showed nothing more than our client running errands and getting lunch. Our client never claimed that she could not complete the activities of daily living. None of our client’s activities are inconsistent with her disability, and these glimpses of life do not depict nor disprove our client’s suffering. Just because our client can use a few moments of the day to shop or go to lunch does not mean she is capable of maintaining full-time employment.

Due to legal precedents, Guardian’s surveillance is inconclusive and does not represent a valid reason to terminate benefits.

Dabdoub Law Firm Highlights Guardian’s Errors

In addition to using unreliable evidence to justify terminating our client’s benefits, Guardian had the audacity to disagree with the Social Security Administration. An SSA judge found our client had severe degenerative disc disease and obesity and asserted she was “disabled based on her physical impairment alone.” The SSA also argued that there are no jobs that our client can do based on her education, work experience, and functional capacity.

This is just one more piece of evidence Guardian ignored. When our firm stepped in, we simply drew attention to Guardian’s many errors and presented the facts of our client’s disability.

When given a second chance to provide LTD benefits, Guardian quickly complied.

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. have won major disability lawsuits and improved the law.
  5. have recovered millions of dollars in disability benefits.

All our lawyers commit every day of their legal career 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 we do not have to be located in your state to help. We help clients nationwide.

Get in touch and put experienced disability lawyers on your side with:

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

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