California Federal Court Rules that VP is Disabled from Trigeminal Neuralgia, Rejecting Denial From LINA

Edward Elliott, a former Vice President at BTIG LLC, claimed disability due to trigeminal neuralgia, a nerve condition causing severe facial pain. He submitted a claim for disability benefits under a group policy issued by the Life Insurance Company of North America (LINA). Mr. Elliott was Initially approved for short-term disability benefits. However, his claim for long-term disability (LTD) benefits was denied multiple times.

Mr. Elliott filed a lawsuit under the Employee Retirement Income Security Act (ERISA) seeking judicial review of the denial. Despite obtaining disability benefits from the Social Security Administration (SSA), LINA upheld its decision to deny Mr. Elliott's LTD benefits. The court, ruling on Mr. Elliott's motion for judgment, analyzed whether he met the criteria for disability benefits under the policy.

The court found Mr. Elliott credible regarding his symptoms and limitations due to trigeminal neuralgia. It noted consistent medical evidence supporting his disability claim, including diagnoses from treating physicians and the SSA's determination of disability. LINA's arguments challenging Mr. Elliott's credibility were not persuasive, especially given its prior acknowledgment of his disability for short-term benefits.

The court concluded that Mr. Elliott was entitled to LTD benefits for the period of his inability to perform the duties of his regular occupation, based on his credible testimony and supporting medical evidence. However, it remanded the case to LINA to determine whether Mr. Elliott qualified for benefits under the “any occupation” provision after the initial 24-month period.

Having the support of your treating physicians, as well as medical records documenting your ongoing symptoms and conditions is essential to a successful disability claim.

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