Mutual of Omaha Disability Help

Mutual of Omaha Reinstates Benefits of Business Development Manager after Appealing the Termination of Her LTD Benefits

Our Client, a successful Business Development Manager began experiencing severe physical limitations resulting from fibromyalgia, low back pain, L4-5 spondylolisthesis, L4-5 degenerative disc disease and chronic fatigue. As a result she was unable to perform with reasonable continuity at least one of the material duties of her regular occupation on a part-time or full-time basis.

Denial Based Solely on Nurse Consultant Review

Mutual of Omaha’s decision to deny her claim for LTD benefits was based on the review of medical records performed by Mutual of Omaha’s in-house nurse consultant, who after merely reviewing the medical records, concluded that fulltime and full duty working activities are not contraindicated with a diagnosis of Fibromyalgia. In her opinion, “this condition and the symptoms associated with Fibromyalgia are typically treated with increased activity, regular exercise program, and regular working activities.”

It was the opinion of this nurse reviewer that it was reasonable to expect the claimant to be able to walk or stand for 6 hours out of an 8-hour day. Lift no more than 20 pounds on an occasional basis and up to 10 pounds on a frequent basis. She further opined that the claimant presented with self-reported symptoms with no acute physical findings. The severity of symptoms documented was inconsistent to provide a clear explanation that she would have any restrictions and limitations.

Claimant Physicians Disagree with Nurse Reviewer Opinions

Mutual of Omaha’s nurse was incorrect in her opinions regarding the claimant’s functional capacity and Mutual of Omaha acted with bias and in conflict of interest when it relied solely on their in-house nurse’s opinion in reaching its decision to deny the claim for long term disability benefits without retaining a physician in the proper specialty to perform a peer review of the claim. The nurse consultant was clearly not qualified to render a medical opinion with regard to the claimant’s functional capacity to perform work duties, nor was she qualified to provide an opinion as to what might be the best medical treatment for her medical conditions.

All of the claimant’s treating physicians concluded, based on their physical examinations and treatment over an extended period of time, the claimant did not have the functional capacity to perform even sedentary work due to severe pain all over her body, fatigue and cognitive deficits.

In her peer review report, the nurse failed to explain on what evidence she based her conclusion that the claimant could walk or stand for 6 hours out of an 8-hour day and could lift no more than 20 pounds occasionally and up to 10 pounds frequently. Further, she failed to explain how the claimant would be able to perform both the physical and cognitive demands of her regular occupation in light of her complaints of severe, disabling pain and fatigue. Her occupation required more than just standing, walking and lifting 10 to 20 pounds. Her occupation as a Business Development Manager required long hours, the ability to multi-task, to think on her feet and ability to focus. The nurse reviewer failed to give consideration to the fact that the claimant suffers flares of her symptoms which prevent her from performing the material duties of her occupation with reasonable continuity, 8 hours per day, 5 days per week, on a continuing basis. During periods when the claimant experienced a flare up of her symptoms, she is completely disabled and barely able to care for herself.

Mutual of Omaha’s Determines It’s Decision Was Wrong

After Attorney Alters submits a length appeal accompanied several physicians’ opinions and medical records all supporting the claimant’s inability to work, Mutual of Omaha overturned its denial and reinstated the claimant’s LTD benefits. She is still unable to work and remains on claim. Attorney Alters will continue to manage the claim the help ensure that her benefits are paid until she is able to return to work.

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Mutual of Omaha Reviews

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1.7 out of 5

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2.4out of 5

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Showing 8 of 660 Reviews

Mutual of Omaha

I do not understand how a “medical review team” who has never laid eyes on my wife can say she is able to return to work when her doctors who see her on a regular basis have documented that she can't

Reviewed by Dwight on November 14th 2017 Verified Policyholder

My wife fell three years ago and broke her back. She has been found permanently disabled and receives Social Security Disability Benefits. She has also been receiving Bene... read more >

Reply

Sent on November 14th 2017 by Attorney Stephen Jessup

Dwight, please feel free to contact our office to discuss the denial of your wife’s claim. It is unfortunately all too common that an insurance company denies benefit... read more >

Mutual of Omaha

THEY SCAMMED ME AND DID NOT CARE

Reviewed by Debbie on January 31st 2017 Verified Policyholder

We have had life insurance with Mutual of Omaha since 1998 with a chronic illness rider that we decided to use in 2016. Our policy was for 500k, they approved us for 66,95... read more >

Mutual of Omaha

This company is awful

Reviewed by Mike on December 17th 2015 Verified Policyholder

I think there should be laws put in to place to cover the average Joe. This company is awful. They say so much they don’t even know what lies they have told. My husband ... read more >

Mutual of Omaha

I would encourage anyone who has problems with Mutual of Omaha or United of Omaha to immediately contact an attorney.

