Articles Posted in Termination of long term disability benefits

O’Ryan Law Firm, on behalf of our client who is a disabled hospital ultrasound technician, recently filed a lawsuit against Madison National Life Insurance Company.  Our client was forced to stop working due to severe chronic migraines, which she suffered several days a week. These migraines were often so intense that they caused her to become nauseous to the point of vomiting, frequently spending entire days in the bathroom as a result.

After our client became disabled, Madison National paid her benefits for nearly four years under the long term disability policy it provided through her employer. The Social Security Administration also awarded our client disability benefits, finding that she was unable to perform any gainful occupation. Madison National even continued to pay our client benefits for more than a year after the policy’s “own occupation” period ended and the policy’s definition of “disability” changed to require her to be disabled from performing not only her own job, but any job for which her education, skills, and experience qualified her.

Unfortunately, in January of 2017, Madison National abruptly notified our client that her claim was being closed based on a review of her medical records that allegedly determined that she was no longer disabled. In our experience, this is a common tactic that Madison National uses to terminate claims that it no longer wishes to continue paying.

O’Ryan Law Firm, on behalf of our client who is a disabled Notre Dame employee, recently filed a  lawsuit against a Cigna subsidiary, Life Insurance Company of North America.  The client had been employed as an Academic Program Administrator with the University of Notre Dame.  Notre Dame is a private, non-profit Catholic research university in the community of Notre Dame, Indiana, near the city of South Bend, Indiana.  Notre Dame is consistently recognized as one of the top universities in the world.  Notre Dame started as a small all-male institution in 1842 by a French priest and seven other members of the Congregation of Holy Cross on 524 acres in northern Indiana.  In April of 1879 a disastrous fire destroyed the main building which housed virtually the entire University; however, 300 laborers, working all summer, rebuilt the structure that still stands today, topped by the gleaming Golden Dome.

In its early days, Notre Dame University enrolled religious novitiates, preparatory and grade school students and manual labor students but its classical collegiate curriculum never maintained more than a dozen students a year in the early decades.  Father John Zahm, who accompanied former President Theodore Roosevelt on a South American expedition, became the builder of the science departments at Notre Dame and inspired the University’s first steps in research. Father James Burns, Notre Dame’s great theorist of education, revolutionized Notre Dame University in the 1920s by eliminating the preparatory school and dramatically upgrading the law school.

Beginning in the 1930s Notre Dame University was strengthened by an influx of distinguished European scholars fleeing the Nazis and, drawing on their expertise, Father (later Cardinal) John O’Hara, expanded the graduate school to include programs in biology, physics, philosophy and mathematics. Notre Dame first enrolled women undergraduates in 1972.  The school is officially named the University of Notre Dame du Lac (University of Our Lady of the Lake).

O’Ryan Law Firm, on behalf of client Stacy K., recently filed a federal lawsuit against Reliance Standard Life Insurance Company after Reliance Standard wrongfully terminated her disability benefits after paying the benefits for three years. Stacy was employed as a Case Manager with Southern Hills Counseling Center which made her eligible for disability benefits under her employee benefit plan.

Stacy was forced to stop working in May 2014 due to the disabling effects of Multiple Sclerosis and severe migraine headaches.  Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.  MS is a type of autoimmune disorder. It isn’t known what causes Multiple Sclerosis, although environmental factors and genetics are believed to play a role.  Common symptoms include problems with balance and sensation, difficulty walking, leg or arm movement, fatigue, muscle spasms, tingling, numbness, and bladder control.  The symptoms, severity, and duration can vary from person to person.  Tremors can occur during precise movements, in the hands, or limbs.

Currently, multiple sclerosis is not a curable disease. Treatment strategies can help slow or modify the course of the disease, including treatment of relapses, and make the patient more comfortable.

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, 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.

The O’Ryan Law Firm has represented numerous employees of Indiana University (“IU”) who have become disabled because of serious illnesses such as chronic pancreatitis, lymes disease, degenerative disk disease, ovarian cancer, and osteoarthritis. A large number of those clients were employees who had worked for Indiana University for many years, some even decades, before reaching the point where they were no longer able to work because of their medical conditions.

