Amy was employed as a Special Education teacher by Elkhart Community Schools until she became disabled in 2015 due to the disabling effects of orthostatic hypotension, syncope and collapse. By definition, orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint.  Amy was also treated for autonomic dysfunction, had bradycardia in 2010 with pacer implant with improvement until she was head-butted by a student resulting in subsequent dizziness and syncope (fainting)

Amy’s primary care physician recommended disability for autonomic problems with syncope episodes.  A treating physician at the Cleveland Clinic placed Amy at a class 4 physical impairment, and class 3 mental with a diagnosis of Orthostatic hypotension, syncope, fatigue, dizziness, and memory loss and stated that Amy is disabled from all work and would never return to work.

When Amy was forced to stop working she submitted a claim to Lincoln National Life Insurance Company who is her disability insurer.  Lincoln National approved her disability benefits on February 5, 2016 and paid benefits through November 2, 2017, when Lincoln abruptly terminated with little notice.  To terminate the claim, Lincoln relied on two of their hired record reviewers. One neurologist reviewer was aware of Amy’s abnormal head tilt testing with induction of symptomatic orthostatic hypotension. At baseline her blood pressure was 113/70. Her heart rate was 63.  After three minutes blood pressure was not found and the heart rate was 63. The test was ultimately aborted.  The reviewer also spoke with Amy’s treating physician, who advised him that she has syncopal episodes.

O’Ryan Law Firm, on behalf of Plaintiff, Jennifer D., recently filed a federal lawsuit against Life Insurance Company of North America (LINA), a subsidiary of CIGNA.  Jennifer was a classroom teacher, responsible for providing instructional services necessary to educate all students to high standards and ensure that all students meet internationally benchmarked Common Core Standards linked to Indiana’s Academic Standards.  Jennifer was forced to stop working when she became disabled due to chronic pain as a result of occipital neuralgia, trigeminal neuralgia, cervical facet arthropathy, and neuropathic pain.  Trigeminal neuralgia is a hideous medical condition which causes severe facial pain with no known effective treatment.  According to the American Association of Neurological Surgeons[1], trigeminal neuralgia is described as follows:

Trigeminal neuralgia, also known as tic douloureux, sometimes is described as the most excruciating pain known to humanity. The pain typically involves the lower face and jaw, although sometimes it affects the area around the nose and above the eye. This intense, stabbing, electric shock-like pain is caused by irritation of the trigeminal nerve, which sends branches to the forehead, cheek and lower jaw. It usually is limited to one side of the face. 

Jennifer tried pain management, physical therapy, chiropractic care, massage therapy, medication changes, injections, surgeries, etc. to alleviate her pain with no success.  An MRI of Jennifer’s brain showed left occipital craniotomy and mild atrophy of the left cerebellar hemisphere.

The United States District Court for the Southern District of Indiana recently overturned Aetna Life Insurance Company’s denial of long term disability benefits to Kimberly Garner, an O’Ryan Law Firm client who was forced to leave her job as an Amazon fulfillment center associate after complications from surgery left her with severe and persistent urinary incontinence. The Court’s opinion, written by Chief Judge Jane Magnus-Stinson, is the result of several months of zealous litigation by the O’Ryan Law Firm on behalf of Ms. Garner. [1]

After several years of working for Amazon, Ms. Garner underwent a surgical procedure that unfortunately caused her to suffer from severe mixed urinary incontinence – meaning she experienced severe and uncontrolled leakage of urine during physical activity or exertion, and due to involuntary and unpredictable spasms of the bladder muscles. Sophisticated diagnostic imaging and testing procedures confirmed that Ms. Garner’s incontinence was severe and uncontrolled. Although she was prescribed various medications and underwent several follow-up procedures intended to address her profound incontinence, including Botox injections and cystoscopy, Ms. Garner experienced no relief from this incredibly frustrating, embarrassing, and debilitating condition.

Although Ms. Garner attempted to return to work, she found herself unable to make it through the day without numerous emergency trips to the bathroom, and frequently had to leave her work area to change clothes when her leakage came on so quickly and unexpectedly that she was unable to reach the bathroom in time. Ultimately, she was forced to leave her job due to her medical condition, and she applied for disability benefits under the policy that Amazon provided through Aetna. Her primary care physician referred her to urogynecologist Dr. Douglass Hale for a specialist’s opinion, and he suggested an implantation of an InterStim device – a last-resort procedure in which electrodes are implanted on the nerves controlling the bladder, in an attempt to prevent the bladder from involuntarily emptying. Unfortunately, because she lost her health insurance when she was forced to leave her job, she was unable to afford the procedure.

