Marc Whitehead & Associates have represented clients across the country who have had insurance companies like MetLife unfairly deny their disability benefits claim after an illness or injury has left them unable to work. We possess the skills and expertise to assemble a successful appeals case and the dedication to ensure you get a fair and just review from the insurance company, even if it means taking them to court.
The Metropolitan Life Insurance Company, more commonly known as MetLife was founded back in 1868 with corporate headquarters in New York City. A Fortune 500 company, Metlife is one of the world’s leading insurance companies, providing insurance, annuities, employee benefits and other products and services to over 90 million customers in the U.S., Latin America, Pacific rim countries such as Japan, Europe and the Middle East.
Marc Whitehead & Associates recently represented a 59 year old woman from Ahoskie, North Carolina, with severe back and leg pain, arthritis, and fibromyalgia, which all lead to chronic pain, in her appeal of MetLife’s decision to deny her claim for long term disability (LTD) benefits.
After reviewing her case, we concluded that MetLife’s LTD denial of benefits ignored the vast medical documentation that proved our client’s disability.
Our Client’s Benefits Were Discontinued After 24 Months Even Though She Was Unable to Work
Our client first submitted her claim for long term disability benefits in the form requested by MetLife and was awarded benefits for 24 months.
During the first 24 months of most LTD benefits insurance policies, the beneficiary must prove that they can no longer work in their own occupation, i.e., the position they had when they went out on disability. A large number of policy holders are granted benefits during this period.
However, after 24 months beneficiaries must prove that they can no longer work any occupation that matches their skill set and experience. Proving that a benefits recipient cannot work any occupation is a difficult task.
After 24 months, MetLife arrived at the decision that our client’ severe medical conditions no longer met their definition of disability. Though she may not be able to return to her own occupation, MetLife felt that she could find employment in a sedentary position.
What is common to every occupation, even a sedentary job, is the necessity that the individual retain the ability to engage in sustained work activities on a consistent basis. To perform sedentary work, a person must be capable of sitting up to 6 hours a day, day after day, week after week, and month after month. Our client’s disabilities were such that she was unable to meet the minimum physical requirements required for any occupation, even a sedentary occupation.
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Appeal of MetLife LTD Denial Filed by Marc Whitehead & Associates
It was the responsibility of Marc Whitehead & Associates to appeal her MetLife LTD denial and prove that MetLife’s decision to discontinue our client’s benefits after 24 months constituted an incorrect determination.
The denial letter sent by MetLife to our client stated that they felt the updated medical information provided to them did not support our client’s inability to perform the essential duties of any occupation.
We knew this simply was not the case. Our appeal focused on the effects of our client’s devastating back pain and the side effects of her medication, evidence MetLife failed to fully address during their review process. We explained these effects in great detail.
We presented evidence that showed that our client:
- Was unable to rise from bed until noon due to the severe pain in her back and legs.
- Was unable to walk for more than 10 -15 minutes at any given time due to this severe back and leg pain.
- Suffered from decreased appetite, sleep issues, arthritis in her hands and arms, and chronic pain that flares to excruciating levels with no warning or schedule.
- Suffered from drowsiness, dizziness and slowed reactions caused by the numerous prescription medications necessary to control her pain.
- Would require frequent unscheduled work breaks due to frequent and severe pain, something a sedentary job in a competitive work setting does not allow.
We were able to prove how all these medical conditions contributed to hinder ongoing employment and prevented our client from having the functional capacity to perform any occupation, sedentary or not. With the help of cooperative representatives, MetLife overturned their decision to cease benefits and has approved benefits past the initial 24 months continuing until age 65.
Importance of Medical Documentation in Reversing MetLife LTD Denial
The more evidence to support a disability claim, the better. Compiling the comprehensive medical evidence and records necessary to prove a client is unable to work any occupation is crucial to prevailing in an LTD appeal. In the case of our client from North Carolina, we were able to include a large list of physician’s statements along with extensive medical documentation supporting our client’s ongoing disability. Each of her physicians went into great detail regarding her many disabilities, how they affect her daily life, and to what effect each disability has upon her ability to work. The medical records helped us prove that our client has done everything in her power to control the chronic pain with little success.
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Attorneys for MetLife Disability Claims
Sadly, it’s not unusual for MetLife and other insurance companies to deny benefits after a specific period of time, whether the beneficiary has recovered or not. Marc Whitehead & Associates have helped thousands of clients all over the U.S. who have become disabled and unable to work obtain the maximum long term disability benefits they deserve. We represent you during every phase of the appeals process, from gathering the necessary medical evidence to support your case to arguing on your behalf in state or federal court.
Don’t let a Metlife LTD denial odiscourage you from seeking the benefits you need. The law gives you the right to appeal their decision. If you believe MetLife, Prudential, Aetna or some other insurance company has unfairly denied your claim for LTD benefits, contact the law offices of Marc Whitehead at 866-365-7898 to schedule a free consultation with an LTD benefits claim lawyer today. We’ll evaluate your case, answer any questions you might have, explain your rights and the ways we can help you obtain your LTD disability benefits.
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