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Shauna was a Quality Supervisor with a large international engineering company for four years until August 2016, when she was forced to stop working due to severe bilateral degenerative foot deformities that have required a total of nine surgeries to date. Shauna also suffers from post-traumatic arthritis of the bilateral hands, feet, and ankles; cervical spondylosis and radiculopathy; degenerative changes to the thoracic and lumbar spine requiring surgical implantation of a pain pump to deliver pain medication directly into her spinal canal; and post-laminectomy syndrome of the lumbosacral region.

Shauna applied for and received long term disability (LTD) benefits under her employer’s LTD policy with Liberty Mutual. The Liberty Mutual policy provided that in order to continue receiving disability benefits for longer than 24 months, Shauna was required to prove that she was disabled from any occupation for which she was reasonably fitted by training, education, experience, age, physical and mental capacity. Unfortunately, Liberty Mutual terminated her LTD benefits in February of 2019, arguing that she was able to return to work in a sedentary capacity and listing several obscure occupations (including thermometer maker and multifocal-lens assembler) that it asserted she could perform despite her condition.

After her benefits were terminated, Shauna hired O’Ryan Law Firm to represent her to appeal the termination of her LTD benefits. We gathered substantial additional supportive medical evidence, including strong supportive statements from her treating physicians, and compiled an appeal of Liberty’s termination of Shauna’s LTD benefits. We also provided updated diagnostic imaging studies and photos of Shauna’s feet showing the extreme degree of swelling that she experienced 24 hours after attempting to sit without elevating her feet for just two hours.

When Symetra Life Insurance Company terminated her long term disability benefits after paying them for over three years, this school principal hired O’Ryan Law Firm to assist with her appeal for benefits.  Before our client became disabled, she worked at the South Bend School Corporation as a special education teacher for 11 years, then as a Principal.  The South Bend Community School Corporation (“SBCSC”) operates the public schools in South Bend, Indiana, and is one of the largest school corporations in Indiana, with a total of 34 schools. It serves most of South Bend, Indian Village, Notre Dame, and Roseland, as well as portions of Granger and Mishawaka.

Symetra Life Insurance Company (”Symetra”) is an Iowa corporation doing business in Indiana.  Symetra’s principal place of business is in Seattle, Washington.  Pursuant to the disability policy, Symetra promises to pay monthly disability benefit payments in the event our client was unable to work due to injury or sickness.

Our client worked for South Bend School Corporation until May 2014, when she was forced to stop working after she was diagnosed with hemiplegic migraines and trigeminal neuralgia.  Hemiplegic migraines or Hemiplegic migraine headache is a rare and serious subtype of classical migraine that typically includes weakness of half the body which can last for hours, days or weeks. It can be accompanied by other symptoms, such as ataxia, coma and paralysis.  Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating facial pain. Our client also suffers from Sarcoidosis, an inflammatory disease characterized by the formation of granulomas—tiny clumps of inflammatory cells—in one or more organs of the body. When the immune system goes into overdrive and too many of these clumps form, they can interfere with an organ’s structure and function. When left unchecked, chronic inflammation can lead to fibrosis, which is the permanent scarring of organ tissue.  This disorder affects the lungs in approximately 90% of cases, but it can affect almost any organ in the body. Despite increasing advances in research, sarcoidosis remains difficult to treat.

Shanna was a Pharmaceutical Sales Representative with a large international pharmaceutical company for seven years until late 2014, when she was forced to stop working after undergoing surgery to remove a neuroma from her right foot. Since that time, Shanna has been diagnosed with a host of additional conditions that leave her unable to return to work, including complex regional pain syndrome (“CRPS”), osteoporosis, osteopenia, degenerative joint disease, degenerative arthritis, advanced osteoarthritis with heterotopic ossification of the jaw requiring bilateral arthroplasty of the temporomandibular joints, spontaneous intracranial hypotension subsequent to cerebrospinal fluid leak, and level 3 chronic kidney disease. Shanna also suffers from severe chronic intractable migraines, which have significantly worsened over the past five years.

As a Pharmaceutical Sales Representative, Shanna was required to frequently travel to medical facilities, often walking long distances throughout the facilities to reach the physicians and staff members with whom she would be speaking. Her job required significant time on her feet, often without the opportunity to take breaks as necessary. As Shanna’s conditions became progressively debilitating, it became increasingly difficult for Shanna to keep up with the volume of sales calls necessary to sustain her position. When she was unable to continue working, Shanna filed claims for short term disability (“STD”) and long term disability (“LTD”) benefits under policies provided by her employer. Both claims were approved, and Liberty Mutual paid her long term disability benefits for more than three years without any issues.

