Our client was a highly educated and skilled mathematician who worked as a Data Modeler for Data Networks Corporation, who was covered under a group long-disability policy purchased from SunLife by her employer and governed by ERISA.
Our client became disabled due to multiple traumatic brain injuries, which caused migraines, fatigue, pain, memory problems and severe vertigo, double vision and dizziness. She cannot focus her eyes for more than a few seconds at a time without causing a migraine and becoming extremely dizzy.
Long-Term disability benefits with SunLife were terminated after three years of payments. SunLife stopped paying because it said she could work as a data modeler even though, in an otherwise mostly normal neuropsychological examination her math scores were now in the 5th percentile and she scored very low in “story recall.”
Our client, recognizing the gravity of the situation retained BenGlassLaw almost immediately after receiving notice of her benefit termination.
The primary arguments made in support of the claim focused on the specific occupational requirements as a data modeler:
- SunLife’s Psychiatric reviewer blatantly ignored evidence from SunLife’s own IME when stating our client did not have cognitive deficits. In fact, the IME showed that our client had scored well below average in two categories which were essential to her job duties (math and story recall.)
- Our client's job duties included the ability to solve complex mathematical problems, a duty which was ignored by SunLife when it wrongfully substituted an incorrect job description in analyzing whether the Claimant could work. In support of the appeal abundant data on the occupation “data modeler” was submitted, including a college course syllabus that emphasized that, in large part, one needed to be highly proficient in advanced math to even take the course.
- Our client's job duties required being able to use a computer for 6-8 hours per day. The nature of her disability and the severity of her condition would not allow her to look at a computer screen for more than a few seconds at a time and thus, was impossible for her to perform her job duties.