A federal appeals court affirmed a Minnesota District Court’s finding that a long-term disability insurance contract’s clause limiting benefit payments for disabilities caused by mental health conditions was inapplicable when the claimant was also independently disabled from physician conditions.
Weyer’s Different Disabling Conditions
Ms. Kelsey Weyer suffered from numerous medical issues, including chronic fatigue syndrome (also known as ME/CFS), Lyme disease, migraines, neurocognitive disorder, anxiety, and depression.
Reliance Standard, the long-term disability insurance carrier, initially approved Ms. Weyer’s claim and paid benefits for 24 months. Thereafter, the insurer abruptly terminated her claim.
The insurance provider alleged that:
- She could perform sedentary work; and,
- Her mental health conditions contributed to her disability, so her benefits were limited to 24 months due to a specific mental health limitation in the policy.
According to Reliance Standard, Ms. Weyer was no longer entitled to long-term disability benefits due to this wrinkle in the policy. Ms. Weyer appealed Reliance Standard’s termination but was unsuccessful.
Using the Courts to Secure a Win
Following the denial of the appeal, Ms. Weyer filed a lawsuit in the United States District Court for the District of Minnesota. The district court ruled in Ms. Weyer’s favor, finding that she was unable to work in any occupation—even a sedentary one—and that the mental health limitation under Reliance Standard’s disability policy did not apply because she was disabled due to her physical conditions. The district court relied on records and reports from five of Ms. Weyer’s treating physicians as well as approval from the Social Security Administration (SSA). In its decision, the court explained that the mental health limitation required a “but-for causation,” meaning that if the physical conditions were independently disabling, then the limitation does not apply. Reliance Standard appealed the decision to the Eighth Circuit and lost that appeal, too.
This case illustrates how important it is to have a long-term disability attorney on your side because many insurance companies will do almost anything to find a way to stop providing policyholders with the benefits they need and deserve.
Proving Disability When Physical Conditions Coexist with Mental Health Disorders
It is to be expected that someone suffering from debilitating medical issues would also suffer depression and anxiety. However, insurance companies tend to take advantage of the situation by alleging the person is only disabled from mental health conditions, and thus, limits their liability to only 24 months of paid LTD benefits.
Typically, in a case with these types of complications, our attorneys of Dabdoub Law Firm would work up the medical evidence to confirm that the physical conditions prevent the claimant from working. For example, with someone suffering from CFS, we would gather their doctors’ support in the form of letters, questionnaires, and medical records, as well as with independent testing such as a cardiopulmonary exercise test or neuropsychological evaluation. We gather the evidence that undeniably demonstrates that our client’s disability is caused by physical conditions, so the insurer’s 24-month mental health limitation should be removed.
Lawyers with Expertise in Disability Insurance Claims
This 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; and
- Being backed by a law firm that has a proven track record of winning tough disability lawsuits.
Call the 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.
The firm represents clients nationwide with disability claims governed by federal law, even if we are not located in your state.
Call (800) 969-0488 or contact us online to speak with an experienced disability attorney. Pay no fees or costs unless you get paid.