Articles Tagged with Spinal Fusion

Dan T. is 60 years old and was a cable splicing technician with a telecommunications company, where he worked for approximately 29 years until late 2015, when he was forced to stop working due to the debilitating effects of bilateral knee osteoarthritis and cervical and lumbar spondylosis. Since that time, he has also undergone total replacements of both knees and developed severe, debilitating chronic cervicogenic/occipital headaches that occur on a daily basis; moderate to severe bilateral carpal tunnel syndrome; and increasingly severe lower back and leg pain that persists despite a lumbar spinal fusion surgery in early 2018.

When Dan was forced to stop working, he applied for long term disability (LTD) benefits through his employer’s disability plan, which was insured by Prudential. Under the terms of the Prudential policy, Dan was entitled to receive LTD benefits for up to 24 months if he was unable to perform the material duties of his own occupation. Because Dan’s medical conditions prevented him from working in his own occupation as a cable splicing technician, Prudential awarded him LTD benefits, which it paid until May of 2018.

However, the terms of the Prudential LTD policy dictate that after 24 months of receiving LTD benefits, Dan was only entitled to continue receiving benefits if he could prove that he was disabled from performing any gainful occupation for which he was “reasonably fitted by education, training or experience.” As a result, Prudential terminated Dan’s benefits after 24 months, based on a vocational review that concluded that he was able to perform certain sedentary work for which he was qualified by his education and experience.