Reliance Standard overturns decision to deny long-term disability benefits to Paediatrician with Ovarian Cancer
Prior to her disability Dr. Julie worked as a pediatric physician for a nationally recognized health system based in Florida. In 2015, Dr. Julie received a diagnosis of ovarian cancer and underwent a total abdominal hysterectomy and chemotherapy. Although the chemotherapy and treatment likely saved her life, she remained suffering from residual neuropathy in her hands and feet, as well as chronic and severe fatigue.
As a result of her debilitating symptoms, Dr. Julie was forced to stop working and submit a long-term disability claim with her employer sponsored group long-term disability insurer, Reliance Standard Insurance Company. After receiving her claim application and attending physician reports declaring her totally disabled from her own occupation as a pediatrician, Reliance Standard approved the disability claim.
However, after only paying benefits for 2 months, Reliance Standard terminated her disability claim, and stated that her impairments from her own occupation were no longer supported.
Dr. Julie’s occupation as a pediatrician required working at a medium physical demand level. It required her to often exert 20 to 50 pounds, which most often occurred when she was lifting and carrying child patients. It also required critical thinking and analysis when treating children, who often presented with a wide variety of acute and chronic health issues. Given her chronic peripheral neuropathy and fatigue caused by her chemotherapy treatment it was absolutely clear that Dr. Julie was unable to work in her own occupation.
Dr. Julie was referred to Dell Disability Lawyers by a local attorney she had contacted. Although the attorney handled employment matters, the handling of a long-term disability insurance claim was outside of her field of expertise. Dr. Julie hired Attorney Cesar Gavidia and his team to address the denial of her disability claim. Although there was the strong likelihood that Dr. Julie’s claim was not governed by ERISA, since her employer was a public hospital, Attorney Gavidia determined that the best and safest course of action was to submit an administrative appeal to Reliance Standard addressing the arbitrary denial.
In addition to submitting evidence of her disability by way of her medical records, Attorney Gavidia and his team attacked the fact that Reliance Standard failed to perform an accurate vocational assessment of Dr. Julie’s occupational duties. The Appeal also addressed that Reliance Standard made no attempt to contact Dr. Julie’s treating physicians to discuss the extent of physical and cognitive restrictions and limitations, nor did Reliance Standard perform a functional capacity examination (FCE) or Independent Medical Examination (IME) to assess her physical functional limitations. It was clear that Reliance Standard’s decision to deny Dr. Julie’s long-term disability claim was not supported on the basis of any reasonable or substantiated medical evidence.
Soon after the Appeal was submitted, Reliance Standard notified Dr. Julie that its prior adverse decision to deny her claim was being overturned. Soon after receiving notice that Reliance Standard had overturned its decision and reopened her claim, Dr. Julie was approved for social security disability benefits as well. Although the initial battle was won, Reliance Standard’s requests for medical records, claim forms and attending physician statements continue. If the requests are not fulfilled in a timely manner, Reliance Standard threatens to terminate the disability claim. Attorney Gavidia and his team remain involved so as to ensure that Reliance Standard does not again arbitrarily deny Dr. Julie’s disability claim.
Feel free to contact Attorney Cesar Gavidia to discuss any questions that you may have regarding your long-term disability insurance claim.
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Short Term Disability Claim/Inconsistent to NO Communication
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Reliance Standard denied my LTD benefits because COVID-19 limited my ability to provide proof of continued disability.
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Reliance Standard cut off my LTD benefits claiming I'm fit enough to work even though I'm more sick than before.
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Reliance Standard notified me that my benefits were being stopped with no warning or reason.
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I was receiving LTD from Reliance Standard due to breast cancer until they suddenly denied me my benefits.
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Reliance Standard never answers or returns my calls, has not provided me my benefits, and falsely claims I never provided necessary paperwork.
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Reliance Standard is unreasonably prolonging the transition from STD to LTD for my boyfriend.
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Q: Are VA disability payments considered “other income” by Reliance Standard?
Q: Denied short term disability and need to file for long term with same insurer
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Q: Why is Reliance Standard trying to recover payments I was awarded through another company?
Q: Do I have to provide additional proof of my disability that's specifically requested by Reliance Standard?
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Q: If I'm not receiving the SSDI benefits for my children from Reliance Standard due to custody, should my SSDI benefits increase?
Q: How can Reliance Standard not coordinate with both of my disability insurance policies?
How to Apply for Reliance Standard Disability Benefits & Top 5 Reasons for a Claim Denial
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
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