Articles Posted in Liberty Mutual

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.

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.

O’Ryan Law Firm, on behalf of their client, recently filed a lawsuit against a Liberty Mutual company, Liberty Life Assurance Company of Boston, for denial of a Dow Chemical employee’s long term disability benefits.  Our client was employed by Dow Chemical Company as a Global Adverse Effects Coordinator, responsible for ensuring compliance with the US FIFRA (Federal Insecticide, Fungicide and Rodenticide Act) regulations which protects consumers and the environment.  As an employee of Dow Chemical, she was eligible for disability benefits under the Dow Chemical long term Disability insurance policy.

Dow Chemical is a large producer of plastics, including synthetic rubber. It is also a major producer of ethylene oxide, various acrylates, surfactants, and cellulose resins. It produces agricultural chemicals including the pesticide Lorsban and consumer products including Styrofoam.

After 27 years of working for Dow Chemical, our client was forced to stop working when she became disabled from the severe symptoms of Crohn’s Disease.  Crohn’s Disease is an inflammatory bowel disease that causes inflammation of the digestive tract, which leads to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.  The inflammation caused by Crohn’s disease often spreads deep into the layers of the affected bowel tissue and can be both painful and debilitating.  Unfortunately, there is no cure for Crohn’s Disease yet.

O’Ryan Law Firm, on behalf of our client, Jeremy C., recently filed a lawsuit against Liberty Life Mutual after they wrongfully terminated Jeremy’s disability benefits. Our client was employed as a Store Manager with Wal-Mart, which made him eligible for disability benefits offered through the Wal-Mart Stores, Inc. employee benefit plan.  Liberty Mutual is actually the insurance company for the long term disability coverage offered to Wal-Mart employees.

Jeremy worked for many years at Wal-Mart, the last several years as a Store Manager, until he was forced to stop working in March 2015, because of his medical conditions the worst of which was Sjogren’s Syndrome.  Sjögren’s is a systemic autoimmune disease that affects the entire body. The symptoms from this disease include profound fatigue, memory loss, recurrent sinusitis, difficulty with speech, reflux, esophagitis, muscle pain, upset stomach, irritable bowel, peripheral neuropathy and many more.

As a result of Sjogren’s Syndrome, our client suffered specifically from gait instability, memory loss, episodes of dysarthria and slurred speech, overall weakness/fatigue, numbness and tingling in the right arm and right leg, tremors after physical activity, abdominal pain, acute sinusitis, colon polyps, gastroesophogeal reflux disease with esophagitis, exhaustion, and continuous headaches.  The multitude and severity of these symptoms made it impossible for our client to continue handling the responsibilities of a store manager at a large Wal-Mart store located in Lebanon, Indiana.

O’Ryan Law Firm recently filed an appeal for Long Term Disability benefits against Liberty Life Assurance Company of Boston (Liberty Mutual) for wrongfully denying a participant’s benefits. The client was a long time employee of a large financial institution and was forced to stop working due to coronary artery disease, hypertension, diabetes, and ischemic cardiomyopathy. The client underwent a coronary bypass in 2010 and had a dual-chamber cardioverter defibrillator implanted in 2015. He suffers from shortness of breath, fatigue, chest pain, and experiences confusion. The high level of stress with the client’s occupation exacerbated the symptoms correlated to his illness. This stress exposed him to a possibility of a severe cardiac event or even death.

Despite the client’s treating physicians providing objective medical proof that he was unable to continue working full time due to his condition, Liberty Mutual hired a contracted physician to review his claim file. The hired contracted physician contended the client could perform a Sedentary occupation on a full time basis. In addition, the hired contracted physician erroneously claimed the client’s treating physician could perform a Sedentary occupation on a full time basis. When in fact, the treating physician never released the client to return to work full time.

Liberty Mutual originally approved the short term disability claim in full, but then turned around and denied his long term disability benefits based on the hired contracted physician review. In an attempt to solidify the client’s denial, Liberty Mutual hired a private investigator to perform surveillance. The private investigator failed to observe any real activity for four entire days, which was consistent with the client’s limitations. Liberty Mutual cited the following definition of “Disability” within the long term disability denial letter:

At the O’Ryan Law Firm, we have represented several clients who have become disabled due to the severe symptoms of Scleroderma.

According to the American College of Rheumatology:

WHAT IS SCLERODERMA?