Indiana University’s Long Term Disability Plan is an income replacement plan for IU employees who become disabled due to an illness or accident[1].  The following are the general terms of the long term disability coverage provided to IU employees:

  • With claim approval, the plan pays a regular monthly income when an enrolled employee becomes disabled.

Earlier this month, Judge Richard Posner abruptly announced his retirement from the United States Court of Appeals for the Seventh Circuit after more than 35 years on the bench, effective the following day. Judge Posner, a prolific writer and author of more than 3300 judicial opinions and nearly 40 books, was one of the most prominent appellate judges in the United States and the most-cited legal scholar of the 20th century, according to a survey by the Journal of Legal Studies. He carefully drafted his legal opinions to be easy to read and understand, and his signature concise, frank, and often humorous writing style helped to modernize the discipline of legal writing, presenting a stark contrast from the overly formal, long-winded “legalese” that had long dominated the legal field.

Just over three months prior to his retirement, Judge Posner authored an opinionKennedy v. The Lilly Extended Disability Plan, 856 F.3d 1136 (7th Cir. 2017), awarding substantial long term disability benefits to Cathleen Kennedy, an O’Ryan Law Firm client who had been forced to stop working in her position as an HR executive for Eli Lilly & Company as a result of severe fibromyalgia, a nightmarish condition characterized by chronic widespread musculoskeletal pain and fatigue that often presents with psychosomatic symptoms such as sleep and memory issues, anxiety, and depression. Unfortunately, because many of the primary symptoms of fibromyalgia – especially pain and fatigue – are difficult to objectively measure, the condition has historically been misunderstood and often goes undiagnosed due to the lack of a reliable means of testing for it. As a result, those who suffer from fibromyalgia also frequently must deal with the frustration caused by doubts about the validity of their condition and symptoms by friends, family, and sometimes even their healthcare providers.

Fortunately, recent scientific advances in the understanding of fibromyalgia have led to increasing acceptance of the validity of the condition and its profound impact on the lives of those who suffer from it. Judge Posner recognized this in his opinion, noting that Lilly itself markets a treatment for fibromyalgia and has been advised by one of its own physicians that fibromyalgia “is not only very common but is typically also very disabling” and that many victims of fibromyalgia “end up needing to stop working because of this condition.” Nonetheless, Lilly had terminated Ms. Kennedy’s long term disability benefits after she had been disabled for nearly four years due to fibromyalgia, despite the fact that her primary treating physicians had declared her to be permanently disabled, largely because there was no objective laboratory data proving the validity of her symptoms. Lilly claimed that although Ms. Kennedy was unable to work full time in her previous executive-level position, she could still work part time in one of “various non-executive positions” in her field.

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, on behalf of a former employee of Purdue University recently filed a lawsuit against Cigna for wrongfully denying the former Purdue employee’s disability claim.  The plaintiff had was a long time employee of Purdue, worked at Purdue for over 32 years, until he became unable to continue working in May 2013 due to chronic respiratory failure, cardiomyopathy,  recurrent pneumonia, atrial fibrillation, bronchial asthma, and osteoarthritis.  The Purdue employee’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these this combination of symptoms.  Cigna originally approved the claim but then terminated his benefits contending that the Plaintiff could return to work.

Prior to Cigna’s termination of the Plaintiff’s long term disability, a Functional Capacity Evaluation was performed that actually showed that he was unable to return to work. The functional capacity report states, “Mr. R has been off work since 2013 after developing problems with lung infections and difficulty breathing. He shows fair static muscle strength in the lower extremities when seated, however, is unable to functionally use his legs on stairs, working off the floor, getting to the floor, sustained walking and standing. Mr. R. showed a consistent standing limit to 2 minutes at a time.” Throughout the exam, Mr. R demonstrated using a cane to walk, labored breathing and slight wheezing, along with needing to rotate positions and taking multiple breaks. The physical ability assessment concluded Mr. R is only able to stand two minutes at a time, rarely able to walk, and rarely able to lift/carry 0-10lbs.

Under video surveillance conducted by Cigna on 3 separate days, there was no activity on the 1st and 3rd days, and when the Plaintiff was observed, he used a cane when walking