Posted on Fri, Mar 30, 2012 @ 01:10 PM
Austin attorney Lonnie Roach has assisted clients across Texas with their long term disability (LTD) appeals. This is true of Houston residents, as well.
A client from The Woodlands suffered from back pain, depression and carpal tunnel syndrome. He had undergone an attempted lumbar decompression and fusion between his fourth and fifth lumbar vertebrae. This failed and was followed by a second surgery that attempted to fuse the third through fifth lumbar vertebrae. The second surgery failed, too, and the client's condition continued to degenerate. He was on constantly increasing pain medications. The Social Security Administration awarded him full disability benefits. Prudential denied his LTD benefits, even though multiple physicians declared him completely disabled. We appealed and got him a settlement.
A Dickinson client was denied Short Term Disability by Cigna. She underwent a neuropsychological evaluation which found cognitive impairments. At the suggestion of the neuropsychologist, she then underwent a Functional Capacity Evaluation which found physical limitations. Both of the tests, which are considered the “gold standard” for making disability determinations, found our client incapable of full-time employment. Her doctor described her limitations so as to include two hours of rest with every one hour of activity. These restrictions were indefinite. Although she could perform some functions, she was limited to part-time work and could not earn 80% of her indexed pre-disability earnings unless she could work at least 80% of a full-time schedule. There was no evidence in the record that she could do so. We fought Cigna when it denied her claim and were granted a settlement.
Another client, from Katy, suffered from Mixed Connective Tissue Disease and gastroparesis. Although her physician was an advocate of the client attempting to return to work, the restrictions he required were such that she remained totally disabled under the terms of the policy. According to a doctor of Principal’s choosing, she would have to begin work at 11:00 a.m. and leave work at 3:00 p.m. She would additionally require at least two sick days each month. The job would necessarily be sedentary to light and, should keyboarding be required, the client would require accommodation such as a voice recognition system. Simply put, no employer could reasonably be expected to accommodate such extreme restrictions. She was awarded disability benefits from the Social Security Administration; however, Principal denied her LTD benefits. We were able to get them reinstated.
A resident of Montgomery worked in the healthcare industry before becoming disabled. She underwent a Functional Capacity Evaluation that demonstrated that she only retained sedentary capacity for activity performed above the waist and less than sedentary capacity for activity below the waist. Additionally, she could not sit, stand, or walk for any extended period. This residual, physical capacity was below that required to perform any occupation. She had been adjudged totally disabled by the Social Security Administration and awarded SSDI and required significant narcotic pain medication due to her objectively documented condition. This was problematic for her continued employment in any healthcare occupation, but Lincoln Financial denied her. We got her a settlement.
The former president of a company in Houston had been receiving disability benefits, and then was denied. The Social Security Administration concurred with his physicians that he was disabled from any gainful activity, much less his former occupation as president of a multi-national corporation. At the time of denial, over ten years after the initial disability determination, he was placed on a heart transplant list. The physician on whom Hartford allegedly relied to deny benefits stated that the client could not work at any occupation. Nonetheless, The Hartford denied his claim. After filing suit, we were able to get his benefits reinstated.
If you are a Houston-area resident that has had your long term disability claim denied, click here or call Lonnie Roach of Bemis, Roach & Reed. He can represent you in the appeals process.
Posted on Fri, Mar 23, 2012 @ 01:45 PM
Lonnie Roach, a partner in the Austin law firm Bemis, Roach & Reed, has successfully assisted hundreds of clients who have been denied long term disability benefits. These clients have suffered from many different conditions and injuries.
A Lubbock-area client suffered from degenerative joint disease of the right hip and left heel. He had a history of osteoarthritis and multiple orthopedic surgical interventions including right ankle repair, lumbar fusion, right rotator cuff repair, and left calcaneal fracture. He also had a Class 1 heart disease. Medical records supported sedentary restrictions and limitations; our client was not expected to improve. He had a limited ability to sit, stand, or walk, only capable of doing those activities 33% of the time or less. Accordingly, the client’s treating physician stated that he would not ever be able to engage in full-time employment. The Social Security Administration (SSA) agreed. Reliance Standard denied his claim in spite of this, but benefits were reinstated after we appealed.
