A lawsuit was filed by the Plaintiff against the Standard Insurance Company (Standard) in the United States District Court for the wrongful denial of long term disability benefits as promised under the terms of a long term disability employee benefit plan that was sponsored by Plaintiff’s employer, CSC Covansys Corporation (Covansys).
In Mildred L Vs The Standard Insurance Company, Plaintiff seeks long term disability benefits wrongfully withheld by Standard.
History of Plaintiff and How She Came To File For Disability Payments
Plaintiff was employed with Covansys for one year until the onset of her disability, June 27, 2007. On or about this date, Plaintiff was unable to perform the duties required by her occupation and applied for disability benefits. Plaintiff had been injured in an automobile accident and was unable to return to active work.
Plaintiff received short-term disability benefits under the terms of the Plan. She continued receiving these benefits until the STD benefits had been exhausted. Plaintiff then filed for long term disability benefits.
Standard Denies Plaintiff’s Request for Long-Term Disability Benefits
Standard denied Plaintiff’s claim for long-term disability benefits on or about April 10, 2008. Standard had required Plaintiff to submit additional medical information to evaluate whether her disability was caused by a preexisting medical condition.
Plaintiff appealed the denial on or about October 6, 2008. Plaintiff submitted medical evidence to prove that her condition had worsened since the time of the original filing. Plaintiff also supplied additional medical information from her treating physicians indicating ongoing conditions of lumbar radiculopathy and ulnar neuropathy. She also provided medical information of her limitations, including an inability to sit for prolonged periods of time and an inability to lift more than 10 pounds or stand up and walk for prolonged periods. Plaintiff’s treating physicians determined that she was unable to work due to her medical condition.
Despite this, Standard denied Plaintiff’s appeal on or about May 8, 2009 due to its belief that Plaintiff’s condition was due to preexisting conditions and that there was insufficient medical evidence of ulnar neuropathy impacting her ability to perform her occupation.
On or about February 2, 2010, Plaintiff requested for a voluntary additional review of the claim, which gave her an opportunity to submit additional medical information. Plaintiff asked for the additional review because new medical information and information from the Social Security Administration became available that was not originally considered by Standard. Second, the initial review and denial made clear mistakes of fact that impacted the way the claim was decided upon.
Standard agreed to the voluntary review, but did not render a decision for 16 months after it received the additional medical information. Its decision was reached on July 6, 2011, with the decision being that the Plaintiff’s claim for LTD benefits was denied. Due to this, Plaintiff has filed this lawsuit against Standard.
Basis of Lawsuit Against Standard
Plaintiff claims that Standard used new reasons for determining the duties of her Usual Occupation that were not part of its original determination of her claim. Standard’s denial was in direct contrast to the Plaintiff’s treating physicians and the Social Security Administration. Its denial was also based on erroneous findings of its medical reviewers.
Relief Sought Against Standard
Plaintiff requests the following relief from this Court:
- Long-term disability benefits under the Plan from the time that Standard stopped paying benefits
- Prejudgment interest on all unpaid benefits at a rate decided upon by the Court
- Judgment that Plaintiff is entitled to all long-term disability benefits under the Plan
- Attorneys fees and costs
- Continued long-term disability benefit payments so long as Plaintiff is eligible under the terms of the Plan
- Prevention of Standard from implementing policies and procedures that are detrimental to the Plan’s participant and beneficiaries
- All other relief deemed proper by the Court