“Our client was a Salesman from Illinois who suffered massive, full thickness rotator cuff tears to both shoulders, and subsequently developed chronic regional pain syndrome. He attempted to return to work but this proved unsuccessful and his doctors recommended additional surgeries.
He applied for Long-Term disability benefits through his employer’s plan with Sun Life. After over a year of reviewing the claim and asking for additional information Sun Life eventually denied our client’s claim because it could not conclusively determine if our client remained covered under the policy after his failed attempt to return to work and was not convinced his conditions precluded him from performing his Own Occupation. The claim was denied mere weeks before our client went back into the hospital for yet another surgery.
Our client reached out to Fields Disability for help fighting this decision. His attorney built an appeal that conclusively established our client remained covered under the policy at all times relevant to the claim, and that due to his substantial condition it was impossible for him to perform not only his Own Occupation but also any other gainful occupation. After reviewing our appeal Sun Life finally reversed its denial, paid our client his back pay and commenced monthly payments. ”