Another client was a field sales representative living in Paige, Texas. He suffered a branch retinal arterial occlusion (stroke) in his right eye, permanently impairing his field of view. Both his treating physician and Aetna’s reviewing physician agreed that he should not be employed in a position that required driving. Because his occupation required extensive driving, the client was forced to stop working and apply for long term disability benefits. Aetna, nevertheless denied his claim. We filed a federal lawsuit and successfully overturned Aetna’s denial.
A Greenville, Texas client’s MRI showed abnormal signals in both frontal lobes of his brain, demonstrating active, demyelinating disease; lab reports showed spinal fluid and findings positive for oligoclonal bands, as well as a definitive Multiple Sclerosis diagnosis by a neurologist. He had a left visual field loss, left-side body weakness, numbness and nausea, and required a cane or walker to walk. In addition, our client experienced memory problems. At the time his claim was denied, Prudential wrote that he did not have a diagnosis that supported his subjective complaints. We convinced them otherwise and benefits were reinstated.
A client from Round Rock was diagnosed with pancreatitis. By 2009, he was on eight medications, including Hydrocodone and Fentanyl. He could not operate a motor vehicle in the course and scope of employment, as required by his occupation, while under the influence of the narcotics he needed to take. He was awarded SSDI benefits, however, Reliance Standard denied his claim. Under appeal, we were able to his benefits reinstated.
Another client from Round Rock had congestive heart failure, uncontrolled arrhythmias, and a surgically implanted pacemaker. This previous heart condition was later complicated by a paralyzed diaphragm that caused chronic Pulmonary Insufficiency. The client was determined to have a Class 5 physical impairment by her treating physician, a Board Certified Cardiologist. She was similarly certified as suffering a Class 5 physical impairment by a Board Certified Pulmonologist. She satisfied Social Security’s criteria for total disability under at least three separate sections. Her pathology was demonstrated by multiple, objective tests and she had been certified as totally disabled by a cardiologist and a pulmonologist. Despite all of this, Sun Life denied her claim. We handled her appeal got her benefits reinstated.
Regardless of whether you are disabled due to injury or disease, heart condition or joint deterioration, whatever your disability might be, if you have been denied benefits, contact Bemis, Roach & Reed.
Posted on Fri, Mar 16, 2012 @ 11:58 AM
Disability claims sometimes have a higher likelihood of being denied if the condition by which you are disabled, such as migraines or fibromyalgia, relies heavily on subjective evidence like self-reported pain or fatigue. Typically, there are no lab tests or x-rays that verify these conditions, so the task of proving your disability becomes much more difficult, though not impossible. Austin attorney Lonnie Roach has successfully assisted several clients with such claims.
A Floresville client had been found totally disabled by the Social Security Administration (SSA). The SSA found that she had a medically determinable impairment, fibromyalgia, which met the criteria set out in Social Security’s Guidelines. She was presumptively disabled due to fibromyalgia under Social Security’s standards, but Liberty Mutual denied her. We challenged the denial and got her a settlement.
One client from Manor suffered from severe migraines over several years. She also experienced migratory polyarthralgia and intolerable back and bilateral leg pain that wasn't responsive to conservative care. Though on many medications, including morphine, a narcotic patch, and Valium, any activity requiring concentration, like work or hobbies, triggered severe migraines. The SSA declared her disabled. She saw several specialists across the country but was never provided with a successful, long-term treatment option. Her daily narcotic medications left her cognitively impaired and caused her to sleep 12-14 hours each day, making it impossible for her to perform her work duties. After several denials, we took MetLife to trial and won a reinstatement of benefits.
Another client suffered from medical conditions Northwestern Mutual had previously found to be disabling, including chronic fatigue with severe fatigue, widespread muscle/joint pain, recurrent infections, insomnia, irritable bowel syndrome, headaches, sore throat, cognitive dysfunction, and tender points (fibromyalgia). She had also been diagnosed with Lyme disease. NW Mutual Life denied her claim, saying there was no medical support for a disabling condition that did not fall under the Mental Disorder provision contained in the group policy. The medical, as opposed to psychological, nature of the client's condition was well supported by her treating physicians, and she had been awarded SSDI benefits. We fought the denial in court and won her case.
