After being approved for disability insurance benefits for almost two years, without warning, Prudential Insurance Company simply terminated a disability insurance claim of a woman suffering from severe and uncontrolled systemic lupus. Financially devastated by the termination of benefits and extremely ill, the claimant was unsure how to proceed. She eventually retained Disability Insurance Law Group, who prepared an administrative appeal and was able to successfully overturn Prudential’s termination of benefits.
Our client, Ms. X, is a young woman suffering from severe systemic lupus. Her disease has essentially attacked every part of her body, causing, among other things, congestive heart failure, bone disease, renal failure, optical ulcers, and a severely lowered immune system. Due to the severity of her condition, the vehement support of her treating specialists, and the fact that Ms. X was approved for Social Security disability benefits, Ms. X was convinced that her claim for continued disability insurance benefits was secure. Accordingly, she and her physicians were shocked when Prudential terminated her benefits, asserting that there was a lack of evidence that she was disabled from any occupational. To support its determination, Prudential hired a nurse to review Ms. X.’s medical documentation, who opined that Ms. X should be able to return to work.
After being retained, Disability Insurance Law Group demanded and received Prudential’s entire file on Ms. X and her condition. It was clear that Prudential had in its possession and clearly ignored substantial evidence to support Ms. X’s continued disability. This suggested that Prudential’s denial was motivated by its financial self-interest. Disability Insurance Law Group obtain all of Ms. X’s medical documentation, took sworn statements from her physicians, and sent Ms. X to undergo an independent medical examination that established that Ms. X was unable to maintain gainful employment in any occupation. Likewise, Disability Insurance Law Group obtained compelling sworn witness statements from Ms. X’s friends, family members, and co-workers. With this information, Disability Insurance Law Group prepared a comprehensive administrative appeal outlining the evidence clearly disregarded by Prudential, setting forth the applicable law, reminding Prudential of its obligations to Ms. X, addressing all of Ms. X’s medical evidence, and informing Prudential that Ms. X planned to file suit if Prudential upheld its unreasonable denial. Once submitted, Disability Insurance Law Group consistently followed up with Prudential and submitted additional support. Based on Disability Insurance Law Group‘s appeal and exhibits, Prudential expeditiously overturned its termination of benefits and provided Ms. X with all benefits withheld. Ms. X is now receiving continued disability insurance benefits and Disability Insurance Law Group continues to administer her claim and act as her representative with Prudential.