Our client, a senior principal electrical engineer, had dedicated his career to solving complex problems in a demanding technical field. However, after he suffered a traumatic brain injury (TBI) and developed post-concussion syndrome, memory loss, and additional complications—including edema, a Factor V Leiden mutation, ADHD, and anxiety and depression, he was unable to continue working.
He received short-term disability benefits for the full benefit period and was initially approved for long-term disability (LTD) benefits. However, MetLife abruptly terminated his claim after just one month, claiming that they had not received the updated medical documentation needed to assess whether he could perform the “essential elements” of his occupation.
Our client submitted an appeal and provided everything MetLife requested, including updated medical records, an Attending Physician Statement, and a Functional Assessment completed by his therapist. His medical providers were clear: his condition was severe, permanent, and disabling.
Yet MetLife denied the appeal, relying on flawed internal reviews that dismissed his cognitive and physical impairments. The physical reviewer claimed his exams were “normal,” and the psychiatric reviewer attributed all symptoms to his TBI, concluding that they weren’t disabling. The result? A denial based on circular reasoning and selective interpretation of the evidence.
That’s when he reached out to the Ortiz Law Firm.
We took immediate action. We gathered additional medical documentation, secured a detailed medical source statement from his treating physician, and drafted a thorough appeal explaining exactly how and why MetLife got it wrong—legally, medically, and contractually. Less than 30 days after receiving our appeal, MetLife reversed its decision and reinstated our client’s long-term disability benefits.
If your long-term disability benefits have been unfairly denied, don’t give up. Call the Ortiz Law Firm at (888) 321-8131 for a free case evaluation. We represent claimants nationwide and we’re ready to fight for the benefits you deserve.