The Hartford did not dispute that our Austin client suffered from Systemic Lupus Erythematosus, a significant chronic disease, as well as Fibromyalgia and Polyarticular Inflammatory Arthritis. According to the record, she suffered near constant oral ulcerations, frequent nasal ulcerations, alopecia (hair loss), fevers, sicca symptoms (dryness of the mouth and eyes), myalgias, Raynaud’s Syndrome, fatigue, and polyarticular inflammatory arthritis. The client’s treating physician stated that the client had been ill since the time she first saw her in April of 2005. The Hartford determined that, since there were no restrictions in the client's ability to sit, stand, walk, or drive, she was functionally able to perform her job duties. However, her treating physician emphatically stated that she did not have the physical ability to return to her previous job or any similar job. We helped the client fight her denial and were able to get her benefits reinstated.
A Dale, Texas client suffered from pseudotumor cerebri, which causes intractable headaches. The headaches, in conjunction with pulsatile tinnitus, awoke the client at night and prevented sleep, which caused her to develop symptoms of depression. Her doctor wrote that she was unable to perform the material duties of her occupation or a qualified alternative. A board certified neurologist stated that she was totally disabled due to her multiple conditions which included chronic, daily headaches. SSA awarded SSDI, but Cigna denied her LTD claim. Bemis, Roach & Reed filed a claim and subsequently obtained a settlement.
If you suffer from disabling migraines, fibromyalgia, or any other disabling condition, and have been denied your long term disability benefits, it might be possible to reverse the determination. Bemis, Roach & Reed would like to help you. Click here for a free consultation.
Posted on Wed, Mar 14, 2012 @ 05:01 PM
Mental health issues are among the most challenging conditions in the disability insurance arena. Some, but not all, long term disability (LTD) policies include a policy limitation for mental health issues while other policies cover them just like any other disability. Austin attorney Lonnie Roach, of Bemis, Roach & Reed, has had tremendous success in helping clients make a recovery after they have been denied.
Multiple physicians, including treating physicians, Aetna’s own reviewing physicians, and independent physicians working for the Social Security Administration, had stated that one of our Austin clients was disabled. He suffered from anxiety and depression, as well as certain features of agoraphobia. He had been suffering from mental health issues with PTSD since childhood. Aetna's own psychologist concluded that our client was functionally impaired since his last day of work, and continued to be functionally impaired. The Social Security Administration determined he qualified for disability benefits. Aetna, however denied his claim. We filed suit and were able to settle his claim.
Originally approved for disability benefits under the Mental Illness clause of his Halliburton policy, our Spring Branch client’s benefits were terminated initially because of the two-year mental/nervous limitation in his policy. Upon review however, the plan administrator found that his condition had been improperly classified as a mental/nervous condition and then properly classified it as Post Concussive Syndrome with Attention Deficit Disorder and Organic Brain Syndrome, a physical condition; benefits were reinstated. It remained classified this way for the next 18 years, until the time of denial. The client had organic brain damage for over 20 years. During that time, The Hartford, or its predecessor, recognized that the client’s organic brain injury rendered him totally disabled from any occupation under the terms of the plan. Since there is no treatment or cure for organic brain damage, the medical evidence of his condition had no expiration date. SSA awarded him SSDI benefits, but The Hartford ultimately denied his LTD benefits again. We filed suit and were able to settle his case.
One of our Cedar Park client’s treating physicians certified him as having a class 4 psychological functioning impairment. He was advised to stop working due to “incapacitating anxiety”. When asked whether our client could return to work, this physician responded “No . . . currently his anxiety and depression are incapacitating and his treatment is just beginning.” Another physician stated that he suffered from Major Depression; recurrent, severe, Panic disorder with agoraphobia; and Dysthymic disorder. Accordingly, he was unable to perform daily chores, attend social functions, attend to legal needs, shop, or venture into the community and manage everyday financial affairs. Our client’s severe depression/anxiety interfered with his concentration, energy, self-confidence, decision making ability, and even his ability to leave the house. MetLife denied his claim, stating that he was no longer receiving treatment for his disability. We appealed his denial and won a reinstatement of benefits.
