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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.

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 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 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:

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:

O’Ryan Law Firm, on behalf of Plaintiff, Kimberly G., recently filed a federal lawsuit against Aetna Life Insurance Company (“Aetna”).   Plaintiff was employed by Amazon Corporation, as a warehouse worker, which made her eligible for Amazon’s employee benefit plan.  Aetna issued the disability policy that provides long term disability benefits to Amazon employees who are unable to return to work due to a serious illness or injury.

Facts of the Case Against Aetna

Plaintiff was employed by Amazon from July 2012 until she became disabled in July 2016.  Plaintiff was unable to work due to significant bladder issues, including incontinence, due mainly to a surgical procedure that compromised her bladder. The Plaintiff’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these ailments.

The O’Ryan Law Firm, on behalf of Plaintiff, Timothy E., recently filed a federal lawsuit against Life Insurance Company of North America (LINA), a subsidiary of Cigna, for their refusal to continue paying disability benefits to a city employee who had been disabled for more than 5 years. The Plaintiff was employed by the City of Bloomington, and became unable to continue working in his extremely physical job from severe back issues and cardiac problems.  He had been employed for the City of Bloomington for more than 20 years when he was forced to stop working because of his medical conditions.  Cigna paid him for 5 years and then abruptly terminated his monthly disability payments saying he had miraculously recovered his ability to return to work, after 5 years.  In the meantime, he had been approved by the Social Security Administration who found him unable to perform any substantial, gainful activity.

Facts of the Case Against Cigna

The Plaintiff was employed by the City of Bloomington from 1987 until he became disabled in June 2010 and unable to work due to coronary artery disease, back pain, COPD, hypertension, fatigue, sleep apnea, and hyperlipidemia. Plaintiff’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these medical conditions.

The O’Ryan Law Firm, on behalf of Plaintiff Sherry M., recently filed a federal lawsuit against Anthem Life Insurance Company (“Anthem”). The Plaintiff was employed with Anthem Life as an Operations Expert, which made her eligible for disability benefits under the Anthem Life Long Term Disability (LTD) Plan (the “Plan”).  Anthem was both her employer as well as the insurance company for her long term disability benefits.  It always is particularly troubling to see an employee, who has worked hard for a number of years for an insurance company, be mistreated when they become disabled by their own employer.

Facts of the Case

The Plaintiff was employed by Anthem Life until she became disabled in 2015 due to the disabling effects of lupus erythematosus.  According to WEB MD, lupus is an autoimmune disease, which means that the immune system mistakes the body’s own tissues as foreign invaders and attacks them. Some people with lupus suffer only minor inconvenience. Others suffer significant lifelong disability. Nine out of 10 people with lupus are women. The disease usually strikes between age 15 and 44, although it can occur in older individuals. There are two kinds of lupus: