Long-Term Disability Benefits Won on Appeal of MetLife Denial for Software Engineer with Narcolepsy
Long-Term Disability Claims for Disabling Narcolepsy – Unfortunate, Yet Common
Our New York Google Software Engineer client Mary (not her real name) suffered from a severe case of Narcolepsy, a surprisingly common cause of long-term disability from working. The problem is, Narcolepsy symptoms range from mild to severe, and it can be difficult to prove that a particular case of Narcolepsy is truly disabling.
Disability insurance companies commonly deny these claims, but appealing the denial can be successful if done carefully.
Why Long-Term Disability Claims for Narcolepsy are Hard to Prove
Mary’s treating physicians told her that she was absolutely unable to work until she got better. Yet MetLife Insurance Company ignored their opinions, opting to favor the opinions of its physicians who reviewed Mary’s medical records without ever meeting her. MetLife claimed that the evidence Mary presented was insufficient to prove her case, despite her treating physicians’ unwavering opinion that she could not work.
Being used to a steady (and high) wage of $160,000, Mary was scared to death about losing everything.
Learning Mary’s Whole Story to Help Appeal the Bogus Claim Denial
We worked closely with Mary to help her build her claim carefully and systematically with new, undeniable evidence far beyond what she had presented to MetLife before they denied her claim.
In helping Mary gather evidence to build her case, we needed to learn all the details of her story. As we did, we quickly realized that Mary simply needed to tell her story more vividly and effectively to the insurance company in her appeal than she had before.
A Talented Energy Software Engineer
For years, Mary was a dynamo for Google. Her position involved the following cognitively demanding roles: project management (breaking down goals into daily tasks; time estimation; planning; etc.), ramp up (learning new concepts; getting familiar with other parts of the code base; etc), design work (put forth design proposals; write design documents; brainstorm possibilities and advocate for a particular technical direction; etc), programming (writing code after a design has already been determined; writing test cases; debugging; etc.), and teamwork (incorporate technical feedback from peers; peer and manager performance reviews; present my work and designs to the team; etc).
Debilitating Sleepiness and Exhaustion
The sleepiness and exhaustion resulting from Mary’s Narcolepsy caused her to become overwhelmed by her required roles. As she put it: “It would simply be too much to hold in my head at once and too much to grasp because of the result of excessive daytime sleepiness.” In a downward spiral, the stress from having to perform any of these responsibilities would severely exacerbate her sleep issues, thus significantly worsening her symptoms.
How Mary Won Her Case: Vividly Presenting Her Story Effectively to Appeal the Claim Denial
With Mary’s help, we were able to present a vivid “day-in-the-life” account of her deep struggles, corroborated by a family member who observed and helped her daily, and verified by her physician as credible, and expected given her medical condition, backed by well-accepted medical literature sources.
Thankfully, presented with undeniable new evidence in Mary’s appeal, along with court opinions, our case law research found where judges had awarded benefits under fact scenarios similar to our client’s case, MetLife finally did the right thing. It paid all of her past due benefits, and began paying her the $8,000 per month that was owed to her under the policy going forward.
Victims Of Disability Should Always Appeal Unfair Claim Denials
In the end, because she continued to fight, appealing the insurance company’s denial of her disability claim rather than just accepting it as the final word, Mary was able to maintain her financial security while she took some much-needed time off to rest and get better with peace of mind.
Unfortunately, disability insurance companies unfairly deny legitimate claims every day. But anyone faced with an unfair claim denial should continue to fight and appeal the denial. These unfair denials can be overturned with stronger evidence, properly presented.
Mary deserved the benefits she had paid premiums for over the years, and it was an honor to help such a wonderful lady overturn such an unfair claim denial.
Results may vary. Every case is different, and no outcome can be guaranteed.
