California Federal Court rejects Prudential's attempt to limit claim
Rosa Wood had carpel tunnel syndrome and left work in 1999 because of it. After receiving short term disability benefits and undergoing back surgery, Ms. Wood applied for long term benefits. Initially, Ms. Wood’s claim for benefits was denied however her plan eventually agreed to pay benefits for the first phase of long term disability. Under the first phase, claimants are entitled to benefits for seven to twenty-nine months based on their ability to perform any substantial gainful work. Prudential then denied long-term disability benefits to Ms. Wood during the second phase which would continue benefits beyond the twenty-nine months. After two internal appeals, Ms. Wood sued Prudential in Federal Court.
The court ruled that any “reasonable trier of fact would find Wood to be disabled” and rejected Prudential’s attempt to limit the claim. The judgment was based on evidence stating no factual dispute that Ms. Wood was diagnosed with carpal tunnel syndrome in 1999 and that she had spinal surgery in 2000 and continues to suffer from pain and numbness in her hands. Reports from all of Ms. Wood’s examining physicians support her disability claim with the exception of Dr. Teital who examined Ms. Wood at the request of Prudential. Dr. Teital did not find that Ms. Wood was exaggerating her symptoms.
Additionally, Prudential’s consulting physician, Dr. Ito, did not examine Ms. Wood nor did he dispute Ms. Wood’s diagnosis or the findings of pain from her other doctors. However, Dr. Ito apparently discounted Ms. Wood’s pain limitations on the basis that they were not supported by objective testing. Prudential’s policy did not require the type of testing Dr. Ito required supporting Ms. Wood’s limitations.
Further, Sandra Richter, a vocational counselor who met with Ms. Woods during her first phase of long term disability benefits, concluded that she is totally disabled. Two other vocational reports were written without meeting Ms. Wood and submitted during the evaluation of second phase LTD benefits. These reports were prepared based on limitations that did not include limitations of her use of extremities. Neither of these reports included analysis of the “gainful employment” language of Prudential’s policy which explained that “gainful occupation” is defined as an occupation that provides at least sixty percent of pre-disability earnings. Prudential must now pay all past due long-term disability benefits to Ms. Wood and re-calculate her claim for the future.
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






