Principal Life Insurance Company denied a claim for disability benefits based upon his complaints of bilateral tinnitus, hearing loss, headaches, and vertigo. The second Circuit Court of Appeals found that the insurance company was wrong because it failed to consider the claimant's subjective complaints.
Many times a disability insurance company will deny a claim based upon the excuse of "no objective evidence" of disability. Here the court said that subjective complaints are an "important factor to be considered in determining disability" and that courts may not "dismiss complaints of pain as legally insufficient evidence of disability."
The court was also critical of Principal's failure to comply with ERISA's notice requirements in that it failed to adequately tell the claimant what it needed when it did not tell the claimant that "subjective complaints" would not be good enough for the claim. The court found the rejection of the claimant's subjective complaints to be arbitrary and capricious.
The court also found it unreasonabe for the disability insurance company to request objective evidence of impairment with tinnitus when it had not identified that any such tests that exist. This is a popular trick that insurance companies use to deny benefits. Don't let them get the better of you if you are claiming tinnitus in your disability insurance claim!
Do You Have a Virginia Disability Claim that has Been Denied?
In order to help you make smarter decisions about your disability claim, we published a free book about disabilty claims and benefits in Virginia. It is a must-read if you are dealing with a disability claim denial.
Additionally, you should call our office at (703)584-7277 to speak with our team about your case. You should speak with an experienced disability attorney before trying to appeal the denial yourself.