Our client was forced to stop working towards the end of 2022 due to a number of serious medical conditions. These included cardiomyopathy, congestive heart failure, high blood pressure, diabetes, migraines, joint pain, GERD, multiple mental health conditions, and a complex history of back issues. Together, these conditions created significant restrictions and limitations that made full-time employment impossible.
Initial Approval for Own Occupation Period
Reliance Standard initially approved our client’s claim for long-term disability (LTD) insurance benefits beginning in early 2023. These benefits continued throughout the 24-month “Own Occupation” period, ending 2 years later. During this period, the insurance company agreed our client could not perform the duties of his own occupation.
Unfair Denial at “Any Occupation” Transition
As the definition of disability under the policy changed from “Own Occupation” to “Any Occupation,” Reliance Standard initiated a medical review to determine if our client could work in “any” occupation. Nurse reviewer Janet Bohnsack issued a report in the end of 2024, noting no significant change in the medical records since early 2024. She stated our client may be capable of sedentary work but advised the claims examiner to request updated records.
However, Reliance Standard did not give our client the opportunity to provide those updated records to the insurance company for review and consideration. Instead, they forwarded the case to a vocational expert, who listed several sedentary jobs they claimed our client could perform, such as Tool Programmer, Dispatcher, and Assembler.
Based on this review, Reliance Standard issued a denial letter in early 2025, asserting that our client was not disabled from performing “any occupation.”
Ortiz Law Firm Appeals and Wins Reinstatement
Our firm stepped in and filed a thorough appeal in the summer of 2025. We submitted updated medical records, a personal affidavit from our client, and two new medical source statements supporting his continued disability.
Following the appeal, Reliance Standard scheduled an Independent Medical Examination (IME). Shortly after the IME, our client’s long-term disability benefits were reinstated.
We Can Help with Denied Disability Claims
If your long-term disability claim has been denied, don’t wait. Call the Ortiz Law Firm today at (888) 321-8131 to schedule a free case evaluation. We help claimants nationwide recover the benefits they deserve.
