O’Ryan Law Firm, on behalf of Plaintiff, Denise D., recently filed a lawsuit against The Prudential Insurance Company of America (“Prudential”). Plaintiff was employed by Advance/Newhouse Partnership, which made her eligible for the Advance/Newhouse Partnership Short Term and Long Term Disability Plans, which were administered and insured by Prudential.
Facts of the Case Against Prudential
Plaintiff was employed by Advance/Newhouse Partnership from 2012 until she became disabled in February 2016 and was unable to work due to lupus, fibromyalgia, migraines, spondylosis and radiculopathy. Plaintiff’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these serious illnesses. Her physicians also confirmed that she was unable to perform the material duties of her job thus meeting the definition of “Disabled” under the Prudential policy.
The plaintiff filed a claim with Prudential for Short Term and Long Term Disability benefits; however, Prudential denied her claims arguing that the medical records did not show that she was impaired. Plaintiff appealed Prudential’s decision to deny her disability benefits; however, Prudential failed to issue a determination on the appeal within the regulatory mandated time period. Prudential failed to deliver a determination on Plaintiff’s appeal within 90 days of receiving her appeal as required by the ERISA regulations.
Lawsuit Filed Against Prudential
The terms of the lawsuit allege that Prudential intentionally and without reasonable justification denied Plaintiff’s disability benefits in violation of the Advance/Newhouse Partnership Short Term plan and the Prudential policy, as well as the Employee Retirement Income Security Act. Plaintiff’s physicians reported to Prudential that Plaintiff suffers from fatigue, poor concentration, chronic joint pain, weakness, sleep disturbance, lupus flares and lupus fog. Plaintiff’s treating physicians submitted multiple attending physician statements outlining her disability and her inability to return to work. Plaintiff’s treating physicians’ opinions were dismissed by Prudential in favor of contracted physicians who had never met or examined the Plaintiff.
A pretrial conference was held in the case and the magistrate judge has scheduled the case for a settlement conference which all parties are required to attend. The Plaintiff will be seeking payment of her unpaid back benefits, interest on those back benefits, and payment of her attorney fees.
If your short term or long term disability benefits have been denied or terminated by Prudential, please contact the O’Ryan Law Firm as soon as possible for a free consultation.