After representing long term disability insurance claimants for many years, we are familiar with many of the resources used by our insurance opponents. This includes the in-house attorneys, the outside counsel retained when things look grim, and the scores of medical doctors hired by the insurance companies who enjoy the benefits of a simplified practice.
Call us cynical, but for the same fee they earn doing one review of medical records, they would have to see numerous patients and their office staff would have to handle the accompanying paperwork. The review of medical records for a generous insurance giant is a great deal for any medical practice — but a danger zone for any claimant.
So when our client, who suffers from a debilitating case of Chronic Fatigue Syndrome, was denied by Met Life, we were not surprised to see why. The doctors who were assigned to his file were a few of the regulars we know all too well. No one they see is ever disabled. Our client had exhausted the administrative process, and was in despair of ever receiving any of the insurance benefits he had so diligently paid for, for so many years.
We took his ERISA appeal to court and won.
The Court agreed with our client’s claim that the Met Life decision was arbitrary and capricious, based on poor reviews of medical records and a failure to consider that he had qualified to receive Social Security Disability Insurance. The Court ordered Met Life to reconsider.
We aggressively attacked Met Life’s doctor, piercing her credibility, citing case after case of paper medical reviews that were overturned by the courts because they were found to be inaccurate.
Our client received back benefits for more than three years, and is currently on claim.
If your disability claim has been denied because of a doctor’s review of your medical records, it’s a good chance that you’ve been denied for the sake of denial. You can fight back. Call our office to learn how we can help.