PROVEN LAWSUIT RESULTS

Technician - Plainwell, MI

Neurocardiogenic Syncope, Autonomic Nervous System Reflex Disorder

“Our team represented a worker who was unable to continue his job due to neurocardiogenic syncope, an autonomic nervous system reflex disorder that causes the individual’s heart rate and blood pressure to drop, leading to fainting episodes. In discontinuing the worker’s benefits, the insurance company relied on the opinions of two doctors who had never even seen the man, but felt that he could perform sedentary work based on their review of his medical records. Additionally, the insurance company stated that the man’s restrictions, as provided by his treating doctor, were preventative in nature and not indicative of his ability/inability to perform gainful work.

The Fields Disability team presented a strong appeal to the insurance company, in which they argued that it had not applied the correct standard of disability when it found that our client was not disabled. We argued that the fact that our client’s restrictions were in place to prevent him from fainting and sustaining further injury did not preclude payment of benefits under his policy. The Fields Disability team also gathered updated medical records for the client and illustrated that his condition had not improved since he was initially awarded benefits. Based on these efforts, the insurance company agreed to reinstate the man’s benefits.”

Housekeeping Staff Manager - Manchester, SC

Chronic Back Pain, Degeneration of Lumbar Discs

“A woman who worked as a housekeeper became entirely unable to work due to chronic back pain and degeneration of her lumbar discs. Aetna paid the woman her long-term disability benefits for 24 months because she could not perform her job as a housekeeper. After 24 months, Aetna ceased her benefits, stating that in order to continue to receive benefits, she needed to be disabled from any occupation. She came to Fields Disability distraught, knowing that she could not work at all anymore due to her pain, but that Aetna was stopping her benefits.

Our attorneys could see that Aetna had failed to properly evaluate our client’s claim. Aetna relied excessively on certain evidence, while ignoring evidence that was supportive of her disability. We drafted an appeal that exposed Aetna’s mistakes. We also reached out to her doctors to obtain reports supporting her disability, which were vital to her case. These reports allowed us to prove that our client was unable to work in any occupation. In the end, we were successful in reversing Aetna’s denial of benefits and our client was awarded ongoing benefits.”

Customer Service Representative - Belton, TX

Congestive Heart Failure, Memory Problems

“A Texas customer service representative began feeling short of breath. His doctor diagnosed him with congestive heart failure, and recommended limiting his activity. He stopped working due to his disability. The insurance company initially approved him for long-term disability benefits, but after nearly two years, they sent a letter saying that he no longer fit their definition of “disabled.”

Frustrated at the decision from his insurer, he contacted Fields Disability to determine his next steps. The attorneys at Fields Disability contacted our client’s doctors and compiled a strong summary of treatment and symptoms. The appeal was unsuccessful but our attorneys filed a lawsuit in federal court to fight for our client’s benefits. During preparation for trial, Fields Disability attorneys were able to negotiate a generous lump-sum settlement for our client’s remaining benefits.”

Bank Teller - Tavares, FL

Advanced Degenerative Disc Disease, Cervical Radiculopathy, Fibromyalgia, Chronic Pain

“A teller at a bank came to us after the insurance company denied her disability benefits. She was distressed because she suffered from advanced degenerative disc disease, cervical radiculopathy, fibromyalgia, and chronic pain and simply could not do her job. She was dealing with ongoing pain in her back, arms and legs that diminished her quality of life and made it impossible for her stand for long hours at work. The insurance company claimed that there was not enough evidence to support her disability and denied her.

The woman called Fields Disability to represent her in appealing the insurance company’s denial. We worked with her doctors to obtain objective evidence of the impairments that make her unable to perform her own occupation. The doctor provided us with information concerning our client’s functional restrictions and limitations, which allowed us to directly attack the insurance company’s assertion that was able to do her job.

After thorough analysis of the law and our client’s case, we drafted an appeal that exposed the insurance company’s improper and deficient review of our client’s limitations. Our appeal was successful and our client now receives the benefits to which she is entitled. She was very relieved that our team was able to fight the insurance company to pay her benefits without having to file a lawsuit.”

Insurance Claims Adjuster - Miami Gardens, FL

Degenerative Disc Disease, Radiculopathy, Carpal Tunnel

“An insurance claims adjuster from Georgia had carpal tunnel syndrome and mild back pain. The pain in her back increased in 2013, and she received treatments and physical therapy. A doctor diagnosed her with a degenerative disc disorder. She also had carpal tunnel syndrome in her wrists that she had controlled with splints on her hands at night.

In late 2013 she started to feel alternating pain and numbness in her right hand and eventually she lost nearly all of her grip strength in her right hand. Combined with her intensifying back pain, the symptoms caused her to stop working in March of 2014. She applied for long-term disability benefits and was denied. The insurance company did an “independent” evaluation of her condition and said that despite being only able to occasionally lift 3 pounds, she was able to work. She appealed the decision and was denied again, in spite of pointing out that she was receiving social security disability benefits.

Shocked and upset by the decision, she contacted Fields Disability for help. The attorneys at Fields Disability reviewed the case file and determined their analysis of the independent evaluation was faulty. The attorneys promptly filed a federal law suit against the insurer to fight for our client’s rights. During preparations for trial, our attorneys negotiated a lump-sum settlement with the insurance company. Our client was overjoyed with the settlement and happy to put her fight against the insurance company behind her.”