New York Life overturned previous denial of long term disability benefits for Washington Crime Scene Photographer
Our client, Mr. B, formerly worked as a Crime Scene Photographer for Sherriff’s Department. In December 2012 a number of medical issues including, chronic pain syndrome, non-traumatic incomplete quadriplegia, chronic and severe neck and back pain, coronary artery disease forced Mr. B to stop working and submit his claim for disability benefits first under his employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. Both benefits were funded and administered by New York Life. Under his employer’s disability policies Mr. B would be considered totally disabled after 24-months if he was unable to perform the material and substantial duties of any gainful occupation, which was defined as any occupation he was qualified to perform by education, training and experience and considering any/all documented functional restrictions and limitations.
After paying Mr. B for more than 2 years under the LTD Policy, New York Life denied further LTD benefits on the basis that he allegedly no longer met the policy definition of disability. Specifically, New York Life determined that Mr. B “would be able to work in light occupations…and therefore [he] would be able to perform in [his] regular light occupation.” After receiving the denial, Mr. B contacted Dell Disability Lawyers and discussed his case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in New York Life’s denial letter and in the evidence it relied on and agreed to prepare and submit Mr. B’s ERISA appeal with the assistance of his appeal team.
The LTD appeal addressed all of New York Life’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of New York Life’s denial. The appeal next addressed the fact that (a) the physical capabilities assigned to Mr. B by New York Life’s medical records reviewer were incorrect and unreasonable; (b) New York Life incorrectly determined that Mr. B could perform his regular “light” occupation; and (c) the available medical information confirmed that Mr. B was and continued to be unable to perform his regular occupation or any other occupation. More specifically, New York Life’s medical reviewer failed to discuss or even mention relevant medical information in an attempt to mischaracterize the significance of his complaints and purportedly support that Mr. B had light duty capabilities. Further, New York Life’s vocational reviewer incorrectly and unreasonably concluded that Mr. B’s occupation required Light capabilities when the evidence clearly supported that his occupation required, at least, Medium capabilities. In support of this argument, Attorney Symonds retained a vocational expert who clearly established the Medium level requirements. And finally, to confirm Mr. B’s functional levels, he attended a Functional Capacity Evaluation (FCE) which clearly established that he had less than Sedentary functional capabilities.
Approximately four months later, and after reviewing the appeal and hundreds of pages of exhibits and medical records as well as the expert reports, New York Life overturned its decision to terminate benefits, paid full LTD back benefits and reinstated Ms. B’s LTD claim. Attorney Symonds continues to represent our client to best ensure that New York Life will not terminate his benefits again. Feel free to call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.
Resources to Help You Win Disability Benefits
Submit a Strong New York Life Appeal Package
We work with you, your doctors, and other experts to submit a very strong New York Life appeal.
Sue New York Life
We have filed thousands of disability denial lawsuits in federal Courts nationwide against New York Life.
Get Your New York Life Disability Application Approved
Prevent a New York Life Disability Benefit Denial
Negotiate a New York Life Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Lyme Disease Disability Claim Denial
Disappointed with NY Life Disability Excuses
New York Life is a joke!
Claiming They Are Not Receiving Paperwork
Keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting
Payment delays!
NYL denied my claim
Hold up on payments!!!
Q: LTD canceled their request for updated med records?
Q: Why is New York Life Insurance giving me a hard time?
Q: NYL LTD also have LLC
Q: Can I submit my resignation while on STD with NY Life? I don’t know if I’ll be able to return when they want and I would rather give a 2 weeks notice.
Q: New York Life LTD offset my disabled adult child.
Q: My father has been in STD Cigna and LTD with New York Life since Jan 2021, diagnosed Pulmonary Fibrosis due to Covid-19. Can insurance and ex job make him return to work?
Q: Do I have to sign agreement to pay back difference in LTD payment and SSDI payment?
Q: Can NYLG just stop payment?
How Will Sale of Cigna Disability Division to New York Life Insurance Co. Affect Disability Claimants?
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
How Do You Fight a Long-Term Disability Denial?
Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
Disability Denial Reason #1 – Paper Review & IME
New York Life Approves Disability Benefits for School Teacher With Multiple Sclerosis
New York Life Sued For Failing To Make A Timely Decision on Appeal
NY Life Disability Benefits Reinstated on Appeal Despite Independent Medical Examination
Project Manager with Migraines Gets NY Life Disability Benefit Denial Reversed
New York Life Overturns a Waiver of Premium for Group Life Insurance Policy
New York Life Admits Error In Denying Disability Benefits
New York Life Overturned Their Denial of LTD Benefits for Nevada Healthcare Coordinator
New York Life Denies Technology Manager under the Own Occupation Provision & Dell Disability Lawyers Wins Appeal
Reviews from Our Clients






