After suffering with abdominal, bladder and colon issues along with significant vision loss, my 57-year-old client was forced to stop working as a health insurance sales representative for a major health insurer. She applied for short-term disability benefits through her company’s benefits plan but was denied by the claim’s administrator, Sedgwick.She contacted me for help with filing her appeal and fighting this wrongful denial. I immediately requested a copy of the administrator’s claim file as well as a copy of the benefit’s plan. I also worked to obtain a significant number of medical records for this client to further support her claim. With this claim, I also did a video interview of the client so that she could explain in her own words her medical conditions, the limitations she suffered with, and the significant life changes she has made as a result of her conditions.After obtaining the medical records and supportive statements from her doctors, and pointing out the lack of support for the administrator’s decision in its claim file, the administrator overturned its denial and awarded the client short-term disability benefits. The benefits covered 6 months and exceeded $30,000.
The claimant’s long-term disability application is now in a stronger position as well. Those benefits have a potential value of over $200,000.
