Our client was a public school speech therapist. She was diagnosed with chronic Lyme disease and place on a course of antibiotic therapy. Liberty Life Assurance, the insurance company that manages the short term disability plan for Fairfax County school teachers and funds the long-term disability plan, denied the claim.
The position of the plan, based upon its independent medical reviewers’ reports, was that (1) our client was misdiagnosed and was being treated for a disease she did not have; (2) the medical records did not support any limitations or restrictions on her activity and (3) our client should be examined for a “mental illness.”
Our client appealed once on her own but that appeal focused on all of the wrong issues. BenGlassLaw was retained to do a second appeal.
In the second appeal, we provided an abundance of medical literature that rebutted many statements that the insurance company reviewers had made about the diagnosis of chronic Lyme disease. The appeal pointed out that both medical reviewers for Liberty Life were frequently hired by disability insurance companies to perform “independent paper reviews” which denied claims. The appeal also included a rebuttal from the treating physician, multiple letters from friends and family and a case report critical of one of medical reviewers in another case.
Liberty agreed to pay the short-term disability claim and to accept for processing the long-term disability claim.
The expected lifetime value of the monthly benefits is $986,000.