O’Ryan Law Firm, on behalf of Plaintiff, Brooke W., recently filed a federal lawsuit against Life Insurance Company of North America (LINA) (LINA is a subsidiary of CIGNA).  Brooke was an Extension Educator for Purdue University.  Purdue’s main campus is located in West Lafayette Indiana and is one of the premiere educational institutions for higher education.

Facts of the Case Against LINA

Brooke was forced to stop working when she became totally disabled due to multiple diagnoses including Diabetes Mellitus Type 1, small fiber autonomic neuropathy, fibromyalgia, Graves disease, migraines and lupus.  Brooke’s rheumatologist confirmed the diagnosis of lupus SLE based on a positive ANA screen.  She also had an abnormal nerve conduction study of her left ulnar nerve for carpal tunnel syndrome.  Brooke’s occupation required her to travel extensively and her cardiologist restricted her from driving because of the precariousness of her medical condition.  Objective medical proof was provided to LINA by her physicians, and confirmed that Brooke was unable to continue working as an Extension Educator at Purdue due to these serious illnesses.

O’Ryan Law Firm, on behalf of Plaintiff, Melissa B., recently settled a lawsuit against American United Life Insurance Company (“AUL”) for the termination of Melissa’s disability insurance benefits after she was diagnosed with cardiomyopathy and congestive heart failure.

Melissa was a teacher with a local public school system and was forced to stop teaching when, shortly after giving birth to her son, she was found to have cardiomyopathy with reduced ejection fraction and chronic systolic congestive heart failure, confirmed by numerous echocardiograms, cardiac MRIs, and other testing procedures. After she was diagnosed with cardiomyopathy, Melissa began suffering from extreme fatigue, shortness of breath, and chest pain. Her cardiologist notified her employer that Melissa had severely reduced left-ventricular systolic function left her at an increased risk for mortality and precluded her from engaging in even light level activities on a full-time basis. Melissa’s treating physicians ordered her off work indefinitely, and AUL awarded her disability benefits under the policy beginning January 1, 2014.

Melissa was awarded Social Security Disability Benefits in September 2015, based on the Social Security Administration’s finding that she had been totally disabled since May 1, 2014.

O’Ryan Law Firm recently filed an appeal for Long Term Disability benefits against Cigna for wrongfully denying a participant’s benefits.  The client was a long-time employee of Toyota, working as a warehouse associate.  She was forced to stop working due to breast cancer, a bilateral mastectomy, and the residual effects of chemotherapy and treatment; including fatigue, migraines, bilateral lower extremity neuropathy and severe pain.

Despite the client’s treating physicians providing objective medical proof that she was unable to continue working due to her condition, Cigna hired a contracted physician to review her claim file.  The contracted physician contended the client could perform a sedentary occupation on a full-time basis even though the client’s own physicians stated she could not work at all.  The treating physicians reported to Cigna that she could not work and never released the client to return to work full-time.

Cigna originally approved the short-term disability and long-term disability claim in full until the time when the definition of Disabled changed to “performing the duties of any occupation.” As soon as this definition kicked in Cigna terminated her benefits.  Cigna’s hired contract physician even agreed with the treatment, limitations and restrictions placed on the client but in order to be hired for another claim file review the contracted doctor opined that the client was able to work a full-time job.  Cigna cited the following definition of “Disability within the long-term disability denial letter:

Human immunodeficiency virus, commonly known as HIV, is a virus that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has acquired immunodeficiency syndrome, commonly known as AIDS.[1]

Over the past three decades, revolutionary advances in treatment have dramatically improved the prognosis of individuals diagnosed with HIV/AIDS. Although no known cure for HIV/AIDS exists, modern treatments have rendered the disease highly manageable. However, while an HIV/AIDS diagnosis is no longer an almost certain death sentence, it still carries the risk of a number of severe, often disabling symptoms.