Unfortunately, in early 2018, Liberty Mutual began seeking to terminate Shanna’s benefits, contacting several of her medical providers to request confirmation that she could return to work in a sedentary capacity. Although Shanna’s physicians disagreed, Liberty nonetheless terminated her benefits in October of 2018 based on a critically flawed report by an “independent” reviewing physician hired by Liberty to evaluate Shanna’s claim.

Navigating through the process of obtaining or keeping your short-term or long-term disability includes obtaining supportive statements from your treating physicians.  Not only is it important to collect medical records for your claim but also it is imperative that you garner an attending physician statement that will support your disability.

Prior to filing for short-term or long-term insurance benefits, you should make an appointment with your doctor to discuss your decision to leave work. Once you arrive at your appointment, be sure to take the time to explain why you need their help in the claims process.  If you need a form or letter written, make sure that the doctor explains in as much detail as possible the severity of the symptoms you experience and how they impact your ability to work.

One of the most common reasons for a disability claim denial by an insurance company is due to lack of proof of disability.  Starting the process with your physician should happen prior to submitting a disability claim.  Waiting to file a disability claim until after confirming first that your physician will be willing to provide support will help ensure a positive outcome.

Michael P is a Gulf War veteran who served in special forces with the US Marines during Operation Desert Storm. During his time in combat, Michael was exposed to hazardous chemicals from burning oil wells and experienced firsthand the horrors of war.

After returning home and receiving an honorable discharge from the Marine Corps, Michael went to work as an electrician in a heavy industrial manufacturing facility in northwest Indiana. As part of his role, Michael was frequently required to work on cranes and other heavy industrial equipment high above a foundry floor in a facility in which molten steel was transported and poured. According to his job description, he was required to keep electrical equipment such as wiring motors, switches, and electrical mechanisms in good repair and operating condition; install a variety of complicated electrical and some mechanical equipment; and diagnose and remedy trouble quickly to avoid shutdowns.

In June of 2017, Michael was diagnosed with very severe post-traumatic stress disorder (“PTSD”) as a result of his combat experience. He also suffered from severe headaches, frequently lasting hours at a time. When he presented for an MRI to evaluate the cause of his headaches, his doctors noted atrophy in the cerebral cortex, a common feature of many brain diseases that is frequently associated with dementia, seizures, and impaired comprehension, often resulting from underlying traumatic brain injury.

Working as a Purchasing Agent for Purdue University for over 40 year, Dennis H. found he could no longer perform his job duties due to debilitating pain caused by osteoarthritis, right cervicalgia, tremors in his head that caused pain, and lumbar radiculopathy.  These medical conditions cause pain or significant discomfort in his neck, especially at the back and along the sides of his neck. Lumbar radiculopathy results from a nerve in the lower back that is pinched or irritated.  Dennis sought relief through many forms of treatment including epidural steroid injections, without success.  He even tried radiofrequency ablation, which burns off the troubling nerve, in order to improve his neck and back function, reduce his pain medications, and to avoid surgery but unfortunately he received very little relief from the ablation.

When he was unable to continue working, Dennis filed a claim for long term disability benefits provided by Purdue’s employee benefit plan and insured by Life Insurance Company of North America (“LINA”), a subsidiary of Cigna.  Cigna is a global health service company with 95 million customers around the world.  Cigna is a major provider of health-related products and services, the majority of which are offered through employers and other groups. Cigna is the long term disability insurance company for Purdue employees.

Cigna approved Dennis’ claim and paid his benefits from October 2017 through August 2018, when they were abruptly terminated by Cigna without any improvement in his medical condition. While he was receiving Cigna disability benefits, Purdue also provided him with medical coverage and life insurance coverage. When Cigna wrongfully terminated the disability benefits, these other critical benefits were also terminated.

Narcolepsy is a chronic neurological disorder affecting the brain’s ability to direct sleep/wake cycles and if left undiagnosed, may interfere with psychological, social and cognitive function inhibiting academics, social interaction and work.  People with narcolepsy may experience broken sleep patterns throughout the night or an inability to sleep.  They may awaken in the morning refreshed only to experience extreme sleepiness during the day.

