Making The Impossible Possible

Cory loved his job and wanted to keep doing it. But his elusive medical condition made it impossible to continue working as an automotive mechanic. “Impossible” is a good description because having a medical diagnosis like Cory’s that isn’t supported with specific medical tests – only mostly through personal complaints – is a recipe for denial of disability benefits and filing a lawsuit. Cory experienced both and luckily for him, he came to our office.

I met Cory – a real client though not his real name – after he had been denied his disability benefits and was referred to me by another attorney.

Cory was relatively healthy until a medical procedure in 2015 left him with “burning in the brain,” dizziness, imbalance, cognitive impairment and fatigue. He was diagnosed with autoimmune encephalitis and treated with bimonthly IV infusions leaving him exhausted and eventually unable to continue working.

Cory filed claims for short-term and long-term disability benefits under his employer’s disability plans with MetLife, which were approved, as well as an approved claim for Social Security Disability benefits.

After nine months on disability, Cory began to experience mild symptoms improvement and tried going back to the job he loved, ending his disability benefit payments. However, back at work, a series of actions left Cory out in the cold. First, Cory’s medical symptoms worsened which led to his physician restricting him from driving. Driving was an integral part of Cory’s job, and this restriction caused his employer to classify him as a “safety risk” ultimately leading to the loss of his job.

Unable to work, Cory notified Social Security and his disability benefits were reinstated. He also filed for long-term disability benefits with his employer’s new disability group insurance carrier, CIGNA, anticipating the claim would be approved.

New Carrier – New Eyes On Claim

Surprise. CIGNA’s reviewing physician determined that the medical documentation in Cory’s file didn’t prove a functional impairment that would keep him from doing his job and Cory’s long-term disability claim with CIGNA was denied.

Our review of Cory’s medical records found that as Cory’s condition progressed, new symptoms were noted, including “horrible” difficulties with sleep causing him to feel tired and easily exhausted throughout the day, along with feeling “periods of anger and rage” since his diagnosis.

No longer able to drive by his physician’s order, Cory received a disabled person bus pass with his mother driving him to his doctor appointments. To gather objective evidence that supported Cory’s subjective complaints, we arranged for a neuropsychological exam, which Cory couldn’t complete due to reported pain and burning in his head.

Armed with this appeal documentation by our law firm, CIGNA was persuaded to approve Cory’s long-term disability claim.

What did Cory think of our help in his claim?

“I’ve never had a lawsuit before, but this was a seamless type of operation, one in which my needs were paramount as well as the compassion of the firm. Professionalism, Quality, Responsiveness, Value. Exceptional service, quality and caring. It definitely was a team experience, and I was part of it every step of the way. Kudos to CJ Henry Law Firm,” said Cory. Case Closed.