I’m honored to share another story of how we helped a client recover the long-term disability (LTD) insurance benefits she desperately needed after her claim was unfairly denied. This is a testament to the power of perseverance and expertise when it comes to fighting for our clients’ rights against large insurance companies like New York Life.
Our Client’s Story
Our client worked as a Mortgage Support Assistant for Navy Federal Credit Union until February 2022, when severe health problems made it impossible for her to continue working. She was battling liver disease, spinal stenosis with radiculopathy, carpal tunnel syndrome, neuropathy, and chronic pain. These conditions caused significant limitations and restrictions that left her unable to perform the duties of her job—or any job, for that matter.
Initially, our client’s LTD claim was approved. However, in July 2023, New York Life abruptly terminated her benefits, claiming there were no restrictions or limitations preventing her from working. Their decision was based heavily on a file review conducted by a medical director specializing in neurology, who had never met our client in person.
How We Fought Back
The claimant turned to us for help, and we launched a full-scale appeal of the denial. Our strategy attacked the heart of New York Life’s decision:
- Exposing Cherry-Picked Evidence: We showed how the medical director’s review ignored critical parts of our client’s medical history and focused only on records that supported the denial. This cherry-picking approach is a common tactic used by insurers, and we weren’t going to let them get away with it.
- Policy Language as a Weapon: We used the insurance policy’s own definitions of “disability” and “proof of loss” to argue that the claimant met their criteria. This strengthened her case for continued benefits.
- Challenging “Sedentary Work” Assumptions: New York Life claimed that our client could perform sedentary work with accommodations such as avoiding repetitive wrist movements. We countered this argument with medical evidence that her conditions rendered her unable to sustain any work environment, even one that required minimal physical exertion.
The Turning Point
As a result of our thorough appeal, New York Life ordered an Independent Medical Examination (IME), in which a physician actually examined our client in person. The IME confirmed what her treating physicians had said all along: her impairments were severe enough to prevent her from working.
With no choice but to acknowledge the strength of our appeal and the findings of the IME, New York Life reinstated our client’s long-term disability benefits.
The Ortiz Law Firm Can Appeal Your Long-Term Disability Denial
If you’re facing a denial of your long-term disability benefits, you don’t have to go through this overwhelming process alone. At the Ortiz Law Firm, we specialize in fighting insurance companies to ensure that claimants receive the benefits they deserve.
Call us today at (888) 321-8131 for a free case evaluation. Let us put our experience and dedication to work for you. Together, we can develop a winning strategy to get your benefits reinstated. Don’t wait—your financial future may depend on it.
