Can I Submit a Long-Term Disability Claim If My Employment Has Been Terminated?
It is not uncommon for employees to struggle and suffer through sickness or injury and work, even if working is counter-intuitive to their own health and effective productivity at their occupation. Unfortunately, these employees often find themselves as targets of work-force reduction or layoff, because despite their best efforts they are unable to keep up with their employer’s expectations and requirements. Regardless of the legality of this type of employer termination strategy, it leaves the sick employee in a terrifying predicament. It is often at this point that the employee decides to apply for long-term disability benefits under their employer sponsored long-term disability plan. However, depending on the circumstances, they can expect significant challenges and even the possibility of the disability insurer arguing that the employee lacked coverage. In most cases, the employee will be told by the disability insurer that their coverage ended on their last date of work, and that the employee lacked coverage for any subsequent claim of disability. However, the employee could prevail in their claim even if their employment was terminated prior to the submission of their disability claim.
Such was the case for Eduardo Nieves, who had worked as a satellite communications technician prior to his disability. After undergoing spinal surgery Mr. Nieves returned to work, however, continued suffering from spine and shoulder pain. Despite his unwavering work ethic and commitment, Mr. Nieves found himself among other fellow co-workers who were terminated following a decision by the employer to reduce its work force.
Mr. Nieves submitted a request to his employer to be allowed to apply for short-term and long-term disability insurance benefits through the employer sponsored long-term disability plan with Prudential Life Insurance Company of America (Prudential), however, the employer refused to provide Mr. Nieves with the necessary application forms. Notwithstanding, Mr. Nieves contacted Prudential directly and applied for benefits. Not long after applying Prudential informed Mr. Nieves that his claim was being denied on account of lacking coverage on the date following his last day of work. In other words, Prudential deemed him covered only through his last date worked, and since, according to Prudential, he had performed all of the duties of his occupation through his last date worked, his date of disability would be the following day, the first day he did not perform any of the duties of his occupation.
Mr. Nieves appealed Prudential’s denial, however, his appeals were denied and he was forced to sue Prudential in U.S. District Court in Arizona.
In an interesting decision, the court found that Prudential had arbitrarily selected the date following Mr. Nieves last day worked, March 11, 2015, as his date of disability, since no where in the record had Mr. Nieves claimed March 11th to be his date of disability. Prudential attempted to argue that it was impossible for Mr. Nieves to be disabled from his last date worked since he had effectively working performing his occupational duties through that day and therefore would not meet the definition of disability.
The Court, citing to the 7th Circuit Court in Hawkins v. First Union Corporation Long-Term Disability Plan, 326 F.3d 914, 918 (7th Cir. 2003), reasoned that there is no “logical incompatibility between working full time and being disabled from working full time” as “a desperate person might force himself to work despite an illness that everyone agreed was totally disabling.”
In the case of Mr. Nieves, because he had attempted to submit his disability claim prior to his employment being termination and he had the necessary doctor support, he was successful in establishing that he was a covered employee under the disability plan. This is distinguishable from a case where someone attempts to establish a disability claim with a date of disability following the termination of employment. In such a case the claimant would likely not succeed in establishing their claim for disability.
Resources to Help You Win Disability Benefits
Submit a Strong Prudential Appeal Package
We work with you, your doctors, and other experts to submit a very strong Prudential appeal.
Sue Prudential
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Prudential.
Get Your Prudential Disability Application Approved
Prevent a Prudential Disability Benefit Denial
Negotiate a Prudential Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Denied but Not Denied but I am Denied
California State Disabilty "OFFSET" never mentioned or outlined when enrolling for STD coverage.
Prudential terminated my LTD, so now I have no income
Reply
Prudential cancelled my policy amid COVID crisis
Reply
I was sold a policy that I cannot use and no one will show me the policy
Reply
Prudential verbally approved my claim and then sent me a denial letter
Reply
It would cost me more to fight Prudential than to let them get away with their games
Prudential told me I would have a decision today, and now the need another week. Guess what, I'm still broke
Reply
Q: I made a Short term disability claim with Prudential but they right away went to consider long term disability
Q: Prudential denied me STD due to a doctor who wrote personal things about me, like I still drive.
Q: Prudential is sending me to an IME but refuses to allow recording. Should I refuse to go to the IME?
Q: What can I do about my long term benefits that’s ending after 2 years?
Q: My mother paid many years for a long-term care policy. When she had to be put in an assisted care facility, Prudential won't pay. Do you accept cases like this?
Q: Can Prudential deny me if SSDI approves me?
Q: How does Prudential calculate attorney fees?
Q: Can I sue my PRUDENTIAL LTD for the cost of hiring a disability attorney to get my benefits reinstated?
Prudential Lump Sum Disability Policy Buyout Options
Is Exhaustion of Remedies Required before filing an ERISA Lawsuit?
What Should I Expect When Suing Prudential for a Disability Insurance Benefit Denial?
Do I need to disclose my disability insurance claim if I filed for bankruptcy?
Can I submit a long-term disability claim if my employment has been terminated?
How Much Time Does Prudential Have to Make A Determination On an ERISA Disability Appeal?
If I File A Short Term Disability Claim With My Carrier And My Claim Is Denied, Do I Also Need To File A Separate Long Term Disability Claim?
Can the disability company limit my disability benefits to 24 months if I have been diagnosed with depression as a result of my physical disability?
Prudential reverses decision to terminate LTD benefits of MRI Tech with Primary Progressive Multiple Sclerosis and degenerative Disc Disease
Engineer With Depression Wins Prudential LTD Appeal
Dell Disability Lawyers Win Disability Insurance Appeal Against Prudential for KPMG Employee
Lawyer Wins 24 Month Mental Nervous Prudential Disability Denial
Research Epidemiologist with chronic fatigue / ME wins LTD appeal against Prudential
JP Morgan Chase Financial Advisor With Cancer Wins Prudential Long Term Disability Appeal
Prudential Fails to Pay Long Term Disability Benefits of Claimant Suffering from Addison’s Disease
Successful Appeal Against Prudential Gets Breast Cancer Survivor Back on Claim for LTD Benefits
Reviews from Our Clients






