[Note: each case is different and depends on the unique facts of that case. Past results do not predict future results.]
BenGlassLaw was hired to file a second appeal on behalf of our client who hired us after filing his own LTD appeal.
Our client was an active surfer, who was injured in a surfing accident. The accident resulted in a fracture of one of his cervical vertebrae. This injury led to extensive orthopedic surgeries and neurologic treatment. This type of injury causes a lot of pain. Our client's pain was well documented by many of his physicians, who described his condition as debilitating.
This type of injury, not to mention the treatment and pain involved, prevented him from returning to his work as a network planner/installer. Though his condition and treatment were well documented, the client's insurance company denied his application for benefits.
Our client appealed the decision on his own, but the appeal was denied. Fortunately, his policy allowed him a second "voluntary"appeal. He hired BenGlassLaw to manage this appeal.
During the ERISA administrative appeal, BenGlassLaw argued that the insurance company did not give the client a full and fair review guaranteed under ERISA. His file was reviewed by an internal medical reviewer, not an unbiased or appropriate healthcare professional. We also argued they could not ignore the evidence and documentation of our client's healthcare and the opinion of his doctors. Finally, the insurance company classified the client's occupation as sedentary without reviewing his actual duties and responsibilities.
After the appeal, our client's benefits were granted. The total lifetime value of his benefits are $947,394.
If your claim for long-term disability benefits has been denied, download Ben Glass's Robbery Without a Gun to learn more about the LTD appeal process.