Our client was a telephone sales consultant for Intuit Inc. She developed interstitial cystitis (a bladder condition which causes urinary pain, urgency and frequency). In 2012, she applied for long-term disability benefits under her employer’s ERISA disability plan. Her initial claim was made without counsel. She was denied.
She retained counsel who prepared an extensive administrative appeal which documented the impact that her condition had on her ability to perform her occupational duties. The carrier, Reliance, reversed its initial decision and reinstated benefits. In 2014, the definition of disability changed from “unable to perform your own occupation” to “unable to perform any occupation.”
After review of additional medical records, Reliance again terminated the claim. Reliance did not cite any improvement in her condition, but felt that there was some type of job that our client could do. Again, an extensive appeal followed. The appeal argued, in large part that having determined that the claimant could not perform her own occupation (which was sedentary in nature), there was no effective change in the disability definition that would warrant termination of benefits.
The appeal included an ex-tensive analysis of ERISA case law, updated witness statements and additional medical literature. Reliance reinstated benefits. Those benefits have a future lifetime value of $488,965.68.