The Dow Chemical Company is a multinational chemical corporation headquartered in Midland, Michigan.  Dow manufactures plastics, chemicals, and agricultural products. With a presence in about 160 countries, it employs about 54,000 people worldwide.  Dow Chemical also has a large complex on the northwest side of Indianapolis.

Liberty Mutual provides disability insurance to employees of Dow.  Liberty Mutual Insurance is an American diversified global insurer, and the second-largest property and casualty insurer in the  world.   Based in Boston, Massachusetts, it employs over 50,000 people in more than 900 locations throughout the world.

In the disability policy provided to Dow employees, Liberty Mutual defines disability as follows:

Disability insurance companies may look to more than just medical records and reports when determining whether a claimant qualifies for disability insurance benefits. Insurers have long used private investigators to perform surveillance of claimants in order to obtain additional information regarding the claimant’s restrictions and limitations. Oftentimes, the private investigators are asked to document their observations with video to provide tangible evidence of the claimant’s daily activities and abilities. Depending on the information gathered, reports from the investigators’ surveillance and the associated video evidence can lead to a denial of disability benefits. Generally, when courts review video evidence they look at whether the observations in the surveillance video are consistent with the claimant’s reported restrictions and limitations.

A common strategy for disability insurers is to schedule surveillance at a time when the claimant has a scheduled appointment with their doctor or a previously scheduled medical examination. This provides the private investigators with a known opportunity to observe the claimant outside of their home. Inevitably, this allows the surveillance team to observe the claimant driving or riding in a vehicle. In Mote v. Aetna Life Insurance Co., 502 F.3d 601 (7th Cir.2007), Aetna’s decision to deny the plaintiff’s disability benefits was upheld by the court. Aetna based their decision in part on video surveillance showing the plaintiff running errands, driving to medical appointments, and loading groceries into her car. This evidence was used to establish that the plaintiff could work in “any occupation.” However, video surveillance in Gessling v. Grp. Long Term Disability Plan for Employees of Sprint/United Mgmt. Co., 693 F. Supp. 2d 856, 864 (S.D. Ind. 2010) only showed that the claimant was capable of driving a little longer than the fifteen minutes he reported to a Hartford Life representative. The court in Gessling found that this video evidence “says nothing useful about (the claimant’s) ability to work in his own occupation.”

Similarly, the Northern District of California found that surveillance evidence depicting a plaintiff “walking, driving and doing errands … for a couple of hours … does not mean that [that p]laintiff is able to work an eight-hour a day job.” Thivierge v. Hartford Life & Accident Ins. Co., 2006 WL 823751, at *11 (N.D.Cal. March 28, 2006). The Eastern District of California reached the same conclusion in a case where Hartford procured surveillance video of the plaintiff driving to the store, visiting a friend, carrying a small bag, and sitting through an interview while taking numerous breaks. Leick v. Hartford Life & Acc. Ins. Co., 2008 WL 1882850 (E.D. Cal. Apr. 24, 2008). The court determined that the plaintiff’s documented activity on a “good day” did not contradict that the plaintiff was unable to perform a full-time sedentary job. Id. See also Hunter v. Life Ins. Co. of N. Am., 437 F. App’x 372, 378-79 (6th Cir. 2011) (surveillance of a plaintiff driving to her functional capacity evaluation, as well as other activities of daily living, did not indicate that Hunter can perform all the physical duties of her former occupation).

Based in Boston, Massachusetts, Liberty Mutual employs over 50,000 people in more than 900 locations throughout the world. As of December 31, 2012, Liberty Mutual Insurance had $120.1 billion in consolidated assets, $101.5 billion in consolidated liabilities, and $36.9 billion in annual consolidated revenue. The company, founded in 1912, offers a wide range of insurance products and services, including personal automobile, homeowners, workers compensation, commercial multiple peril, commercial automobile, general liability, global specialty, group disability, fire and surety.

Liberty Mutual Group Benefits department provides mid-sized and large businesses with short- and long-term disability insurance products and group life insurance. Many Indiana employers, such as Dow Chemical and Subaru, have purchased short term disability group coverage and long term disability group coverage through Liberty Mutual. Although, oftentimes Liberty Mutual is only the claims administrator for the short term disability coverage and does not insure the short term disability benefits. By issuing the short term and long term disability policies, Liberty Mutual agrees to pay income replacement benefits to employees who become disabled due to injury or illness.

On their website Liberty Mutual notes that as far as Long-Term Disability: