What You Should Know:
- A former university tennis coach was forced to stop working due to disabling symptoms of long COVID and ME/CFS.
- Despite approving short-term disability benefits, The Standard Insurance Company denied long-term disability benefits on procedural grounds.
- Comprehensive medical evidence, including a 2-day CPET and multiple physician opinions, confirmed the claimant’s inability to return to work.
- Dabdoub Law Firm focuses exclusively on disability insurance claims, and has a strong track record of success in appeals involving long COVID and ME/CFS.
Career Cut Short by Long COVID
Once a top-ranked professional athlete and later a successful collegiate head coach, our client devoted more than a decade to building a respected coaching career at an Ivy League university. He led practices, developed competitive strategies, and mentored student-athletes until long COVID and ME/CFS forced him to step away from the sport and career he loved.
After contracting COVID-19 twice, he developed persistent and worsening symptoms including chronic fatigue, cognitive impairment, dizziness, and post-exertional malaise (“PEM”). Despite multiple attempts to continue working, with reduced hours and modified duties, he was eventually forced to stop working altogether in September 2024.
Long Term Disability Denial: An Unreasonable Shift from Approved STD
The claimant applied for and received short-term disability (STD) benefits from Standard Insurance Company. These benefits were paid in full for the 25-week maximum period, acknowledging his inability to perform the duties of his own occupation.
However, when the claim transitioned to long-term disability (LTD), Standard reversed its position. The insurer claimed he was not disabled during the LTD “benefit waiting period”, even though this was the same time frame for which STD benefits had already been approved.
We often see this hypocritical position taken by disability insurance companies in an effort to limit their liability from long term disability benefits. We fight these unreasonable denials everyday and successfully get our clients paid long term disability benefits.
Objective Evidence of Disability: 2-Day CPET
To support his appeal, the claimant underwent a two-day cardiopulmonary exercise test (CPET) conducted by a nationally recognized expert. The CPET is considered the gold standard in evaluating fatigue-based conditions such as long COVID and ME/CFS.
Results from the CPET confirmed:
- Severe ventilatory dysfunction consistent with post-viral illness
- Post-exertional symptom exacerbation lasting days after minimal activity
- Inability to meet even sedentary work thresholds
The independent reviewer concluded the claimant could not sustain any reasonable level of physical or cognitive work on a full-time basis.
Consistent Medical Support From Specialists
The appeal also included extensive documentation from multiple treating providers, each of whom had physically examined the claimant:
- A long COVID specialist confirmed the claimant’s physical symptoms would flare with minimal exertion and that cognitive impairments were consistent with brain fog and memory loss.
- An ME/CFS specialist affirmed the diagnosis and severity of limitations, fully endorsing the CPET findings.
- A therapist documented the mental and emotional toll of ongoing symptoms, including how they interfere with daily functioning.
- A vocational expert concluded the claimant’s prior role—both physically and cognitively demanding—was incompatible with his current functional abilities.
Firsthand Persona Statements Describe Daily Life After Disability
In addition to the medical documentation, the claimant submitted personal statements from himself, his spouse, and a former coaching colleague. These first-hand accounts revealed the significant impact long COVID had on his life:
- He could no longer manage basic tasks without rest.
- Family time and physical activity were severely limited.
- Attempts to work, even in reduced capacity, led to worsening symptoms and prolonged recovery.
A Justified Approval Of Long Term Disability Benefits
Faced with overwhelming evidence, including objective testing, treating physician support, vocational analysis, and personal statements, Standard was left with no reasonable basis to uphold the denial.
With the comprehensive long term disability appeal, Standard acknowledged disability and approved benefits, recognizing the severity and legitimacy of the claimant’s condition.
A Life-Altering Illness, A Life-Changing Win
This case illustrates how long COVID and ME/CFS can profoundly alter a person’s ability to work, even someone as physically fit and mentally sharp as a professional coach. The denial of LTD benefits was not just wrong, it was unsupported by both medical science and basic fairness.
Through persistence and expert legal advocacy, this appeal resulted in a full LTD approval, restoring critical financial benefits and peace of mind. If your insurance company denied benefits despite overwhelming medical evidence, we can help by:
- Submitting a disability insurance claim
- Appealing a long-term disability denial
- Negotiating a lump-sum settlement
- Filing a lawsuit against your disability insurance company