Attorney Brandon Operana was recently successful in obtaining past-due Long-Term Disability benefits for a client from The Standard Insurance Company.
Michelle, who worked as a technician in a hospital, suffered from lupus, a lifelong autoimmune disease. When the Covid-19 Pandemic started in March of 2020, she became increasingly ill with lupus flare-ups and had to stop working. The hospital where Michelle worked offered its employees disability insurance through The Standard Insurance Company. Michelle applied but was quickly turned down.
In denying her claim, The Standard had its own doctors review Michelle's medical records and argued that her Lupus flare-ups were not severe and that she was able to return to work as a technician in the hospital.
After getting denied, Michelle reached out to our office for help with her appeal. We obtained a copy of The Standard's file and immediately found errors by The Standard's doctors and vocational experts. One of the major errors included The Standard misclassifying Michelle's job description, listing it as "light duty" rather than "medium duty."
On appeal, we reached out to Michelle's doctors to obtain opinions and pointed out several instances in which The Standard's doctors were incorrect or misstated the medical evidence. We then conducted our own vocational review to support that Michelle's job was actually performed at medium duty, rather than light duty. This involved us gathering information from the Department of Labor and Dictionary of Occupational Titles, along with various job descriptions from other hospitals online.
Following our appeal, The Standard again denied Michelle's claim. However, in its denial, The Standard failed to acknowledge our arguments concerning her job duties. We filed a second appeal and again argued that legally, The Standard must review this information.
Finally, after battling The Standard for over two years, they agreed with our position and paid out all of Michelle's past-due benefits.
Michelle's case is a perfect example of why having an attorney matters. Insurance companies like The Standard usually just want you to provide them with medical information to support your case. However, it is also important that the insurance company has an accurate job description and a list of all the duties you performed while working, in order to properly evaluate whether you are disabled from your job. If we had not did a thorough vocational review, Michelle would have most certainly been denied again.
If you were denied long-term disability benefits, or feel that your insurance company is misrepresenting your job duties or job description, contact us to discuss your rights.
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