Another Austin client suffered from Bipolar disorder and took lithium and lexapro for this condition. She was dysphoric and had cognitive deficits secondary to her Bipolar illness. She suffered from decreased memory, poor organizational skills, poor executive functioning, and low frustration and stress tolerance. According to her treating psychiatrist, she was totally disabled from this condition. She had been found totally disabled by the Social Security Administration. Furthermore, because of the significant mental impairments caused by her condition, the Administrative Law Judge who decided our client’s social security disability claim made a finding that the evidence suggested she was not capable of managing her own funds. MetLife withheld payment of her claim after two years based upon the policy’s 24-month mental health limitation. However, we demonstrated that bipolar disorder was not subject to those limitations and we were able to get her benefits reinstated.
If you suffer due to mental health issues and have been denied your LTD benefits, contact Lonnie Roach at Bemis, Roach & Reed to see how he may help you.
Posted on Fri, Mar 09, 2012 @ 02:58 PM
Lonnie Roach, attorney at Austin firm Bemis, Roach & Reed, assists many Texas residents with their long term disability (LTD) appeals. His clients suffer from many types of conditions and injuries, including various back injuries.
One client, from Wichita Falls, Texas, stopped working due to a degenerative spinal condition and filed for short term disability through AT&T, which was both her employer and her LTD insurance provider. She was under the medical care of a board certified neurologist and remained on short term disability until those benefits expired. At that time, her claim was transitioned to long term disability under AT&T’s Disability Income Plan. Her doctor determined she was totally disabled, both from her own occupation at the phone company, as well as any occupation within the open labor market in which she resided. Her employer was acquired by another which reviewed and denied her claim. She hired us, and we were able to settle her claim.
One Bastrop client, who worked for Albertson’s, had an inoperable, severely herniated disc in his lumbar spine, which caused both spinal stenosis and severe intractable back pain. His disability Plan Administrator claimed that he was capable of performing sedentary work, so his claim was denied. It was determined that, in an eight-hour work day, the client could only stand, sit, or drive in 30-minute increments. He required and took on a daily basis Methadone, Percocet, Neurantin, Paxil, and Klonopin. These medications prevented him from obtaining any gainful employment. Two of his treating physicians wrote that his condition was so severe that they did not even recommend performing a functional capacity evaluation on him, because it would violate his lifting restrictions and could do further damage to his severe back problem. Bemis, Roach & Reed took his case to trial and won, with a benefit reinstatement award.
An Austin client suffered from severe back pain resulting from L4-5 disc disease, as well as bilateral facet/SI joint pain. His medications included Celebrex, Sanaflex, Norco and others. He is permanently disabled and will never be able to return to work. Indeed, that is what each of his physicians had stated and this was the finding reached by the Social Security Administration. In its denial letters and the appeal denial letters, Reliance Standard showed a lack of deference to the findings of our client’s doctors and surgeons and, in fact, a total reliance on its internal claims review personnel to support its denial. He was unable to sit or stand for more than 30 minutes at a time and spent most of his days in bed due to pain. He was unable to drive due to pain and medication. We won after taking his case to trial, with benefits reinstated.
Physicians had previously certified that our client from Streetman, Texas had a class 5 physical impairment and was totally disabled. Aetna’s own file reviewer indicated that the client was unable to be employed as a Registered Nurse. The denial letter suggested that she could engage in other types of nursing. This analysis did not, however, take into account her current restrictions and limitations. She had a history of a lumbar fusion surgery as well as chronic and persistent lumbar radiculopathy with chronic pain syndrome. This resulted in a very poor sitting tolerance of approximately ten minutes. She was also noted to have a short walking tolerance and was unable to lift more than five or ten pounds. For these reasons, our client was incapable of working full time. She was awarded disability benefits from the Social Security Administration. Though Aetna denied her claim, we were able to get her benefits reinstated.
