Woman’s estate might inherit disability benefits

When your disability benefits are held up or denied, it can have consequences across your entire life. Disability insurance is provided or purchased for the sole reason that people want to protect themselves from complete loss of income if health or body capability suddenly makes them unable to perform their job. Denial of benefits through that insurance can mean a struggle to pay for basic life needs or the loss of a home or other asset.

One woman lost her disability benefits when it was determined she didn’t meet a definition for disability under the plan. In this specific case, the woman was diagnosed with pelvic floor muscle dysfunction and pudendal neuralgia after having a hysterectomy. Both conditions are associated with pain that occurs when the person is sitting down.

The woman reportedly had medical documentation of these diagnoses and a physician had noted that she was still recovering from her surgery. The woman reportedly filed a claim for long-term disability with the insurance provider several months after the surgery. She stated that she could no longer sit and perform job duties because of the pain.

The benefits were initially paid but then discontinued. That occurred in April 2013. The woman brought a legal action in the case, but the lower level courts sided with the insurance company. Since then, the woman has passed away.

The woman’s estate is still involved in the matter. An appeals court ruled that the insurance company failed to address the diagnoses in her record. It remanded the case to the insurance company for a full inquiry into the matter.

While it’s certainly tragic that this woman did not live to see her benefits reinstated, this case illustrates the point that a carrier decision is not always final. If you believe you were wrongfully denied disability benefits, you have legal options for pursuing the matter.

Source: Business Insurance, “Appeals court favors woman’s post-hysterectomy disability claim,” April 07, 2016