Reviewed by Robbie Winder on July 24th 2015 Verified Policyholder

I would encourage anyone who has problems with Mutual of Omaha or United of Omaha to immediately contact an attorney. I want to talk about a specific situation in which I ... read more >

Mutual of Omaha

MOO attempted to strong arms me with collection tactics. Now, they're stalling

Reviewed by Jeff on February 11th 2015 Verified Policyholder

I was disabled in 2009 with a multitude of medical problems. I started a process with Mutual Of Omaha Disability. After months of jumping through hoops they finally decide... read more >

Mutual of Omaha

MOO stopped my husband's benefits before telling him. They handled his claim terribly

Reviewed by Jerry on January 30th 2015 Verified Policyholder

My husband has been on claim for disability insurance since July, 2008. He was found to be able to do sedentary work but had no transferrable skills in 8/2009 and benefits... read more >

Reply

Sent on January 30th 2015 by Attorney Gregory Dell

Jerry, you and your husband are certainly not alone in your dealings with Mutual of Omaha. Please feel free to contact our office to discuss how we may be able to assi... read more >

Mutual of Omaha

This company is very corrupt, Be aware

Reviewed by M. Girmes on January 28th 2014 Verified Policyholder

Please hesitate & educate yourself when deciding on short term or long term disability insurance via Mutual Of Omaha. The company is very corrupt. They speak to you like y... read more >

Mutual of Omaha

Mutual of Omaha is a rip off.

Reviewed by Genita Hill on November 13th 2013 Verified Policyholder

Mutual of Omaha is a rip off. When my husband died in 2011, they refused to pay his death benefit because they said he was disabled when I insured him. He retired from his... read more >

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Answered Questions by Our Lawyers

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Showing 8 of 18 Answered Questions

Q: Can I ask for another appeal?

Answered on July 13th 2020 by Attorney Alex Palamara

A: Giovanna, you should consult with the attorney(s) that represented you in your appeal to the Third District Co... Read More >

Q: I'm in jeopardy of losing everything because of MOO. Can you help?

Answered on March 3rd 2020 by Attorney Alex Palamara

A: Amy, first and foremost, I am sorry to hear of MOO’s delay tactics and the fact that they sound like they mi... Read More >

Q: Can MOO deny my claim on the basis of preexisting condition when my condition is not preexisting?

Answered on October 27th 2018 by Attorney Gregory Dell

A: Doomed, if your claim has been denied then Mutual of Omaha will give you the right to appeal. Pre-existing con... Read More >

Q: What is my "regular occupation" if I started my own business after resigning from my old job?

Answered on September 1st 2018 by Attorney Gregory Dell

A: Rachel, the answer depends on when you became disabled. If you became injured after resigning from your accoun... Read More >

Q: Am I able to work part time at a different job that is nothing like the one I was at when I was injured?

Answered on June 5th 2018 by Attorney Gregory Dell

A: Russell, whether you can work part time in a different occupation depends on the specific language of the Grou... Read More >

Q: Can I get a lump sum check from MOO?

Answered on May 10th 2017 by Attorney Stephen Jessup

A: Pam, Mutual of Omaha may be willing to negotiate a lump sum buyout of the remaining time on your policy, but t... Read More >

Q: Should I be able to restrict the release of medical records to under 24 months period?

Answered on March 20th 2017 by Attorney Jay Symonds

A: Connie, although you could attempt to limit the medical records to be released to Mutual of Omaha, the likely ... Read More >

Q: Should I write an appeal letter? What should it include?

Answered on March 3rd 2017 by Attorney Jay Symonds

A: Cam, if you are still within your 180 timeline to file an appeal it is imperative that you go through the appe... Read More >

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After appeal filed by Attorney Jay Symonds, Mutual of Omaha overturned its previous denial of short term disability benefits for Colorado Senior Manager

Our client, Ms. J, formerly worked as a Senior Manager of a treatment facility. In October 2016 a number of medical issues, including fibromyalgia, chronic pain syndrome, chronic fatigue and depression forced Ms. J to stop working and submit her claim for disability benefits, first under her employer's short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. The STD c... Read More >

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Reviews from Our Clients

Keith G.

