The Disability lawyers at Marc Whitehead & Associates have enabled thousands of clients to secure badly needed benefits after their claims for Long Term Disability Benefits were unfairly denied by Prudential and other insurance companies. We’ve represented Prudential policyholders through every step of the appeal process, from gathering the documents that support your claim of disability to arguing your case in front of a Judge in Federal Court.
Marc Whitehead & Associates were recently forced to file suit on behalf of a disabled worker who became severely disabled while covered under a long term disability insurance policy issued and administered by Prudential. Our client, a resident of Texas, was employed as a truck driver and is currently disabled to musculoskeletal problems.
We took this action to secure all long term disability insurance benefits to which our client was entitled under a disability insurance policy underwritten and administered by Prudential. Our client was covered under the policy by virtue of plaintiff’s employment.
The Employee Retirement Income Securities Act (ERISA)
This claim was governed under federal ERISA law. ERISA stands for the Employee Retirement Income Security Act of 1974. It’s the federal laws that regulate the handling of Employee Benefit Plans and the remedies of the beneficiaries of these Plans. ERISA applies to all employees benefit plans established or maintained by an employer engaged in commerce or by an employee organization representing employees engaged in commerce. Practically all long term disability plans offered by a private employer are governed by ERISA’s laws. Challenging a disability denial under an ERISA governed plan or policy means a policyholder must appeal their claim pursuant to ERISA regulations and procedures.
Venue & Jurisdiction of Long Term Disability Lawsuit
Our client’s lawsuit was filed in federal court in Texas pursuant to 28 U.S.C. § 1331 (“The district courts shall have original jurisdiction of all civil actions arising under the Constitution, laws, or treaties of the United States”) to our client’s rights under the ERISA, as allowed by 29 U.S.C. §§ 1132, 1133, & 1140.
Allegations of Wrongful Denial of Disability Benefits Under ERISA
Prior to our lawsuit, the Social Security Administration had issued a fully favorable decision on our client’s claim for Social Security disability benefits under Title II and Title XVI of the Social Security Act, finding that he was “disabled” during the relevant time period — a fact that Prudential was very much aware of.
Prudential notified our client that they stood by their original decision to deny his claim for long term disability benefits, completely ignoring the findings of the Social Security Administration.
To make things worse, Prudential also notified our client that he had exhausted all administrative remedies and they would consider no further claims or evidence. Prudential, in its final denial, discounted the opinions of our client’s treating physicians, as well as the thoroughly documented limitations from which our client suffers including the effects of his impairments on our client’s ability to engage in work activities. Our client had now exhausted all available administrative remedies, and was left with no other option except to file a lawsuit to obtain his rightfully owed disability benefits.
Let ERISA’s Rules Work for You – Not Against You
Disability Insurance claims are governed by a complex set of laws and procedures. Insurance companies use these laws and procedures to their benefit. They often write their policies to take full advantage of ERISA rules and regulations to make it difficult for a disabled worker to get receive benefits or to keep them for the entire length of the term of their insurance policy. They know these laws are full of traps for the unwary and inexperienced. Don’t fool yourself into thinking you can handle the insurance company’s administrative appeal process all by yourself, hiring a lawyer only as a “last resort” if you lose and have to file a lawsuit. Unfortunately, we’ve seen people make this make this mistake time after time.
We had a client come to us with such a claim. “Don’t worry about the administrative appeal, I filed it myself,” he said. “I just need you to file my lawsuit.” It turns out his appeal consisted of a one page letter asking the insurance company to reconsider because he “really was disabled.” He was shocked to learn that this one page letter was the only evidence the judge could consider in his case other than what the insurance company chose to include when they denied him. In other words, he had blown any chance to present his case in court. Don’t let this happen to you.
Long Term Disability Benefits Claim Denial Attorneys
Marc Whitehead & Associates have helped clients all over the United States obtain the long term disability benefits they deserve. If you feel your claim for disability benefits from Prudential or another insurance company were unfairly denied, reach out to Marc Whitehead & Associates without delay.