Donald Kurth, M.D., sought disability benefits after medical conditions impaired his ability to safely and consistently practice medicine. Treating providers documented limitations affecting endurance, cognitive functioning, and the ability to perform complex professional tasks required of a physician. Hartford denied the claim based exclusively on file reviews conducted by non-examining physicians and declined to obtain […]
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Mitchell v. Metropolitan Life Insurance Co.
Michael Mitchell stopped working after developing chronic fatigue syndrome, restless legs syndrome, hemochromatosis, and major depressive disorder. Treating physicians documented profound fatigue, sleep disruption, cognitive impairment, and reduced stamina that prevented sustained work activity. MetLife denied long-term disability benefits by relying on non-examining file reviewers who discounted treating-provider assessments and emphasized the lack of objective […]
Wible v. Aetna Life Insurance Co.
Dennis Wible, acting as trustee for the estate of Marianne Wible, sought ERISA disability and life insurance benefits after Ms. Wible became unable to work due to systemic lupus erythematosus and related autoimmune complications. Medical records documented severe fatigue, joint pain, systemic involvement, and fluctuating symptoms characteristic of lupus, which impaired her ability to maintain […]
Bowen v. Consolidated Electrical Distributors, Inc. Employee Welfare Benefit Plan
Cheryl Bowen alleged that prolonged exposure to toxic mold and bacteria in her workplace caused the recurrence of systemic lupus erythematosus that had previously been in remission and triggered severe asthma and allergic disease. Her condition resulted in repeated episodes of anaphylactic shock, emergency treatment, and frequent hospitalizations, sometimes occurring every four to six weeks. […]
Thompkins v. BC Life & Health Insurance Co.
The claimant sought continued inpatient psychiatric treatment for major depressive disorder (recurrent), dissociative identity disorder, post-traumatic stress disorder, and bulimia. Treating psychiatrists documented dissociative episodes, eating-disorder behaviors, and a high risk of decompensation without structured inpatient care. The insurer initially approved inpatient treatment from May 11, 2004 through August 29, 2004, then denied further coverage, […]
Keller v. Albertsons, Inc. Employees’ Disability Benefits Plan
Warren Keller worked as a Loss Prevention Manager and stopped working due to multiple medical conditions, including hypertension, cardiac arrhythmia, lumbar degenerative joint disease, a knee meniscal injury, and a torn rotator cuff. He initially received long-term disability benefits. When the claim transitioned to the plan’s “any occupation” standard, the plan terminated benefits, asserting Keller […]