HIV/AIDS is most frequently treated with antiretroviral medications, which slow the growth of the virus in the patient’s bloodstream, allowing the patient’s immune system to recover and fight off the virus until it is undetectable in blood samples.[2] These medications are typically administered in the form of a single pill that contains a “cocktail” of multiple different antiretroviral drugs. Although these drug cocktails are highly effective in fighting HIV and can essentially eliminate it from a patient’s bloodstream, “reservoirs” of the virus remain in the patient’s body and allow the virus to return to dangerous levels if the patient ceases properly adhering to an antiretroviral treatment regimen.[3] This means that even after patients’ viral loads become undetectable in blood tests, they must continue to adhere to their antiretroviral treatment regimen for the rest of their lives. It is also common for HIV/AIDS patients to have to switch from one antiretroviral drug cocktail from another after the HIV virus in their bodies develop an immunity to one or more of the antiretroviral drugs in the cocktail, so HIV/AIDS patients are always at risk of contracting serious illnesses when their immune systems become compromised due to newly-developed resistances.[4]

O’Ryan Law Firm, on behalf of our client, Deborah P., recently filed a lawsuit against Madison National after they wrongfully terminated her disability benefits. Our client was employed as a Teacher with the Hanover Community School Corporation, which made her eligible for disability benefits offered through the Hanover Community School Corporation employee benefit plan.  Madison National is often times the insurance company for long term disability coverage offered to most teachers.

Deborah began her teaching career in 1984. After 30 years of teaching, Deborah was forced to stop working in December 2014 due to infiltrating ductal carcinoma, hypothyroid, chronic fatigue syndrome, GERD, neuropathy, knee pain, chest pain, shortness of breath, weakness, edema, nausea, palpations, cardiomyopathy, Hashimoto’s thyroiditis, migraines, and insomnia.

In October 2013, Deborah received a devastating diagnosis of invasive ductal carcinoma stage 2. Her life became overfilled with treatments, doctor visits, tests, decisions on treatments, etc. Since the tumor was almost 5cm, Deborah underwent chemotherapy first to see if the tumor would shrink and offer her more options. Deborah underwent extremely aggressive chemotherapy and continued to teach during treatments in hopes of beating the cancer and returning to teaching full time. Deborah began experiencing pain in her joints, profound fatigue, and was nauseous all the time. In March 2014, Deborah underwent a lumpectomy. Since 3 out of 5 lymph nodes were removed and tested positive, Deborah lives in daily fear that her cancer will return. In addition to chemotherapy and surgery, Deborah also underwent proton radiation. Deborah has tried to return to work, but became too profoundly fatigue to make it through a normal school day.

O’Ryan Law Firm, on behalf of Plaintiff, Dave C., recently filed a lawsuit against a Cigna subsidiary, Life Insurance Company of North America (LINA), after they wrongfully terminated our client’s long term disability benefits which were paid under a Cigna disability policy.  Dave worked for Purdue University as a Health Desk Technical Support Supervisor until he became disabled and eligible for disability benefits under the Cigna policy.

Facts of the Case Against Cigna

After over 18 years of employment at Purdue University, Dave was forced to stop working when he became totally disabled due to Seizure Disorder and the resulting symptoms from this disorder.  As you can imagine, seizure disorder can be difficult to prove with objective tests because there are very little signs of the seizures unless they are actually occurring.  However, Dave’s treating physicians provided objective medical proof that he was unable to continue working due to his seizure disorder.

As a new employee to Ball State University, have you ever questioned whether your insurance carrier will “be there” when you are disabled from an injury or accident?  As a BSU employee, you may make monthly premium payments for long term disability coverage through payroll deduction, only to find out that when you need it, the insurance carrier is putting up road blocks to your rightful and deserved disability benefits.  The consequences of denials or early terminations in disability benefit claims can be devastating.

The O’Ryan Law Firm has represented numerous employees of several universities, including Ball State University, who have become disabled because of serious illnesses such as chronic pancreatitis, Lyme’s disease, fibromyalgia, degenerative disk disease, and cancer. A large number of those clients were employees who had worked for a university for many years, some even decades, before reaching the point where they were no longer able to work because of their medical conditions.

Ball State University’s Long-Term Disability Plan is an income replacement plan for BSU employees who become disabled due to an illness or accident.  The following is general information regarding long-term disability coverage provided to BSU employees: