Free Consultation 877.583.2524
We do not handle social security disability claims
logo celebrating

Nationwide Leaders in Disability Insurance Law

shook hands


Wednesday, July 27th, 2016

A Federal Judge has determined that the report and recommendation of the assigned Magistrate Judge should be affirmed, and granted further long term disability insurance benefits to a claimant who had been paid for about six years under her coverage with Mutual of Omaha. She was disabled due to symptoms relating to Meniere’s Disease and other co-morbid medical problems.

Mutual of Omaha sought to develop an inconsistency between the claimant’s doctor’s support statement and the office records. It also sought to cherry pick portions of the medical records which could be favorably considered to support the termination, while failing to credit other evidence supportive of continued impairment.

Then, based upon an in-house medical review, Mutual of Omaha determined that restrictions and limitations were no longer supported. In considering her appeal of the terminated claim, Mutual of Omaha arranged for a Functional Capacity Evaluation, which reached the determination that the claimant had part-time functionality only. After Mutual of Omaha sought “clarification” as to full-time work capacity, the FCE provider indicated no to full-time work status, but affirmed the part-time functionality, and indicated that she might be able to build up from that. Despite this, Mutual of Omaha reached the determination that the claimant could perform full-time sedentary work.

In reviewing Mutual of Omaha’s decision and claim handling, the Court indicated that the conflict of interest of Mutual of Omaha, as claim payor and claim administrator, influenced its claim handling, including its misrepresentation of the FCE results, as well as factual information provided to the FCE examiner about her functionality.

The Court determined that Mutual of Omaha’s claim decision was “illogical, implausible, and without support” concerning the inferences that it drew from the record. The Court was also troubled by its finding that Mutual of Omaha’s claim personnel took an advocacy position when engaging with the claimant’s treating doctor, rather than as a neutral. The Court also took issue with the failure to afford consideration to the approval of the claimant’s Social Security disability claim.

Accordingly, the Court ordered reinstatement of benefits, with interest.

No one v. United of Omaha

Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications



Ready To Talk?

Fill out the form to request a FREE legal consultation

Sorry, we do not handle SSDI/Social Security claims.

Frankel & Newfield does not currently handle any Social Security Disability Insurance claims.


*Required fields are marked

I have read the disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.


This is about a Social Security Disability claim.

Ipad image

Download Our Free eBook


Secrets the Disability Insurance Companies Don't Want You to know!

Sign Up for our mailing list to receive disability insurance law updates

Your information is 100% secure and will never be shared with anyone


No matter where you are nationwide, we are here to help.

We have the resources and support to take on the largest insurance companies.

Contact us today for our nationwide service.

Contact Us
Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Nebraska Nevada New Hampshire New Jersey New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina
South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming