Is Plaintiff Entitled to LTD Benefits When Unable to Work in Any Occupation?
In Tiedel v. Reliance Standard life Insurance Company (Reliance), Plaintiff Tiedel, a full-time flight engineer for Kalitta Air, was in the pilot seat of a single engine plane that crashed in January 1979. He suffered numerous fractures and required surgery. He developed Hepatitis C due to a blood transfusion he received following the accident.
In December 2013, the Hepatitis C recurred and there was a remarkable increase in his viral load. He suffered from weight loss, fatigue, memory lapses, joint pain, and fluctuating blood pressure. These symptoms made it impossible for him to fly planes and he did not pass a requalification exam that was administered on or about March 17, 2014.
Plaintiff began a 12-week treatment for the Hepatitis, but the side effects of this medication, along with the side effects of medications he was taking to control his blood pressure, caused dizziness, tunnel vision, and fatigue. At the advice of his treating physician, Dr. Wagner, Plaintiff voluntarily relinquished his flying privileges while he waited for his health to improve.
Dr. Wagner also wrote to Plaintiff’s employer explaining that the recurrence of the Hepatitis C, along with the side effects of the medications, were the reasons Plaintiff did not pass the requalification exam. Reliance then granted Plaintiff both short-term disability (STD) and long-term disability (LTD) benefits effective March 18, 2014. He was told by letter that to continue receiving benefits, he would need to remain totally disabled.
Reliance terminated Plaintiff’s LTD benefits on March 10, 2015, but on administrative appeal, reinstated his benefits. The letter informing him that the termination of benefits decision was reversed did not explain why it made that decision.
On October 22, 2015, Reliance again terminated Plaintiff’s LTD benefits. The termination letter stated that a “claim specialist concluded that the medical records did not support the conclusion that [Plaintiff] could not perform the material duties of any occupation.” The claims specialist listed several “transferable skills” and for an example, identified one occupation Reliance believed Plaintiff could perform: An Aircraft Log Clerk. The claim specialist relied on a report authored by Carol Vroman called a “Residual Employability Analysis Report.”
Plaintiff filed another appeal. Both Plaintiff and Reliance provided additional reports concerning Plaintiff’ physical and mental abilities. Plaintiff submitted several medical reports supporting his claim.
Reliance required Plaintiff to undergo an IME with Dr. Mandel who provided a report. Reliance also submitted a report from a licensed psychologist who reviewed the opinion of Dr. Harris, Plaintiff’s psychologist.
Reliance then upheld its termination decision and Plaintiff filed this ERISA lawsuit in the U.S. District Court for the Western District of Michigan, Southern Division. The District Court reversed the decision of Reliance and held on April 15, 2020, that Plaintiff had proven he was totally disabled and deserved benefits dating back to the date of the erroneous termination decision of September 17, 2015.
De Novo Standard of Review Applied
Both parties agreed that de novo was the correct standard of review. This means that the Court reviewed the administrative record with a “fresh eye” and gave “no deference or presumption of correctness” to the plan administrator’s decision. The Court noted it was required to give “proper weight to each expert’s opinion in accordance with supporting medical tests and underlying objective findings.”
Relevant Plan Requirements
The plan provisions were fairly common. Plaintiff had the burden of proving he was totally disabled. At the time of the termination, he had to prove he was disabled from performing “any occupation” for which he was qualified based on his education, training, and experience. Reliance agreed that Plaintiff could not perform his job as a flight engineer. Instead, Reliance argued that he was “not so disabled that he cannot perform the material duties of any occupation.”
Although Reliance argued that “Plaintiff’s medical records… do not provide any evidence that would not allow Plaintiff to return to work in a sedentary exertion occupation…” the Court reviewed all the evidence provided by both Reliance and Plaintiff and reversed Reliance’s decision terminating LTD benefits. The Court did not remand the case to Reliance, but instead ordered Reliance to reinstate Plaintiff’s LTD benefits.
The Administrative Medical Record
The District Court conducted an extensive review of the administrative record and noted the weight it gave to each report. The court gave little weight to three letters from Plaintiff’s treating physician Dr. Wagner. The Court found them conclusionary without support by any medical evidence in the record. The Court did rely on medical evidence in the file from Dr. Harris that supported the Court’s finding of disability.
The Court gave short shrift to the report of Dr. Ilka, who was retained by Reliance and who submitted an initial IME report. The Court found this report to be “largely unhelpful to the inquiry” and afforded them “little weight.” This meant little weight was given to the transferable skills report provided by Reliance’s Carol Vroman since she based her report on Dr. Ilka’s conclusion that Plaintiff was capable of sedentary work.
The Court afforded greater weight to the report of Psychologist Harris which was submitted by Plaintiff. Dr. Harris met with Plaintiff twice and conducted six tests. He concluded that the tests provided “objective evidence of impaired speed of information processing, divided attention, short-term recall, and executive function.” Harris concluded that Plaintiff suffered from “neurocognitive dysfunction” with “underlying organic pathology.”
The Court finally concluded: “On this record, as of September 17, 2015, [Plaintiff] could no longer perform the duties of Any Occupation. Accordingly, Reliance should have awarded him long-term disability benefits… Plaintiff Michael Tidal cannot perform the duties of any occupation, as that term is defined in his disability insurance plan… He provided objective medical evidence to show a cognitive impairment and expert opinion evidence that the impairments prevent him from working. The evidence offered by Defendant Reliance Standard Life Insurance does not undermine Tiedel’s evidence.”
This case was not handled by our office, but we feel it may be helpful to claimants who need to prove they are unable to work in any occupation. For questions about this case, or any question concerning your STD or LTD benefits, contact a disability insurance attorney at Dell & Schaefer for a free consultation.
Resources to Help You Win Disability Benefits
Disability Benefit Denial Options
Submit a Strong Reliance Standard Appeal Package
We work with you, your doctors, and other experts to submit a very strong Reliance Standard appeal.
Sue Reliance Standard
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Reliance Standard.
Protect Your Benefits
Get Your Reliance Standard Disability Application Approved
We help claimants throughout the entire application process.
Prevent a Reliance Standard Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.
Negotiate a Reliance Standard Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Reliance Standard Reviews
(660)
Policy Holder Rating
5
0%
4
0%
3
0%
2
57%
1
42%
Timely Payments
1.8out of 5
Handling Claim
1.9out of 5
Customer Service
2.2out of 5
Dependable
2.0out of 5
Value
2.0out of 5
Showing 8 of 660 Reviews
Reliance Standard
Short Term Disability Claim/Inconsistent to NO Communication
When I did call & reach a live person they were kind & helpful. The person assigned to my claim left one phone message & I have not spoken to her since. Information she re... read more >
Reliance Standard
Staff Lie
I had my disability cut off the day I was scheduled to find out whether I should have surgery. The claims examiner was aware that I had an appointment on that date and sai... read more >
Reply
Reliance Standard
Reliance Standard denied my LTD benefits because COVID-19 limited my ability to provide proof of continued disability.
Hello, I have a LTD policy with Reliance Standard and it has been paid (considered disabled) for 14 plus years. However, due to limited doctors visits / records this past ... read more >
Reply
Reliance Standard
Reliance Standard cut off my LTD benefits claiming I'm fit enough to work even though I'm more sick than before.
It should be criminal that this company treats sick people like this who just want PTO be left alone! I received a call from Reliance on 7/6/20 cutting me off after 1 year... read more >
Reply
Reliance Standard
Reliance Standard notified me that my benefits were being stopped with no warning or reason.
Horrible company! Phoned me on June 4th to let me know that I would no longer be receiving benefits as of June 3rd. Just like that! No questions asked and no info given!
Reply
Reliance Standard
I was receiving LTD from Reliance Standard due to breast cancer until they suddenly denied me my benefits.
I was diagnosed stage 2 breast cancer June 2015 and went out on std with Reliance. Within 4 months following my status changed to stage 4 with Mets to my spine. STD conver... read more >
Reply
Reliance Standard
Reliance Standard never answers or returns my calls, has not provided me my benefits, and falsely claims I never provided necessary paperwork.
I have been on STDI since April 28th, 2017 and I have only received what they say is a “courtesy payment” because they know the hardship which I am facing. I call mult... read more >
Reply
Reliance Standard
Reliance Standard is unreasonably prolonging the transition from STD to LTD for my boyfriend.
In August 2016 my boyfriend was placed on disability by his family physician. A short background, he is a type I Diabetic since age 4 and had to have multiple lumbar back ... read more >
Reply
Answered Questions by Our Lawyers
(25)
Showing 8 of 25 Answered Questions
Q: Are VA disability payments considered “other income” by Reliance Standard?
A: The disability policy may allow Reliance Standard to deduct and offset your monthly benefit payment by your VA... Read More >
Q: Denied short term disability and need to file for long term with same insurer
A: We would be more than happy to speak with you and review your denial letter and policy and discuss how we can ... Read More >
Q: Will Reliance Standard reduce my LTD payments due to my pension benefits or rental income?
A: ARH, I am happy to hear of your LTD approval, though I am sorry to hear of your medical conditions. The LTD po... Read More >
Q: Why is Reliance Standard trying to recover payments I was awarded through another company?
A: Dani, your disability plan may contain a provision which allows Reliance to claim and recover an overpayment o... Read More >
Q: Do I have to provide additional proof of my disability that's specifically requested by Reliance Standard?
A: Fred, I am sorry to hear all that you have been through medically and in dealing with Reliance Standard. Unfor... Read More >
Q: How do I access a copy of my STD policy with Reliance Standard?
A: Vicki, I am sorry to hear the trouble you are having with the Standard. It seems they are certainly make thing... Read More >
Q: If I'm not receiving the SSDI benefits for my children from Reliance Standard due to custody, should my SSDI benefits increase?