They were very professional with their responds and on time with keeping you inform about everything with your case. I would recommend My lawyer Stephen Jessup, he was on point with everything, thank you. You guys are awesome people to work with. God bless you guys.

Keith L.

I was not able to work as a physician for about 14 months due to neck/back issues. Even though I had 3 medical doctors explicitly state that I was not to work AT ALL as a physician at that time, New York Life (NYL) Disability Insurance denied my long term disability claim (which apparently they deny a high percentage of people similar to me- only they know why they do this to so many- I have my own suspicions). I was in pain from my medical issues and so frustrated with NYL considering I had many bills coming due. I then decided to call Dell Disability Lawyers. One of their attorneys, Alex Palamara, spoke to me on the phone right then to hear and understand my story and then offer ways he could help. Long story short, within a few months of me returning back to work, he was able to persuade NYL to pay me my long term disability claim. He (and his kind assistant, Tabitha) were always very helpful, informative, and available to me. I feel quite certain that NYL would NEVER have paid me what was appropriate based on my insurance agreement/ contract with them without the help of Alex. I highly recommend him/Dell Disability Lawyers. If you find yourself in a similar situation of disability insurance denial of your own personal/group policy, especially if you are a medical provider/physician like me, then consider contacting them for advice/direction PRIOR to appealing your claim on your own.

Kyle D.

Jay Symonds and his assistant, Sonia helped me tremendously. The insurance company that worked for my former employer did everything they could to make my life literally miserable. That all changed when I hired Jay. He and Sonia fought for my rights and forced the insurance company to pay what they should have.

If you have a disability claim hire Jay as if you go it alone the insurance company will screw you. Jay and Sonia will fight for everything you are entitled for. I couldn’t recommend them more highly.

Frank R.

I cannot say enough positive things about my experience with Dell Disability Lawyers. Attorney Stephen Jessup and Amanda offered an opportunity to provide clarity on a complex issue regarding my disability claim. Mr. Jessup offered advice on an offset to my claim after my insurance company asked for additional information from Social Security. With counsel from Mr. Jessup, I was able to address the outstanding issue with the Social Security office and provide my insurance company with the required documentation to address their concerns. Mr. Jessup always responded in a timely manner with expert advice and offered the opportunity for follow up. I strongly recommend Dell Disability Lawyers to those seeking legal counsel for disability matters.

Wesley D.

I have been able to help others as a soldier, a police officer, and a pharmacist. I needed help forcing the insurance company to keep their commitment to take care of me and my family. I called Dell. Alex, Tabitha, and their entire team were very compassionate, extremely patient, and extraordinarily knowledgeable. Many thanks Dell!

Samar A.

My husband had applied for Long Term Disability and was denied. We sought out Rachel Alters at Dell Disability Lawyers to help us with our appeal. Rachel and her team were so diligent and meticulous in every aspect of the process. The process was seamless, and we never had any doubts that she would get it done and that she did! We are forever grateful to Rachel and Catherine for all of their determination and tenacity to get us the outcome we needed and deserved.

We could not recommend better representation and are indebted to them for making us whole again. Thank you so much Rachel and team!

Jam

Alex Palamara is one of The Best lawyers in the world and Dell Disability Lawyers are the Best by Far. Alex and his Assistant Tabitha helped me get the compensation I needed for a Horrific Disabling heath condition I’ve been dealing with for over a year. Alex and his team were so professional and caring. They treated me like I was there own family. Alex Knowledge, Expertise and skills as a Lawyer is among the Best of the Best in his field and I would HIGHLY recommend that if you ever have any issues with any Insurance Company over your Disability issues, please don’t hesitate to seek out Dell Disability and Alex Palamara. They truly are Amazing and caring. Thank God for them. Outstanding Job Alex and Tabitha

G.T.

9 years ago when I had to apply for disability benefits from my private disability policy the insurance company ignored my inquiries until Dell and Schaefer represented me and I have received the benefits without interruption til my policy expired at age 65. I have appreciated not having to deal directly with the insurance company and having attorney Greg Dell and assistant Danielle Lauria handle all communications which included monthly progress reports. I thank them for their efforts on my behalf and highly recommend them to all those in need of disability benefits.

Misty A.

I’m so thankful I chose to reach out to the attorneys at Dell. They have always been quick to respond to any and all questions I have had. The anxiety I had while dealing with Lincoln Financial on my own has decreased immensely since Alex and Danielle took my case. They were able to get my LTD denial reversed and I am so very grateful!

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