Court Rules Standard Insurance Company Wrong for Terminating Long-Term Disability Benefits of Office Manager Disabled from Pain
Ms. Norma Jean Stephens worked for the Harbin Clinic for 18 years before filing for disability. She ceased working in June of 2015 due to lower back pain, pelvic and abdominal pain, and left leg pain.
Unable to continue working, Ms. Stephens pursued long-term disability benefits from the Standard. Her claim was initially approved by the Standard after it found Ms. Stephens was incapable of performing her own occupation as an office manager. Specifically, two doctors hired by the Standard agreed with Ms. Stephens’s doctors that she was disabled.
Ms. Stephens received disability benefit payments for 24 months before the Standard terminated her claim. It argued that she was no longer eligible for benefits and was able to work in some other occupation.
Ms. Stephens appealed the Standard’s termination of benefits. The Standard denied her appeal. The termination of benefits and denial of the appeal were based exclusively on medical record reviews completed by a third and fourth doctor hired by the Standard.
After the Standard denied her appeal, Ms. Stephens filed a lawsuit to recover her benefits.
The Court’s Decision
After reviewing the facts of the case, the court ruled in favor of Ms. Stephens after finding that Standard’s termination of benefits was wrong and unreasonable. The court highlighted two reasons for its ruling:
The Standard never hired consultants to examine Ms. Stephens in person, despite two of the Standard’s reviewing physicians recommending the Standard do so.
Not only did the first two doctors hired by the Standard doctors agree that Ms. Stephens was disabled, they also recommended the Standard at some point hire doctors to physically examine Ms. Stephens. The Standard never did so and terminated benefits based solely on future medical records reviews, and not medical examinations.
The court decided that had the Standard physically examined Ms. Stpehens perhaps it would additional context and perspective on Ms. Stephens’s chronic pain complaint.
Standard’s denials relied on the reports of doctors who disfavored a disability finding and relied little or not at all on the opinions of doctors who favored a disability finding.
The court found that the Standard’s reliance on the two doctors who provided the fewest restrictions on Ms. Stephens’s ability to work was wrong. In fact, the Standard had two prior records reviews confirming disability but chose to ignore these reports, and the conclusions of Ms. Stephens’s treating doctors, in its denial. Instead, the Standard relied on the reports of doctors whose conclusions matched the least costly result - a denial of benefits.
The court ruled for Ms. Stephens and instructed the Standard to award her benefits.
Help from an Attorney with Expertise in Disability Insurance
Disability insurance law is complicated. If your claim for long term disability benefits was denied or being delayed by an insurance company, it is important to get help from a lawyer with expertise in disability law.
- Our lawyers specialize in disability insurance;
- Our lawyers have experience with Boston Mutual, UNUM,Hartford, CIGNA, Reliance Standard, and just about every other insurance company;
- Our lawyers have won tough disability insurance lawsuits;
- Our lawyers have recovered millions in disability benefits for clients who were wrongly denied.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
Dabdoub Law Firm represents clients nationwide with:
- Submitting a disability insurance claim,
- Appealing a long-term disability denial,
- Negotiating a lump-sum settlement, or
- Filing a lawsuit against your disability insurance company.
Call to speak with a disability insurance attorney. No fees are costs unless clients are paid.