A client in San Angelo suffered from chronic pain resulting from failed surgical spine syndrome with arachnoiditis entrapping nerve roots and retrolisthesis, which caused significant spinal stenosis. He experienced significant radicular pain with lifting, carrying, and prolonged walking and standing. Two physicians and the SSA certified him to be totally and permanently disabled from any occupation. Johnson & Johnson, however, contended that, though he could no longer perform his previous job, he was not disabled from any profession and could work a full-time, sedentary job. We appealed his denial and got his benefits reinstated.
If you have suffered a disabling back injury but have had your long term disability claim denied, contact Lonnie Roach. Bemis, Roach & Reed wants to make sure you receive the benefits you deserve. Click here for a free consultation.
Posted on Fri, Mar 02, 2012 @ 12:18 PM
Long Term Disability cases can be difficult and drawn out. It's very important to be represented by an attorney who is good with details and is persistent over the long term. Attorney Lonnie Roach, of Bemis, Roach & Reed, has successfully assisted long term disability clients all over Texas, including San Antonio, obtain the benefits they deserve.
One San Antonio resident had been found to be totally disabled by the Social Security Administration. She suffered from severe spinal stenosis, severe degenerative facet arthropathy, and a grade 2 spondylolithesis. Under Social Security’s guidelines, a person with our client’s objectively documented condition is presumptively disabled from any gainful activity. She required a combination of Vicodin and Ultram simply in order to function. These medications are known to be cognitively impairing, however, and she had previously reported to Liberty Mutual that she could not concentrate when taking Vicodin and that her concentration was impaired by painkillers and pain. Liberty Mutual denied her claim, but we appealed, convincing Liberty Mutual to settle.
According to the denial letter, MetLife did not dispute that another San Antonio client was totally disabled, but rather that his disability was limited by the policy’s 24-month limitation for disabilities caused by Neuromusculoskeletal and soft tissue disorders. We challenged this classification of our client’s symptoms, arguing that our client did not have a Neuromusculoskeletal and soft tissue disorder and had never based his claim on this condition. He did suffer from Grade 3-Grade 4 chrondromalacia of the patella, a torn rotator cuff, and severe osteoarthritis of the knees and shoulder. According to the Social Security’s guidelines pertaining to these two separate disabling conditions, our client’s disability should have been classified as major dysfunction of a joint and reconstructive surgery or surgical arthrodesis of a major weight-bearing member. He could barely walk, could not lift more than 5 pounds, and was home-bound. We appealed his denial and got benefits reinstated.
The only medical justification referenced in the denial letter for Prudential’s determination that another client’s disability was due to mental illness, and thus limited to 24 months of benefits under her policy, was a Medical Evaluation by a reviewing physician. This doctor clearly stated that our client was totally disabled but felt she was possibly in a psychotic state on the day of the examination. This doctor also offered that “this may very well be related to lupus or some sort of arthritis.” This, of course is possible. Systemic Lupus Erythematosus is well known to cause Lupus Psychosis. Lupus Psychosis is not, however, a mental illness. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, it is a “psychosis due to a general medical disorder.” Our client suffered from numerous other documented, serious health conditions for which her treating physician had certified her as being totally disabled. She had also been awarded SSDI benefits. The reviewing physician admitted that our client's chronic pain alone rendered her disabled, but Prudential chose to deny her benefits. We filed suit on her behalf, and Prudential settled, awarding our client a lump sum.
We represented a client for her short and long term disability claims. She suffered from failed back surgery syndrome, lumbar radiculitis, fibromyalgia, severe sleep dysfunction, moderate to severe depression and, quite probably, rheumatoid arthritis. She had been instructed by her primary care physician to “discontinue the workforce” for at least the next several years, but also advised that her condition was unlikely to change. This diagnosis was supported by another physician. She had multiple surgeries as well as diagnostic tests objectively verifying the pathology responsible for her chronic pain. She was awarded benefits from the Social Security Administration, but eventually denied by AT&T’s LTD plan administrator. We were able to get her benefits reinstated.
