Our client, a mom of three boys with a fast-paced career, was always on the go. She had a career she loved and family – both immediate and extended – was everything to her. Before her devastating accident, she enjoyed learning about science and computers, entertaining and cooking for parties that she hosted. Her large extended family celebrated any and every occasion with a party, and she loved caring for them.
In 2019 her life completely changed when a vehicle rammed into the side of her car. As a direct result of the accident, our client suffered from whiplash and a frozen shoulder. She also experienced a worsening of her pre-existing conditions, such as carpal tunnel and chronic neck pain. Her whiplash caused many problems: headaches, memory issues, sleep difficulties, intense pain, and numbness/tingling. Although she tried to return to work after the accident, her symptoms made it impossible to concentrate. The disability insurance company, The Standard, initially approved her short-term claim. However, they flat-out denied her long-term benefits because, it seems to us, it became clear her symptoms were not going away and there was no “end date” in sight.
The Standard’s denial obscured the evidence in favor of our client's claim. They ignored her doctors' opinions as well as objective MRI results showing evidence of her injury. Instead, they hired their own doctor, who never met our client, to decide whether or not she was disabled. He conducted a cursory "paper review" of her records and disagreed with her doctors (who of course had examined her in person many times). Using his report, The Standard denied her disability claim, claiming there was no documented evidence of her subjective symptoms.
The client hired Ben Glass to appeal this unfair decision. It was a complicated appeal, because in addition to highlighting the support she had from her doctors, we needed to dig into the policy language to challenge The Standard’s outright dismissal of our client’s “subjective symptoms” of severe pain. While it is technically correct to say that there is no “objective evidence” of severe pain, insurance companies still must give weight to pain complaints when they are supported by objective evidence of a medical condition (such as whiplash) that is known to cause pain.
We researched our client’s medical conditions to show that they are generally known to cause extreme pain and included that research with the appeal. We pointed out court decisions in similar cases where the claimant is credible and has objective evidence of a condition known to cause severe pain. We submitted nearly 100 pages of additional medical records and other material showing clear support from her doctors for her disability. We were hoping to win at the appeal level, but were preparing the file for a judge’s review in case we lost.
Fortunately, our leg work paid off and we won the appeal. The Standard was obligated to pay our client the back benefits she deserved and recommence monthly disability benefit payments. BenGlassLaw will manage her case going forward to ensure we do everything possible to keep her on claim for as long as she remains disabled – which, everyone hopes, will not be for long.If the client does remain disabled until the maximum end of benefits date, the total value of the case is $1,396,990.35.