Our 29-year-old client had a promising career ahead of him as an Actuarial Associate. Bright, outgoing, and excited to pursue a career in his industry, he was devastated when his career came crashing to a halt.
Once an avid golfer and tennis player, he never anticipated having to stop working and enjoying an active lifestyle because of a medical issue. He suffers from Fluroquinolone toxic poisoning caused by fluroquinolone (FQ) antibiotics, which have been documented in medical literature to cause irreversible nerve damage resulting in peripheral neuropathy. This occurred from taking Cipro, a widely used antibiotic.
As a result of this condition, he suffered additional co-morbid conditions include ligament laxity, where his ligaments are too loose and joints are not held in correct alignment when they move; cervical disc disorder and radiculopathy; severe alar instability (excessive motion at the head and neck junction); kyphotic neck (the cervical spine curves forward instead of towards the back) and numerous related restrictions and limitations, including chronic pain, myofascial pain, neck, back, wrist, shoulder, knee and hip pain, headaches, cognitive issues, as well as difficulty with gait and standing, sitting or walking for any length of time.
He could not work and could barely engage in day to day functioning, and certainly not with any predictability.
Our client’s claim for disability insurance benefits from New York Life was wrongly terminated while he was still in the short-term disability process. The denial came despite medical support from a wide range of specialists provided to New York Life by no less than seventeen doctors, including many specialists.
His age was a glaring red flag for New York Life; at age 29, his claim will be paid for decades, making it an expensive disability claim for the company.
After engaging our office to submit an ERISA appeal to overturn New York Life’s wrongful termination of his short term disability claim and prepare for the expected denial of his long term disability claim, we got to work developing his case.
New York Life’s denial was not only inaccurate but lacked any proper medical or vocational analysis. Working closely with our client, his treating doctors, and providers, we developed a powerful ERISA appeal, providing New York Life with ample support as to why our client could no longer work on a full-time sustained basis in what had been a physically and cognitively demanding career. To support the appeal, we engaged a vocational expert to conduct functional testing, which served to support with objective evidence the impact of his conditions upon his work abilities.
Our appeal contained a wealth of support, including powerful medical support from numerous doctors, a comprehensive Functional Capacity Evaluation conducted by a Licensed Occupational Therapist and Certified Vocational Evaluator, strong subjective support, and statements from many people within our client’s sphere, and a wealth of medical literature – informing New York Life of the severity of our client’s conditions and educating the insurance company about Fluroquinolone toxicity.
Upon review of our ERISA appeal, New York Life admitted that its prior determination was improper, and reversed its decision. Our client’s short term benefits were reinstated and equally importantly, his long-term claim was approved.
He is now devoting what energy he has to learning to live with his disability, rather than squandering precious time and energy doing battle with an insurance company. New York Life benefits are being paid monthly and we manage his claim to be sure the payments continue.