A disability attorney in the state of Georgia recently filed a lawsuit against the Prudential Insurance Company of America in the Gainesville Division of the United States District Court. The plaintiff, Robert Lucas, is seeking payment of the remainder of his short-term disability benefits followed by long-term disability benefits from Prudential Insurance Company of America as part a welfare benefit package with his employer, Wm. Wrigley Jr. Company.
Facts of the Case Against Prudential
Forklift driver, Robert Lucas worked for Wm. Wrigley Jr. Company that provided short-term disability benefits under a welfare benefit plan. In December 2009,Mr. Lucas suffered a heart attack and had to have open-heart surgery. He did not return to work until March 15, 2010 and due to complications of his surgery including heart palpitations, panic attacks and other side effects of the medications he went out on disability leave again on March 26, 2010. Prudential denied disability benefits as of May 16, 2010 even though documentations from doctors and psychiatrists clearly state the plaintiff was unable to return to work. The psychiatric issues were related to the medications he was taking and his attempt to return to work in the same environment he worked prior to the initial heart attack in December 2009.
Exhaustion of Plaintiff’s Final Appeal
Before Prudential terminated Mr. Lucas’s benefits and denied all his ERISA appeals, Prudential never sent him for an independent psychological or psychiatric evaluation. Because of the defendant’s refusal to hear any of plaintiff’s appeals, Wrigley notified the plaintiff on November 29, 2010 that he must either return to work in the same capacity or a limited capacity with the company or he would be fired. Since Prudential refused to pay disability benefits in spite of the contract with Wrigley and he was unable to return to work because of his disability, Wrigley terminated employment with Mr. Lucas on February 15, 2011 citing involuntary separation for health reasons.
Provisions of the Lawsuit Against Prudential
On May 19, 2011 lawyers for the plaintiff filed a lawsuit in the Gainesville office of the District Court of the state of Georgia. They are requesting reinstatement of the short term disability benefits beginning May 17, 2010 and continuing until those benefits are exhausted; at that time the plaintiff will be entitled to long-term disability benefits. If the lawsuit is successful, Mr. Lucas will also be reinstated retroactively for other benefits such as life insurance, retirement and disability benefits. The plaintiff’s attorney is also asking for payment of litigation fees, court costs and all attorneys fees in addition to any other sums the court feels is justified in this case.
Entitlement to Benefits
The complaint alleges that Mr. Lucas has fulfilled all the terms and conditions that are necessary for entitlement to disability benefits. The insurance company was not within its rights to deny or cancel coverage with the plaintiff or his company. As a result it was necessary to file a lawsuit in order to force Prudential to pay benefits they denied the plaintiff in this case. Mr. Lucas meets all the requirements necessary to collect both short-term and long-term disability benefits.