Articles Tagged with “denied disability benefits”

The O’Ryan Law Firm has represented several clients in disability claims against Madison National Life Insurance Company. Most of these clients have been teachers or other former employees of school corporations located in Indiana. Madison National has issued disability coverage to numerous school corporations across the State of Indiana committing to provide income replacement benefits to Indiana teachers who have become disabled due to an injury or illness. We have represented several teachers who have had a stroke, suffer from bipolar disorder, or who have been diagnosed with fibromyalgia, among other medical conditions, in disability claims denied by Madison National.

Madison National has been headquartered in Madison, Wisconsin since

1961. They are a wholly-owned subsidiary of Independence Holding Company, a NYSE listed corporation with principal interests in the life and health insurance business. Madison National is involved in several lines of life, health and disability business including Group Life, Short-Term Disability and Long-Term Disability for both public and private sector employers across the country.

For several of our clients, their insurance company has denied or terminated their short term or long term disability benefits for a strange reason: housework. Just recently we represented a client in a Unum case where Unum terminated our client’s monthly disability benefit payment, in part because they claimed “[y]ou have reported a significant level of housework at home.” Oftentimes, you will receive a call from your disability benefits claim specialist asking you several questions about your activities of daily living or you may be required to complete forms regarding your daily activities. On occasion, the insurance company may send a field investigator to your home to interview you about your daily activities and to observe what you are able to do over the course of the interview.

Some of the insurers will take reports about housework and utilize this information to deny benefits claiming that vacuuming, doing laundry and preparing meals indicates that an individual is able to work. Several courts have rejected this as a reason for denying disability benefits. For instance in Hawkins v. First Union, 326 F.3d at 918, the Seventh Circuit specifically rejected this type of reasoning finding that as a matter of common experience an individual’s ability to do some activities at home did not establish that he could do a full-time job. The court noted, for example, that “when one is working at home it is easier to interrupt one’s work every few minutes if need be than to do so at the office.” The court concluded that engaging in a certain amount of activity at home simply “does not prove” that a person is not disabled.

Similarly, in the case of Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998) the court reasoned that “[D]isability claimants should not be penalized for attempting to lead normal lives … Many home activities are not easily transferable to . . . the more grueling environment of the workplace, where it might be impossible to periodically rest or take medication.’ . . . Only if the level of activity were inconsistent with the Claimant’s stated limitations would these activities have any bearing on Claimant’s credibility.” Further, as stated by the court in Lewis v. Callahan, 125 F.3d 1436, 1441 (11th Cir. 1997), participation in everyday activities of short duration, such as housework or fishing” does not disqualify a claimant from disability and does not establish that a claimant can perform sedentary work. Lastly in Gentle v. Barnhart, 430 F.3d 865, 867 (7th 2005), the judge found that equating household work to work in the labor market is not appropriate.

Over the years, we have represented numerous employees of Indiana colleges and universities who have become disabled because of serious illnesses such as diabetic neuropathy, lyme disease, degenerative disk disease, multiple sclerosis and lymphoma. A large number of those clients were disabled Purdue employees who had worked for Purdue University for many years, some even decades, before reaching the point where they were no longer able to work because of their medical conditions. Purdue has a very generous employee benefit package so our clients were very surprised and extremely disappointed when their disability claims were either denied outright or prematurely terminated by the insurance company.

stock-photo-3175050-bell-tower.jpgPrudential Insurance Company previously insured Purdue’s long term disability program and now Cigna is the insurance carrier for the Purdue long term disability program, or more specifically Cigna’s subsidiary Life Insurance Company of North America. Many Purdue employees have contacted our office after Cigna denied their claim upon their initial application or when Cigna terminated the benefits before the individual was truly able to return to work.

Cigna typically hires consulting physicians, who never examine our clients, to review the person’s medical records and conclude, contrary to the treating physicians, that the client does not have any restrictions or functional impairments. Cigna then relies upon the conclusions of the consulting physicians to deny legitimate disability claims.