Long Term Disability Insurance claims can be difficult to pursue in federal court when the primary disabling condition is chronic pain syndrome. One of the difficulties for claimants to overcome is the restrictive rules that have evolved from the common law governing the Employee Retirement Income Securities Act (ERISA). ERISA applies to most disability insurance claims.
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Subjective Symptoms of Pain Often Ignored by Disability Insurance Companies
Disability Insurance companies such as Unum, Cigna, Aetna and Prudential often write their policies so to make it difficult for a disabled person with “subjective” symptoms such as chronic pain to receive benefits or to keep them for the entire length of the term of their insurance policy. Other insurance companies with a large share of the disability market include The Hartford, Standard Insurance, SunLife, MetLife and Liberty Mutual.
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Federal Courts Have Ruled Pain Cannot be Ignored by Insurance Companies
The Federal Court of Appeals for the Fifth Circuit has recently indicated that subjective complaints of pain cannot be dismissed by the insurance companies. In Burdett v. Unum Life Insurance Company of America, the district court explained
In stacking the evidence, [p]laintiff has presented objective medical evaluations that confirm her condition and pain that she is experiencing. She provided proof of medical tests, including an MRI, an EMG, and a lumbar myelogram, all of which confirmed that [p]laintiff suffered from objective disabilities. She also provided proof of surgeries that were designed to alleviate her condition, although they were not entirely successful and resulted in further complications, including a spinal leak.
Similarly, in Schexnayder v. CF Industries Long Term Disability Plan, the plaintiff was denied benefits because the retained physicians performing paper reviews found that Mr. Schexnayder=s “complaints of pain to be subjective and ‘not consistent’ with the objective findings.” 553 F. Supp. 2d 658, 666 (M.D. La. 2008). The plaintiffs in Burdett and Schexnayder, submitted medical documentation of impairments Aestablishing facts and conditions@ that would reasonably cause pain. Those impairments were confirmed by their physicians and the Social Security Administration. These court decisions held the insurance companies accountable for their denials. Further the court in Audino v. Raytheon Co. v. Short Term Disability Plan, 129 Fed. Appx. 882, 885 (5th Cir. 2005) held that the accounts of pain cannot be ignored.
If you have a long term disability insurance claim that has been denied and you have questions, contact disability attorney Marc Whitehead at tel:8005629830 or visit him at disabilitydenials.com and download his free ebook.
