Our 29-year-old client had a promising career ahead of him as an Actuarial Associate. Once an avid golfer and tennis player, he never anticipated having to stop working and enjoying an active lifestyle because of a medical issue. He suffers from Fluroquinolone toxic poisoning caused by fluroquinolone (FQ) antibiotics, which have been documented in medical literature to cause irreversible nerve damage resulting in peripheral neuropathy.
His additional co-morbid conditions include ligament laxity, where his ligaments are too loose and joints are not held in correct alignment when they move; cervical disc disorder and radiculopathy; severe alar instability (excessive motion at the head and neck junction); kyphotic neck (the cervical spine curves forward instead of towards the back) and numerous related restrictions and limitations, including chronic pain, myofascial pain, neck, back, wrist, shoulder, knee and hip pain, headaches, cognitive issues, as well as difficulty with gait and standing, sitting or walking for any length of time.
Our client’s benefits were wrongly terminated while he was still in the short-term disability process. This despite a litany of medical support from a wide range of specialists provided to New York Life by no less than seventeen doctors, including many specialists. He retained the services of Frankel & Newfield to submit an ERISA appeal to overturn New York Life’s wrongful termination of his short-term disability claim and prepare for the expected denial of his long-term disability claim.
New York Life’s denial was not only inaccurate but lacked any proper medical or vocational analysis. Working closely with our client, his treating doctors and providers, we developed a powerful ERISA appeal, providing New York Life with ample support as to why our client could no longer work on a full-time sustained basis in what had been a physically and cognitively demanding career. To support the appeal, we engaged a vocational expert to conduct testing, which served to support with objective evidence the impact of his conditions upon his work abilities.
Our appeal contained a wealth of support, including powerful medical support from numerous doctors, a comprehensive functional capacity evaluation conducted by a Licensed Occupational Therapist and Certified Vocational Evaluator, strong subjective support and statements from many people within our client’s sphere, and a wealth of medical literature – informing New York Life of the severity of our client’s conditions and educating the insurance company about Fluroquinolone toxicity.
Upon review of our ERISA appeal, New York Life reversed its decision. Our client’s short-term benefits were reinstated and equally importantly, his long-term claim was approved. He is now devoting what energy he has on learning to live with his disability, rather than squandering precious time and energy doing battle with an insurance company.
