Hopelessly Outclassed in ERISA Long Term Disability Case

For anyone who thinks that handling an appeal of your long term disability case on your own is a good idea, think again. Another respected federal judge has declared the long term disability world a tilted playing field.

Judge William Acker, a respected federal judge recently made these points in a case involving a claimant who had represented herself in an appeal to Sedgwick the plan administrator for AT & T:

  1. A pro se ("do it yourself") claimant will be hopelessly outclassed. The judge said this "David could not slay a well-armed Goliath.
  2. Sedgwick was a fiduciary who demonstrated more loyalty to the company paying it AT & T, than it did to the claimant. (fiduciaries are supposed to treat everyone equally.)
  3. Sedgwick jealously guarded it client's money.
  4. The claimant was faced with the unenviable task of separately appealing to a conflicted judge (Sedgwick) each of the judge' three shorter term denials and hit a brick wall each time.
  5. While the social security administration found the claimant fully disabled, that came after her appeal and after the administrative record was closed. Thus, it could not be considered.
  6. Remands of a claim to the claim administrator after or during litigation are "rarely, if ever, worthwhile".
  7. The Sedgwick claims process was a "briarpatch."

Basically, the judge called the ERISA long-term disability process essentially a complete and utter fraud and invited the Supreme Court of the United States to one day look at the due process aspects of the case.

 

The case is May v. AT & T Integrated Disability.

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