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.
After an incident at work in which a crane he had inspected two days earlier had an electrical malfunction that caused it to drop a full load of molten steel, Michael suffered extreme exacerbation of his PTSD and anxiety. Fortunately no one was injured or killed, but Michael was overwhelmed by flashbacks to his time in Iraq during the Persian Gulf War in which he was repeatedly required to lead his special forces team on missions that risked the lives of every member of his team. He sought treatment from a VA psychiatrist who concluded that due to his conditions, he was strongly advised “to not drive, operate dangerous or heavy equipment, work from heights above ground or floor level or do any other kinds of work or activities that would create a hazardous condition if a person were to suddenly lose full mental functioning, consciousness or control of muscles or movement.”
Unfortunately, when Michael filed a claim for short term disability (“STD”) benefits under his employer’s STD plan, the claims administrator, Sedgwick Claims Management Services, denied his claim, citing insufficient medical evidence.
Fortunately, Michael contacted O’Ryan Law firm to assist him in appealing Sedgwick’s denial of his claim. We worked with Michael to gather as much information as possible from the VA and his other healthcare providers to submit to Sedgwick in support of Michael’s claim. After reviewing the appeal, Sedgwick overturned the denial and awarded Michael full benefits for the maximum duration under his STD policy.
If your short or long term disability benefits claim has been denied because an insurance company claims you haven’t provided enough medical support for your claim, call O’Ryan Law Firm for a free consultation.