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Guardian Approves Appeal for LTD Benefits for Our Client with Myasthenia Gravis

Our Jacksonville, FL client worked as Area Supervisor and Coach for 30 years until Myasthenia Gravis, chronic autoimmune, neuromuscular disease, and other health issues forced him to leave his position in September 2021.

Our client’s limited physical capabilities are due to:

Guardian Life Insurance Company (Guardian) wrongfully denied our client’s claim to receive long-term disability (LTD) benefits in November 2021. The insurance company considered that nothing prevented him from holding a full-time job. Guardian did not take into account any of the medical reports demonstrating our client’s inability to perform simple daily tasks due to a wide range of symptoms such as extreme fatigue, speech issues, and overall muscle weakness.

Frustrated with the insurance provider’s response, our client reached out to Dabdoub Law Firm. Our disability insurance attorneys helped him prepare and file an appeal, so he could receive a fair review as required by federal disability laws.

Treating Providers and Independent Evaluations Confirm Our Client’s Disability

Our client suffers from a wide range of debilitating and unpredictable symptoms due to both MG and other health issues. To challenge Guardian’s unreasonable decision, he submitted himself to a variety of medical evaluations by both his regular doctors and independent professionals.

His attending physician completed a Medical Assessment Form in January 2022, noting the following symptoms:

  • Severe muscle weakness
  • Severe fatigue
  • Impaired attention and concentration
  • Blurred vision and double vision weakness
  • Shortness of breath

This doctor reported that a premature return to work would likely result in aggravated MG symptoms, especially as our client experiences flare-ups two to three times a week, each requiring up to three days of recovery.

In April 2022, a physical therapist filled out a Physician’s Questionnaire and reported additional observations:

  • Inability to stand or walk for more than 15 minutes at a time
  • Leg weakness
  • Chronic pain
  • Deteriorated eyesight
  • Unsteady gait, loss of balance, and reduced motor strength
  • Decreased sensation in lower extremities bilaterally

This physical therapist confirmed that our client could not return to work in his prior occupation or any other capacity.

To ensure thoroughness and objectivity, our client underwent an independent Functional Capacity Evaluation (FCE) in January 2022. This assessment involved a careful review of his medical history, a battery of tests, and clinical observations.

The doctor who performed the FCE confirmed our client’s inability to rejoin the workforce due to his severely limited physical abilities and his progressive weakness. An outside physical therapist reviewed the FCE and considered that our client’s limited cardio-respiratory fitness level and endurance do not allow him to engage in any sedentary work.

Guardian Had No Reasonable Grounds to Deny Our Client’s LDT Benefits

When Guardian unfairly ended our client’s long-term disability benefits, the company breached its fiduciary duty under the Employee Retirement Income Security Act of 1974 (ERISA). Guardian failed to properly review available medical documents supporting our client’s claim of disability.

When Dabdoud Law Firm assisted our client in preparing and filing the appeal, we also gathered statements from friends and family besides the medical assessments. Friends and children who provided letters all outlined a drastic difference between the active man and involved father our client used to be until his disability left him sad and barely able to get out of bed on most days.

After careful review of our appeal, Guardian revised its decision and has resumed our client’s LTD benefits.

Disability Insurance Companies Have Lawyers. Shouldn’t You?

We created Dabdoub Law Firm to focus on disability insurance and have developed expertise in this complex area of the law.

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

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 other insurance providers.

Because federal law applies to most disability insurance claims, we do not have to be located in your state to help. We help clients nationwide.

Call us today at (800) 969-0488 to get experienced disability lawyers on your side with:

Contact Dabdoub Law Firm today at (800) 969-0488 for a free consultation with a disability attorney. We only get paid if we win your case.