Employees in Chicago making long-term disability insurance claims under individual or group disability policies frequently call me surprised at how an insurer denied the claim. Frequently, the medical records reference normal strength, normal range of motion, or normal gait. Sometimes, these notes in medical records do not really reflect that the doctor took that note during that visit, but the nature of electronic medical records may result in field automation, or automatically populating certain fields from past appointments. Your doctor may not have really addressed your strength or range of motion during that visit, but the field in the electronic form lists it because it did in the last visit. And that may have come from a prior visit, too. These notes can be particularly troubling in long-term disability cases based on chronic pain and fatigue, such as when the claimant suffers from Fibromyalgia or Chronic Fatigue Syndrome.
In a recent case, Wright v. Reliance Standard Life Insurance Company, No. 19-14643, 2021 WL 303428 (11th Cir. Jan. 29, 2021), Wright worked as a Vice President of Health Information Services at Integrity Health Care. This job entailed light physical exertion level work, likely because it involves standing and walking to a significant degree, not uncommon for executives who travel frequently for work. She suffered from Fibromyalgia, dysautonomia, and Postural Orthostatic Tachycardia syndrome. But her medical records often listed in the physical examination section normal strength and normal range of motion. Reliance Standard denied Wright’s claims, and upheld the denial on appeal. When she sued under ERISA § 502(a), the court found the notes of normal strength and range of motion too persuasive.
If you have a long-term disability insurance claim, and your records note things like normal strength, normal range of motion, or normal gait, something can be done. But it requires getting your doctors more involved to explain your limitations, and the reason for the discrepancy in the records. Hire a skilled ERISA long-term disability lawyer to help steer you away from the traps and pitfalls of disability claims, and give you the best chance of getting your claim paid.