Disability Insurance Claim: Lupus

Our client was a financial analyst for a large defense contractor.  She had to stop work due to severe symptoms related to her diagnosis of Lupus.  Lupus is an autoimmune disease in which the immune system attacks one’s own body.  Our client was treated with medication to suppress her immune system, which exposed her to other illnesses and infections which her suppressed immune system could not fight.

The client had disability insurance with MetLife through her employer.    MetLife paid benefits for 2 years then cut her off after having her examined by its own physician.  MetLife’s physician reported that client “could probably” perform the tasks of sedentary work; however, he qualified his opinion by stating that with her extensive problems, he did not know whether she could function within the average stress of a workplace.  MetLife ignored the opinions of all treating physicians who supported her disability claim and instead relied on the ambiguous report of its doctor.

After we filed a lawsuit on behalf of our client and took the case to trial, a Federal judge agreed that MetLife abused its discretion in denying ongoing disability benefits.  The court questioned why MetLife would pay benefits and then subsequently terminate benefits without a showing of improvement of her medical condition; questioned why MetLife totally ignored the opinions of the treating physicians and instead relied on the ambiguous and equivocal opinions of its doctor; the court awarded the client back disability benefits, attorney’s fees and the entitlement to future benefits.

To review the court’s entire 30-page opinion, see Watts v. Metropolitan Life Insurance Company, 2011 U.S. Dist. LEXIS 44805.

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