Nearly all individuals with narcolepsy with cataplexy have extremely low levels of naturally occurring chemical hypocretin.  Hypocretin regulates your REM sleep and wakefulness.  While the causes of narcolepsy are not totally understood, much of the research shows that it may result from a combination of factors such as autoimmune disorders, family history and brain injuries

Narcolepsy is diagnosed by clinical examination as well as a detailed medical history.  A physical exam is important to rule out other conditions that may be causing the symptoms but there are two specialized tests, Polysomnogram and Multiple Sleep Latency Test, performed to diagnose Narcolepsy.  Although there is no cure for narcolepsy, some of the symptoms can be treated with medications such as Modafinil, antidepressants, sodium oxybate, and life style changes.  Taking short naps, maintaining a regular sleep schedule, avoiding caffeine or alcohol prior to bedtime, avoiding smoking and exercising daily are just some of the things you can do to reduce the symptoms of narcolepsy.

Lois M was a factory worker for a large manufacturing company. By June of 2017, decades of working in very heavy duty manufacturing jobs had taken their toll on her body, leaving her unable to continue working due to severe and debilitating degenerative joint disease in her left hip, mild scoliosis, severe multilevel degenerative disc disease, bulging discs, facet arthrosis of the lower spine, and osteoporosis.

When she was unable to continue working, Lois filed a claim for short term disability (“STD”) benefits under a disability benefits plan provided by her employer and administered by Life Insurance Company of North America (“LINA”), a subsidiary of Cigna. Despite significant supportive medical records and strong statements from her treating physicians in support of her claim, LINA denied Lois’ claim based on a review by a nurse case manager.

After her claim was denied, Lois hired O’Ryan Law Firm to represent her to appeal the denial of her STD claim and assist her in filing a claim for long term disability (“LTD”) insurance benefits. We helped Lois gather substantial additional supportive medical evidence, including strong supportive statements from multiple treating physicians, and compiled an appeal of LINA’s denial of her STD benefits. Unfortunately, Lois’ employer continued to refuse to pay her STD benefits despite overwhelming evidence that she was truly disabled from performing her heavy duty manufacturing occupation.

On behalf of our client, Charlene L., O’Ryan Law Firm recently filed a lawsuit against Cigna Life Insurance Company of New York (“Cigna”). Prior to becoming disabled, Charlene was employed as a Store Manager with Ann Taylor, Inc.  Ann Taylor, Inc. is an American group of specialty apparel retail chain stores for women. The company is headquartered in New York City and currently operates as a subsidiary of Ascena Retail Group. The stores offer classic styled suits, separates, dresses, shoes and accessories. The brand is marketed under five divisions: Ann Taylor, Loft, Lou & Grey, Ann Taylor Factory and Loft Outlet.  As Store Manager, Charlene managed all aspects of the operation of a retail store, including sales, scheduling, pricing, inventory management, accounting, and employee supervision.

Charlene was forced to stop working due to the disabling symptoms of severe recurring headaches, chronic pain, fibromyalgia, and hypertension.  According to the Mayo Clinic, “fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.  Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress.  Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.”

When Charlene was unable to continue working due to her disabling medical conditions, she submitted a claim for long term disability  (LTD) benefits to Cigna.  Cigna initially approved her LTD benefits for two years, but Cigna notified her that it was terminating her benefits based on a review by its in-house medical staff.  Cigna claimed that although she could no longer perform her job as a Store Manager, she could perform jobs that were more sedentary.

A Facility Maintenance Manager with Purdue University hired O’Ryan Law Firm to assist him with his appeal for long term disability benefits with Cigna.  Cigna approved him for long term disability benefits and Cigna paid him disability benefits for 19 months, under the terms of the Cigna policy, but then they abruptly terminated his benefits in September 2017.  Our client worked at Purdue for over 13 years before he became disabled.  As a Facility Maintenance Manager he was responsible for keeping the Purdue campus premises and office buildings in a clean and orderly condition.  This position required heavy lifting, carrying, pushing and pulling from 20-50 pounds frequently.

Purdue’s main campus is located in West Lafayette, Indiana and is one of the premiere educational institutions for higher education in Indiana.  Purdue offers more than 200 majors for undergraduates, over 69 masters and doctoral programs, and professional degrees in pharmacy and veterinary medicine.

Cigna is a Pennsylvania insurance company who provides the group disability coverage to all Purdue employees.  Under the Cigna policy, Purdue employees are entitled to receive disability benefits if they are determined to be disabled pursuant to the following definition from the policy: