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MetLife Restores LTD Benefits for Boulder Nurse After Appeal

In December 2021, MetLife terminated our Boulder, Colorado client’s long-term disability (LTD) benefits beyond December 14, 2021. Our client, a nurse, had been receiving LTD benefits payments from the insurance company since June 29, 2018. Despite no improvement in her condition, MetLife unilaterally decided to terminate her benefits.

Our client has been experiencing severe chronic pain in her neck, irritable bowel syndrome, and mental health issues. She has a long and detailed list of medical records confirming her condition and how it has deteriorated since MetLife first approved her for long-term disability benefits.

This nurse from Boulder reached out to Dabdoub Law Firm to assist her in appealing MetLife’s unjust decision.

2022 Objective Medical Testing Confirmed Our Client’s Deteriorating Health

In April 2022, our client’s treating medical provider completed a Pain & Capacity questionnaire. Some of her key findings were high-level chronic pain, cervical radiculopathy, functional bowel disorder, and multi-level neural foraminal stenosis.

The physician noted how our client can sit, stand, or walk, for less than two hours during an eight-hour workday timeframe. Her medication also causes disrupting side effects like sedation and adrenal suppression.

In addition to this questionnaire, our client had a cervical MRI and cervical x-rays in February 2022 that confirmed she is not pretending or embellishing any report on her near-constant pain. The following month, she received another trigger point injection in hope of alleviating some of her symptoms, although the treatment had not had long-term effects when she had previously received it.

In March 2022, our client underwent a comprehensive functional capacity evaluation (FCE) to effectively challenge MetLife’s unreasonable claim that she had no physical restriction preventing her from going back to work. The occupational therapist who performed the evaluation concluded that our client was physically unable to perform even sedentary job duties due to a variety of symptoms such as her inability to sit for more than 36 minutes or stand for more than 23 without her pain becoming unbearable.

Another licensed occupational therapist independently validated the FCE and added that our client’s extremely low grip strength would “prevent any sustained hand activities,” and that she was barely able to open standard hinged doors. He also reported reduced balance and gait difficulties.

MetLife Based Its Wrongful Termination on Outdated Medical Records

As an insurance provider, MetLife must adhere to the Employee Retirement Income Security Act of 1974 (ERISA) and “act solely in the interests of the participant and beneficiaries.” By unjustly terminating our client’s LTD benefits after providing payment for several years, the company failed in its fiduciary duty.

MetLife based its decision on a 2020 review of medical documents that were mostly from 2018. The review had attempted to dismiss some findings due to our client’s age regardless of how the condition was disabling.

Dabdoub Law Firm provided 2022 medical reports that included objective testing and other doctors’ notes that established how our client’s health had worsened in recent years. One of the key findings that she cannot go through a three-hour assessment without requiring medication or laying down shows that she is unable to engage in an eight-hour workday.

Following how Social Security Administration (SSA) had approved our client’s disability status, Dabdoub successfully appealed MetLife’s decision and the insurance provider agreed to resume LTD benefits payments.

Help from a Lawyer with Expertise in Disability Insurance

Disability insurance law is complex, which is why hiring an experienced disability attorney is important. Our whole team focuses on disability insurance claims, which gives us the legal expertise you need for your case.

At Dabdoub Law Firm, we have:

To help you get the help you need, we never charge fees or costs unless you get paid.

Our firm can help at any stage of your disability insurance claim, including:

Because federal law applies to most disability insurance claims, our lawyers can represent clients across the country. We have helped clients secure a positive outcome with insurance companies like CIGNA, Provident, Mutual of Omaha, LifeMap Assurance Company, and Aetna.

Call Dabdoub Law Firm today at (800) 969-0488 or fill out our online form to speak with an experienced disability attorney. We offer free consultations.