After 2 appeals, man finally wins long-term disability case

When people in Wisconsin sign up for long-term disability insurance coverage they expect the terms of the policy to be honored. Unfortunately, all too often once someone becomes disabled due to an illness or injury an employer or an insurer fail to hold up its side of the deal. When this does happen, the disability claimant does not have to give up without a fight.

In a recent case in New York, a man was finally awarded disability benefits after being denied twice. The insurance company had initially denied his claim because it found that he was still able to work.

The man in this case was an engineer and his job required him to sit for extended periods of time. After sustaining seven back surgeries–he had degenerative disc disease, stenosis and neurological problems–he applied for disability benefits but was denied.

He appealed that decision and was denied again, and he appealed one final time.

The final time, the man was awarded a lump sum of $80,000, followed by about $5,000 a month until he reaches retirement age.

In the midst of all of these appeals and denials, the man was able to obtain Social Security disability benefits. Of course, obtaining such benefits does suggest that the man was in fact unable to work, as the Social Security Administration has very stringent standards one must meet to prove a disability.

This case should remind people that it is not impossible to obtain disability benefits after a denial. It is, however, very difficult in some cases. It is necessary to provide medical documentation of a disability and also to understand the terms of the policy and any applicable laws. Those who are having trouble with a disability claim may benefit from seeking legal representation.

Source: Buffalo Law Journal, “Buffalo firm notches $347k disability case,” Matt Chandler, March 4, 2013


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