Our client, a 58-year-old Strategy Plan and Administrative Manager, enjoyed her successful career working for a well-regarded banking institution on the West Coast. Unfortunately, she suffered from numerous aliments which impacted upon her ability to work. Her Chronic Intractable Migraines and Vestibular Migraines, Vertigo, and Chronic Pain, combined with her Persistent Postural-Perceptual dizziness (PPPD), resulting in her deficits and inability to perform her daily activities.
When she could no longer continue working, her physicians advised her to stop working and to apply for short term disability. MetLife willingly approved her short-term claim on the basis of finding her disabled from performing her own occupation on a full-time sustained basis. It was not Met Life’s money when they agreed she was disabled. After her short-term disability claim was exhausted, her physicians did not release her for work and advised her to apply for long term disability, which was subsequently denied by MetLife – despite the same evidence and support. This time, it was Met Life’s money.
MetLife denied the claim predicated upon a faulty vocational analysis which miscategorized our client’s occupation as a Management Analyst. Although our client’s own occupation was a Strategy Plan and Administrative Manager, as often occurs, MetLife performed an erroneous vocational analysis. Because our client was still within her OWN occupation period of disability, MetLife’s actions were premature and arbitrary and capricious. In doing so, MetLife completely disregarded her duties as a Strategy Plan and Administrative Manager and only acknowledged the sedentary physical requirements of the occupation, despite the position being significantly more physically demanding requiring travel. Nor did Met Life properly consider the cognitive work requirements, which were deeply impacted by her conditions.
On appeal, utilizing a Vocational Expert – coupled with our strong attack of the arbitrary transferrable skills analysis, and working closely with our client’s medical providers, we developed powerful support for why our client could no longer work on a full-time sustained basis on both a physically and cognitively demanding career. Furthermore, on appeal, we worked closely with our client in establishing evidence with her employer delineating her day-to-day occupational duties as a Strategy Plan and Administrative Manager, reinforcing the fact that her own occupation could not possibly be viewed as “sedentary”.
We attacked MetLife’s purported “independent” peer reviewing consultants, and the well-known pro-insurance and symbiotic third-party vendor MetLife collaborated with to engage these “independent” consultants. We also worked closely with her physicians in rebutting MetLife’s inaccurate and unreliable peer reviews. The appeal contained subjective medical support, an expert vocational report and a plethora of medical literature – informing MetLife of the severity of our client’s conditions and the resulting impact upon her functionality.
Additionally, we developed powerful arguments revealing MetLife’s bias and egregious conduct. These arguments included MetLife’s failure to consider our client’s well documented and credible subjective complaints of impairment; MetLife’s failure to consider her co-morbid conditions; MetLife’s failure to properly evaluate our client’s own occupation and its refusal to consider the nature of the institution where she was employed and the general characteristics of her position.
After providing supporting materials documenting the material and substantial duties of our client’s job and undercutting the biased reviews of its insurance pandering medical reviews were we able to reverse MetLife’s decision. As we often do upon our successful appeals, we continue to represent our client in monitoring her claim in ensuring that MetLife does not terminate her disability claim.