A: Bill, it depends on terms and conditions relating to “other income benefits” and “offset” under your f... Read More >
Q: How can Reliance Standard not coordinate with both of my disability insurance policies?
A: Jerry, you will need to review your RSL policy to determine what it deems to be a source of “Other Income”... Read More >
Helpful Videos
(910)
Showing 12 of 910 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips
How to Apply for Reliance Standard Disability Benefits & Top 5 Reasons for a Claim Denial
At Dell & Schaefer we’ve handled hundreds of long term disability insurance claims against Reliance Standard, and have learned a few things in the process. When you’re experiencing an injury or illness that makes it difficult (or impossible) to work, it can be tempting to file a claim as quickly as possible – but unless a claimant has all their ducks in a row, this could actually delay the ultimate r... Read More >
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea... Read More >
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med... Read More >
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ... Read More >
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c... Read More >
How Do You Fight a Long-Term Disability Denial?
Getting a denial letter from your disability insurance company is one of the ultimate insults. You are sick and not able to work, yet your disability insurance company is telling you to return to work. The disability insurance company has denied your disability benefit claim and is basically calling you a liar. When receiving a disability denial letter or a ph... Read More >
Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
One of the top reasons for terminating a claimant's long term disability benefits involves the change in the disability insurance policy's definition of "disability." This definition change often happens in conjunction with a vocational review, or an analysis of a claimant's medical records that tells the insurance company which jobs the claimant should be able ... Read More >
Disability Denial Reason #1 – Paper Review & IME
At Dell Disability Lawyers, we've seen insurance companies give countless reasons to deny long term disability benefits. However, most disability benefit denials tend to fall into one of a few categories - and one of the biggest ones is the paper review and independent medical exam (IME). Learn more about what this review process entails and what your claim file... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases
How does Reliance Standard deny long term disability benefits after paying for three years?
A former Payroll Manager for Solairus Aviation, a large Private Jet Charter and Aircraft Management Company was significantly injured in a serious motor vehicle accident which occurred on June 26, 2017. This accident changed her life forever. Due to the accident, our now client suffered from a traumatic brain injury which led to diagnoses such a post-concussi... Read More >
Reliance Standard overturned its previous denial of long term disability benefits for Texas Retail Store Manager
Our client, Mr. S, formerly worked as a Store Manager for a large national retail chain. In August 2016 Mr. S suffered from multiple Transient Ischemic Attacks (“TIAs”) or mini-strokes which left him with debilitating physical and cognitive impairments. Mr. S made several attempts to return to work failed but continued to suffer slurred speech, headaches, pressure in the back of his head and memory loss, h... Read More >
Reliance Standard overturned LTD denial for Tennessee Technology Sales Consultant
Our client, Mr. L, formerly worked as a Sales Consultant for a global technology company. In September 2014 a number of medical issues following an ischemic stroke forced Mr. L to stop working and submit his claim for disability benefits under his employer's long-term disability (LTD) policy, which was funded and administered by Reliance Standard. Under his employer's disability policy he would be considered t... Read More >
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 fa... Read More >
Reliance Standard reinstates disability benefits to Project Manager
Our client, a former Senior Project Manager for a national corporation, was receiving long term disability benefits from Reliance Standard due to debilitating chronic pain stemming from a multitude of lumbar and cervical spine disorders. Reliance Standard initially approved his claim for short term disability benefits and without issue approved his claim for long term disability benefits once the period of sho... Read More >
Reliance Standard Reinstates Benefits for Former Employee of Parent Company, Delphi Financial, Following Successful Appeal
Our client, Ms. L, formerly worked as a National Account Manager for Delphi Financial Group, the parent company of Reliance Standard Insurance Company. In 2015, a number of medical issues, namely, chronic daily pain, sleep difficulties, fatigue and cognitive and memory impairments forced Ms. L to stop working and submit her claim for long-term disability benefits. In addition to these symptoms her doctors susp... Read More >
Reliance Standard Overturns Denial of Benefits on Appeal After Claiming It Failed to Receive Medical Records
Ms. L was employed as a registered nurse when she was diagnosed with anterior ischemic optic neuropathy, optic atrophy and visual field defect. Her employer, a large medical healthcare system, provided Ms. L and its other employees group long-term disability insurance through Reliance Standard Life Insurance Company ("Reliance Standard"). In 2014 Ms. L's vision degraded so severely that her doctors diagnosed h... Read More >
After sending claimant to a psychiatric IME, Reliance Standard realizes its decision to deny benefits was incorrect
Reliance Standard Incorrectly Denies BenefitsThe claimant had been suffering from severe depression and anxiety due to many stressors in his life including a child custody battle which threw him into major depression and severe anxiety preventing him from being able to work in his occupation as an engineer. The claimant contacted Dell Disability Lawyers to assist him with his appeal as he did not believe h... Read More >
Disability Lawsuit Stories
(765)
Reviews from Our Clients
