ERISA

Michael Horrow and his dedicated team of ERISA attorneys at Donahue & Horrow LLP recently assisted a client who was unjustly denied disability benefits by her insurance company. Despite being unable to work due to a range of debilitating conditions—including chronic pain syndrome, polyneuropathy, migraines, fibromyalgia, insomnia, fainting episodes, nausea, dizziness, radiculopathy, osteoporosis, anxiety, depression, and an unsteady gait—the client faced an unfair ERISA claim denial. With compassion and expertise, the legal team successfully advocated on her behalf.

Our client worked as a bookkeeper for a company that had employed her for 40 years. Over the years, while working, she proactively pursued continuing education, completing courses in tax preparation and loan processing, and with that education, received promotions reflecting her expanding workplace responsibilities. Unfortunately, as she got older, she started to become affected by a variety of ailments. 

One day, while at work, she began experiencing cervical neck pain, which radiated down to her lower back and greatly limited her movement. She visited the emergency room and was treated with pain medications administered via IV drip. However, after discharge, our client continued to experience intense, radiating neck and back pain at a level 10. Her mobility was also significantly impaired, and she had to resort to using a cane, even for short distances.

Despite these setbacks, our client—a hardworking and dedicated employee—returned to work, continuing to fulfill her duties while managing her symptoms. However, about six months after her initial emergency room visit, she fainted at work and had to return to the hospital. After being discharged, she made another attempt to resume her job but ultimately had to acknowledge, both to herself and her employer, that after four decades of unwavering commitment to a company she cherished, she could no longer meet the physical and cognitive demands of her role due to her disabling diagnoses and associated symptoms.

After being forced to stop working, our client filed a claim for disability insurance benefits under the ERISA plan offered by her employer. Initially, the insurance company approved the claim, and our client received monthly benefits. However, about a year later, less than a month before her 67th birthday, the insurance company denied her claim. 

With the help of the skilled ERISA attorneys at Donahue & Horrow LLP, she filed a timely appeal and explained that her physicians continued to validate her diagnoses, in addition to the restrictions and limitations. She also provided a report by a vocational expert who opined that she was unable to perform the substantial and material acts necessary to meet the obligations required of her job.

Despite this and other supporting evidence, the company upheld its original decision to deny the claim. Michael Horrow promptly filed an ERISA complaint in the Central District of California, Western Division, which covers disability insurance claims that occur in Los Angeles County, Ventura County, Santa Barbara County, and San Luis Obispo County.

Shortly after receiving the complaint, the insurance company’s counsel reached out to Michael Horrow to discuss the possibility of an early settlement. Based on the strength of her supporting medical evidence and the documents and information Donahue & Horrow LLP gathered in support of her appeal, our client was able to quickly reach a settlement with the insurance company that ended the litigation. This allowed her to focus on her health rather than spend her time fighting with an insurance company.

If your insurance company unfairly denied your disability insurance claim, call Donahue & Horrow LLP at (877) 664-5407 for a free consultation. Our dedicated team is ready to fight for the benefits you deserve.