If you are a San Antonio-area resident and have had your LTD claim denied, contact Bemis, Roach & Reed to see how we can help you.
Posted on Wed, Feb 29, 2012 @ 05:38 PM
Texas long term disability attorney Greg Reed was contacted by an employee of the Texas Department of Health and Human Services regarding denial of a long term disability benefit claim. The employee battled with depression and anxiety for an extended period of time. Her condition deteriorated to the point that her treating physician took her off work.
The Texas Employees Benefits Act provides health and disability benefits to state workers through the Employee Retirement System (ERS) of Texas. The statute is found in Chapter 1551 of the Texas Insurance Code. Although the benefits are authorized by statute, the plan is administered by a private insurance company. In this particular claim for long term disability benefits, the administering company was Dearborn National.
The claimant in this case properly submitted an application for long term disability benefits. Her application contained a physician’s certification of disability as well as an employer statement regarding her job title and job duties. Even though all documents were submitted in a timely fashion, Dearborn National denied the claim. They asserted that there was no “objective medical evidence” to support the disability claim.
Mr. Reed consulted with the claimant and reviewed medical records, after which he agreed to take the case.
Claims for denied disability benefits must first be appealed to Dearborn National. If the appeal is unsuccessful, a grievance can be filed with ERS. The claim will be set for a hearing before an administrative law judge in Austin, Texas. This particular claimant is set for her hearing and is looking forward to her day in court. We’ll keep you posted.
If you are disabled and have been turned down for ERS disability benefits, contact long term disability attorney Greg Reed, at Bemis, Roach & Reed.
Posted on Fri, Feb 24, 2012 @ 09:57 AM
HIV is a life-changing diagnosis that brings a number of symptoms and related illnesses. Some who suffer this disease qualify for long term disability, but are unfairly denied. Lonnie Roach, of Bemis, Roach & Reed, has helped several people suffering with HIV fight unfair denials.
One client, from Dallas, was totally disabled due to HIV/AIDS and the various symptoms and side effects of the disease and the drugs required to control it. Every qualified medical doctor who had reviewed his records, including doctors hired by CIGNA, his Long Term Disability insurer, agreed with this assessment. The only contradictory medical evidence CIGNA cited came from a physical therapist and a doctor who, for the past 20 years, was the director of the Burlington County Correctional Facilities in Mt. Holly, New Jersey. Our client had been advised by his doctors that an attempt to return to the workforce could be fatal due to the “ravages of his wrecked immune system”. In fact, each time he attempted a return to the workforce, he contracted a severe illness (pneumonia, meningitis). He had been awarded SSDI. After over 15 years and several diagnoses of total disability from multiple physicians, CIGNA still denied LTD benefits. After filing suit to pursue his claim, CIGNA was convinced to settle, providing our client a lump sum payment.
A Lincoln Financial enrollee from Houston suffered from HIV dementia, a progressive and debilitating disease. There is no medical research supporting a cure or a course of action to regain mental function lost to this disease. Social Security determined that he was disabled and Lincoln Financial Group initially approved our client’s Long Term Disability claim. Later, though, and in spite of a deterioration in his condition, Lincoln decided to deny any further benefits under the plan. Lincoln failed to explain how our client was capable of performing each of the main duties of his regular occupation. Instead, it only submitted a laundry list of positive notes gleaned from the medical records and ignored all of the documented disabling conditions which prevented him from performing each of the main duties of his regular occupation. We appealed his denial and got his benefits reinstated.
Due to HIV, another client had been certified as totally and permanently disabled by his treating physicians and found to be totally and permanently disabled by the Social Security Administration. The Hartford had known for several years that he suffered from an incurable disease which totally disabled him and that he would never get better, yet The Hartford denied his claim. He was medically restricted from working. He had reached maximum medical improvement and his treating physician did not anticipate that he would ever be able to return to work. We fought the denial on our client’s behalf and were able to get him a lump sum settlement.
