BenGlassLaw Long-Term Disability Win Secures $1,200,000 in past and future benefits for Facebook employee who worked as records manager.
The Facebook Long-Term Disability Plan
Sometimes the coolest companies to work for don’t always have the coolest benefit plans. Helen had begun working for Facebook in January 2017 as a Manager of Records. She frequently had to travel the country to different court cases to testify on behalf of Facebook. Her job dealt with important and sensitive information. She needed to show excellent judgment and decision making skills while under pressure. This high-level position was often stressful, but it was Helen’s dream job. She was planning to stay and grow with Facebook until retirement.
How a Sudden Illness Derailed Our Client’s Career
Helen had been healthy for many years while managing her Coronary Artery Disease. Taking over-the-counter aspirin, she experienced no symptoms until late February 2017. But something changed, and she started to feel increasingly ill. Her doctors were concerned and by April 2017 they recommended she stop working so they could focus on finding out what was wrong. Helen was experiencing severe symptoms of pain, fatigue, insomnia, chest pain, depression, and anxiety. As the symptoms worsened, Helen needed heart surgery to put in a stent and remove a blockage. Then the bad news got worse: a CT scan revealed that she also had a herniated disc and thyroid cancer, which couldn’t have come at a worse time. She was taking blood thinners after the stent procedure, so surgery for these new conditions would be impossible until she finished her anticoagulation medications.
How Cardiac Surgery Delayed Care and Surgery for the Back Issues
After heart surgery, many patients are prescribed blood thinners to prevent blood clots. These medications reduce the risk of stroke, heart attack, and other complications by preventing platelets in the blood from clumping together. Blood thinners are crucial, especially following surgeries like heart valve replacement or after treatments for atrial fibrillation, where the risk of clot formation is high.
However, while blood thinners are beneficial for preventing clots, they also increase the risk of bleeding. This is a critical concern when it comes to any subsequent surgeries, such as back surgery. During surgical procedures, some amount of bleeding is expected. But for patients on blood thinners, the normal clotting process is inhibited, which can lead to excessive bleeding during or after the surgery. This not only complicates the surgical procedure but can also lead to further complications such as increased healing time, infection, or even life-threatening hemorrhage.
Therefore, if back surgery or any other invasive procedure is required after heart surgery, there might be a need to delay it until it is safe to reduce or temporarily stop the blood thinner medication. The timing of when to safely pause and resume blood thinners around surgery is carefully planned by healthcare providers. They balance the risk of clotting against the risk of excessive bleeding, based on the patient’s overall health, the type of blood thinner used, and the urgency of the surgery. This careful timing ensures optimal conditions for both the success of the surgery and the patient’s recovery.
A Surprise Denial From the Insurance Company, Liberty Mutual
Helen applied for long term disability benefits. She was shocked to have her claim denied. Liberty Mutual said in the denial letter that even though she was having numerous medical issues, she wasn’t eligible for disability benefits. Why? They said she could sit without restrictions, so she could work her at her “sedentary” job. And they said that because she was taking aspirin, her blockage was a “preexisting condition” and would not be covered. Liberty Mutual did not take into account the pain she was experiencing. They did not talk to her doctors. They just cherry-picked a few notes from her office visit notes and denied her claim.
Helen came to BenGlassLaw to help overturn the denial of long term disability benefits.
On the first call she told us that she was impressed with the information at our Long-Term Disability Claims YouTube Channel.
How BenGlassLaw Was Able to Help With This Claim
Using the information (and lack of information) in the denial letter and claim file, BenGlassLaw was able to win this case. We proved that Liberty Mutual had stated themselves that Helen didn’t have a “sedentary” job, since she was required to travel frequently. We showed that the treating physicians recommended she shouldn’t work. And we verified that her severe pain was related to her test results showing serious back and neck issues, and was a major disabling factor in her life. Pain restricted her ability to sit, move, think and concentrate. All the medical documentation supported her disability, and Liberty Mutual was wrong to rely on “experts” who only looked at the medical records instead of examining Helen directly or talking to her doctors. Importantly, we also argued that just because your doctor recommends that you take a daily aspirin, that does NOT mean you have a “pre-existing condition” if you later experience a heart blockage!
With her Long Term Disability benefits reinstated, Helen received over $60,000 in back benefits, and now receives a monthly benefit check of over $6,000. She’ll continue to receive these benefits as long as she remains disabled. She hopes and plans to return to work, but if she cannot, the potential value of her claim until retirement is over $1.2 million.