Short & Long Term Disability Cases We’ve Won for Our Clients Against Various Insurers

A commercial sales representative for ADT sold and created plans for alarm systems with large commercial businesses. He loved his job, particularly interacting with customers and meeting their needs to protect not only their facilities, but also their intellectual property. Unfortunately, one day he developed a severe headache that kept him out of work for several days. He assumed the headache would go away as, at times, Tylenol and ibuprofen would ease the pain. But, when the headache increased and persisted to where it became unbearable, he saw a doctor who diagnosed severe migraines and started him on a treatment plan. While the treatment plan provided some improvement, the headaches affected his ability to do his job which required focus, concentration and an outgoing personality.

He could no longer do his job and filed for Long Term Disability benefits. Despite medical records clearly documenting the severity of the headaches, CIGNA denied the application for benefits. Left with no options and a lack of income to support his family, he hired Fields Law. The attorneys at Fields Law engaged his doctors, assembled medical records and reports, and filed a successful, favorable appeal. To our client’s great relief, the disability payments and back pay were issued and he could now meet the financial needs of his family and continue with his treatment plans with the hopes of resolving his medical condition and returning to full-time work.

In New Jersey, a man worked as a pipe fitter and welder. He suffered from severe back pain due to a workplace injury. MRI’s showed pressure on his spinal cord in his lumbar spine along with a bulging disc. As a result of his pain, he could not work. His insurer initially approved his claim for Long Term Disability benefits but the claim was later denied. The denial letter asserted that the medical information available did not support ongoing disability.

Unsure of what to do, he reached out to Fields Law. His attorney reviewed the insurance company’s file and developed a plan to fight the denial. Our attorney updated medical records and requested reports from the client’s treating doctors. With the updated records and reports, we then drafted a winning appeal. The insurance company reversed their decision, reinstating our client’s monthly benefits and paid all the past-due benefits. Our client was incredibly relieved to know that his source of income had been restored.

A counter manager in New Jersey applied for Short Term Disability benefits with an insurance company provided by her employer. Her Short Term Disability benefits were approved by the insurance company and it paid her benefits for six months until she exhausted these benefits. She then applied for Long Term Disability benefits with an insurance company provided by her employer. Her Long Term Disability benefits were also approved by the insurance company and it paid her benefits until they terminated her Long Term Disability benefits just two weeks after approving her claim. The insurance company sent a denial letter for the Long Term Disability benefits based on the determination that she could work her regular occupation as a counter manager.

Disappointed with the sudden loss of income, she contacted the attorneys at Fields Law to help appeal the adverse decision. The attorneys at Fields Law acquired medical records, functional capacity evaluations, and reports from our client’s treating doctors and submitted an appeal. The insurer, in response to the appeal, issued a decision and overturned their prior determination to terminate our client’s Long Term Disability benefits and she was paid back all the benefits she was entitled to.