$160,000 Lawsuit Settlement of Denied Long Term Disability Claim After Doctor says “keep working with your cardiac condition and you will have a heart attack”
Summary:
Our client, James Porter (not the claimant’s real name, of course!), was employed as a Senior Project Manager at a major technologic innovation company in Tyson’s Corner, Virginia when he applied for long term disability benefits for his cardiac condition. Unfortunately, he developed serious health conditions, including Coronary Artery Disease (CAD), Atrial Fibrillation (A-fib), and Dyslipidemia. These conditions severely impacted his ability to work, especially in a high-stress environment.
Despite the severity of his health issues, the long term disability insurance company denied his claim for long-term disability benefits, stating that there was insufficient clinical evidence to support his inability to work.
James appealed the denial of benefits on his own. As is most often the case with claimant-filed appeals, James’ appeal did not convince the insurance company to change it’s decision. There are nine essential steps involved in appealing a denial of long-term disability benefits.
The next step after a denied appeal is a lawsuit.
The BenGlassLaw long term disability litigation team stepped in to assist James and filed his lawsuit. The team has experience representing long-term disability claimants with cardiac conditions. We also took a deep look into his claim file in order to fully understand his condition, the reasons he cannot work and why, exactly, the insurance company denied his claim.
We discovered that the insurance company had upheld their denial because they claimed that James could return to work in a less stressful job, and that his heart condition did not qualify as disabling under their policy terms.
When we pointed out that we had recently won a major case involving disability benefits for a cardiac condition, the insurance company came to the table with good money to settle the case. Each case is different and settlements depend on a number of issues, including the age and salary of the claimant.
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Disabling Medical Conditions:
Atrial Fibrillation (A-fib): A heart rhythm disorder characterized by rapid and irregular beating, causing palpitations, weakness, and shortness of breath, significantly limiting our client’s ability to perform his job duties.
Dyslipidemia: Abnormal levels of cholesterol and other lipids in the blood, contributing to the development of cardiovascular diseases and exacerbating our client’s overall health condition.
Coronary Artery Disease (CAD) in native artery: This condition affects the arteries supplying blood to the heart, leading to reduced blood flow, chest pain, and increased risk of heart attack. For our client, this meant frequent episodes of chest pain and fatigue.
Ultimately, we secured a favorable settlement for James, ensuring that he received the long-term disability benefits he rightfully deserved. This victory not only provided financial security for James but also set a precedent for recognizing the critical role of job-related stress in evaluating disability claims.
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