Sun Life Financial Terminates Benefits for New Jersey Nurse After Double Knee Replacements and Chronic Pain
For much of our client’s career as a nurse at a rehabilitation facility in Hamilton, New Jersey, she dealt with degenerative changes in her knees. After years of significant pain and numerous surgical interventions, our client was forced to replace both knees.
In 2017, our client replaced her left knee, underwent months of physical therapy, and returned to work. Unfortunately, our client suffered an injury soon after returning, aggravating her already fragile knees.
Our client then endured a second knee replacement and more months of physical therapy. Nevertheless, our client continued experiencing pain and weakness in both knees and was unable to return to work. Nine months after replacing her right knee, our client also fell and broke her wrist. Additionally, our client’s ongoing hip and lower back pain got worse, and a 2018 MRI revealed she was suffering from lumbar spondylosis and other conditions.
To manage the pain, our client had 2 epidural steroid injections. These injections provided some relief, but the pain continued.
Our client felt lucky to have a disability policy with Sun Life Financial. She filed a disability claim, and Sun Life approved her for long-term disability (LTD) benefits in June of 2018. Although our client’s condition had not improved by June 2020, and she was totally disabled from any occupation due to her knee pain and back pain, Sun Life terminated her benefits.
Fortunately, our client called Dabdoub Law Firm for help.
Why Did Sun Life Financial Terminate the Disabled Nurses Benefits?
Disability policies have special rules. For the first 2 years, the policyholder only has to be disabled from their own occupation to recover LTD benefits. After this point, the insurance company only has to continue paying if the policyholder is disabled from all occupations.
Sun Life Financial used progress notes from 2 dates to justify terminating our client’s benefits – 2 notes from years of ongoing medical treatment. In making this decision, Sun Life violated the Employee Retirement Income Security Act of 1974 (ERISA) and ignored an overwhelming amount of evidence of our client’s disability.
To make matters worse, our client’s condition has only worsened since she first qualified for LTD benefits. Multiple doctors have documented her ongoing pain and tenderness in both of her knees and even identified that our client is severely allergic to the knee implants she received during surgery. Our client can only sit or stand for 15 minutes at a time, cannot sit for more than 2 hours in an 8-hour workday, cannot carry more than 10 pounds, and does not have good days. To resolve her knee pain, our client will have to go through yet another double knee replacement.
This does not even scratch the surface of our client’s medical conditions. Her severe and lower back pain prevents her from fulfilling a normal workday, and she cannot work in a sedentary role. According to her treating physicians, our client does not have good days and is always in severe pain. A functional capacity evaluation (FCE) even found that our client is “unable to safely perform at a sedentary level.”
Sun Life simply ignored all this information to terminate our client’s benefits and look after its own bottom line.
Remedying a Wrong and Unreasonable Situation
Our client is not only disabled from work, but she also struggles with the tasks of everyday life. Her injuries, pain, and limitations prevent her from walking her dog, doing her laundry, and going to the grocery store, and our client’s adult daughter resides at home to take care of her mother.
Sun Life’s decision was wrong and unreasonable, and Dabdoub Law Firm gave the insurance company a chance to remedy the unfair situation it put our client in.
To avoid litigation, Sun Life agreed.
Dabdoub Law Firm has always focused only on disability insurance law.
Because we specialize in long-term disability, our clients get the benefit of:
- Having an attorney who is an expert in long-term disability claims.
- Having an attorney who has experience with every major disability insurance company.
- Being backed by a law firm that has a proven track record of success in tough disability lawsuits.
Contact Dabdoub Law Firm to get experienced disability lawyers on your side.
We can help 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.
Our lawyers represent clients nationwide with disability claims governed by federal law, which means we are here for you –even if we are not located in your state.
Call us at (800) 969-0488 to speak with an experienced disability attorney. You will not owe us any legal fees unless you get paid.