Call Lonnie Roach if you are disabled due to HIV or related complications and have been denied long term disability benefits.
Posted on Fri, Feb 17, 2012 @ 12:30 PM
We’ve outlined in previous blogs several ways you can strengthen your disability case in preparation for the appeals process. One of the most important ways is work with your lawyer and doctors to ensure your medical records on file are detailed and complete, and clearly document your disability. This record becomes extremely important in the event your appeal has to go to trial.
But there is a second way to help your case that might surprise you—your vote for Governor. According to a recently issued report by Court Watch called “Thumbs on the Scale: A Retrospective of the Texas Supreme Court, 2000-2010,” the Texas Supreme Court of the past decade (which has had many members appointed by our current governor) has consistently ruled against Texas consumers on the side of corporate interests. Court Watch found that consumers lost 79% of the cases brought before the Texas Supreme Court between 2000 and 2010. Click here for the full article. Sadly, a large number of Texans with legitimate cases fought their battles and won at trial—only to see their judgment taken away by the Texas Supreme Court.
If you are facing the possibility of an appeal of your long term disability denial, contact Bemis, Roach & Reed for a free consultation. We will give you a frank assessment of your case.
Court Watch is a project of the Texas Watch Foundation, a non-partisan 501(c)(3) public education nonprofit organization. Texas Watch Foundation is dedicated to fair and open access to the civil justice system for all Texans. Court Watch has been monitoring and reporting on the Texas Supreme Court and the impact its decisions have on Texas families since 1996.
Posted on Tue, Feb 14, 2012 @ 06:25 PM
Austin attorney Lonnie Roach assists clients from across the state in fighting long term disability denials. Several of Mr. Roach’s clients have come from the Dallas-Fort Worth area.
A Fort Worth client's physician certified that she suffered from “constant neuropathic pain.” The same physician also certified that her condition would impair her for the remainder for her life, that she had regressed, and that he never anticipated a fundamental or marked change in her condition. The doctor did not anticipate that the client would ever be able to return to work. These conclusions were supported by two other physicians, but The Standard chose to deny her claim. We were able to get her a lump sum settlement.
Our client, from Euless, had long term disability insurance with Lincoln Financial. He was diagnosed with Severe Legg-Perthes disease and chronic pain. He could not sit for more than 15 minutes before experiencing severe pain and could not walk for more than five minutes before his pain increased. He had exhausted all surgical options and was on long-term pain management. He was denied benefits by Lincoln Financial, but we were able to reach a settlement agreement for him.
Continuing neck and back problems plagued one Grand Prairie, Texas client, followed by multiple surgeries. After one of the surgeries, one of her treating physicians, a neurosurgeon, stated on Cigna’s attending physician statement that she was unable to work secondary to pain and weakness and that she would never be able to return to work. The client underwent a two-day FCE protocol after which a Board Certified Orthopedic Surgeon wrote that her results were "about the clearest-cut case of someone applying for long-term disability that deserves it that [that physician had] seen in 27 years of clinical practice as a spinal surgeon." The doctor further indicated that client was not fit for employment and that this would be a lifetime condition. She was awarded SSDI, but Cigna denied her LTD claim anyway. We challenged the denial and Cigna settled.
A Frisco, Texas client suffered from severe, intractable low-back pain. Imaging studies revealed multi-level degenerative disc disease of his lumbar spine. Because of the extent of the degeneration, his orthopedic surgeon restricted him from bending, lifting anything exceeding ten pounds, and twisting. Even with these restrictions, his doctor stated that the client was unable to return to work due to continuous low back pain, that walking more than 100 feet was virtually impossible for him, and that he was unable to sleep for more than two hours at a time due to pain. Physical therapy only aggravated his condition. The doctor felt that he was unable to return to any type of meaningful occupation for the foreseeable future and that he should be considered persistently disabled until further notice. After CIGNA denied him anyway, he hired Bemis, Roach & Reed. We were able to get him a settlement.
If you live in the Dallas-Fort Worth area, or anywhere in Texas, and have had your long term disability claim denied, call Bemis, Roach & Reed. We’re here to help.