Like many brave medical professionals on the frontlines of the pandemic, our client got COVID-19 while working as a nurse in Dallas, Texas. Unlike many COVID patients, however, she failed to recover from the virus.
Although her COVID tests show she is “negative” for the virus, she still experiences the symptoms of COVID-19. Our client has become a COVID long-hauler, and her symptoms have only gotten worse with time.
After failing to return to work at an extremely reduced capacity, our client made the difficult decision to apply for long-term disability (LTD) benefits. Anthem Life Insurance Company approved our client’s claim. Unfortunately, the insurance company abruptly terminated our client’s LTD benefits mere months later.
With no change in her condition and mounting financial hardships, our client called Dabdoub Law Firm for help.
Our Client’s Medical Records Show No Signs of Improvement
Recovering from COVID-19 and returning to work is all our client wants to do. Her medical condition makes that impossible. From July 27, 2020, to November 22, 2021, our client’s medical records showed no signs of improvement. Her doctors noted consistent symptomology, along with concerning changes like increased pain and brain fog.
After more than a year of treating her, our doctor’s primary care physician made the following conclusions:
- Our client is always in pain
- Her pain is severe
- She cannot sit for more than 15 minutes at a time
- She cannot sit for more than 2 hours total on a given day
- She cannot care for herself and has difficulty getting around
- She needs to rest and be off her feet for most of the day
- Our client’s physical abilities are steadily declining
With these restrictions and limitations, our client cannot return to her occupation as a nurse.
In addition to notes from her primary care physician, our client provided notes from specialists, including a rheumatologist, an orthopedist, a pain management specialist, a gastroenterologist, and a urologist.
These doctors have noted chronic fatigue and pain, along with urinary incontinence, gastrological issues, degrative joint disease, and osteoarthrosis. Our client cannot get through a physical examination without moaning in pain and uses a walker to get around; how does Anthem expect her to return to work?
As if the opinions of several medical professionals were not enough, Dabdoub Law Firm also provided Anthem with objective medical evidence, including an electromyography (EMG), an MRI, and a functional capacity evaluation (FCE). All of this objective testing confirmed our client’s disability.
Anthem Abuses Its Discretion
By terminating our client’s LTD benefits without receiving any new medical information to support its change in position, Anthem abused its discretion and violated the Employee Retirement Income Security Act of 1974 (ERISA).
Our client briefly tried returning to work before her LTD claim was approved, but since then, nothing has changed for her. In fact, her condition has only gotten worse. Even Anthem’s doctor agreed that our client was disabled, but the same doctor suddenly changed his mind and decided our client’s medical records no longer reflected a disability. With these inconsistencies alone, Anthem failed to provide a fair and full review.
COVID-19 changed our client’s life for the worse, and Anthem does not need to add insult to injury. We gave the insurance company a chance to correct its mistakes. Fortunately, Anthem complied and reinstated our client’s LTD 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 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 have:
- expertise in disability claims.
- fought all major disability insurance companies and know their tactics.
- a track record of success.
- won major disability lawsuits that improved the law for claimants like you.
- 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 ERISA law applies to most disability insurance claims, so we do not have to be located in your state to help. We help clients nationwide.
Contact us to get experienced disability lawyers on your side 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 us at (800) 969-0488 for a free consultation with a disability attorney.