In one case we had with Lincoln Financial, Lincoln terminated our client’s long-term disability benefits upon a change in definition to the “any occupation” definition of disability, concluding our client could perform sedentary occupations, or jobs where you sit most of the time. The client suffered from chronic lower back pain and deformed vertebrae, and needed a cane to walk. So according to Lincoln Financial, the client could still work if he just sat. Our client’s doctors explained the client could not sit long enough to work in a sedentary occupation, but Lincoln terminated the benefits anyway. In the termination, Lincoln asked the client to submit any evidence that corroborates the treating doctor’s opinion that the client cannot sit enough to work full-time. We obtained a functional capacity evaluation which proved exactly what our client’s doctor told Lincoln, showing the client could not sit more than 10 minutes at a time. Result: payment to client. Another case we litigated, after another firm abandoned the client, the client suffered from Migraine Associated Vertigo and could not tolerate looking at a computer screen for any meaningful duration of time. Despite a challenge others would not take, we recovered for the client.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)