standard insurance

If we consider the highlights of the insurance company tried to terminate benefits only after the payment.

George Nevitt was a lawyer, who has fallen, and the flight of stairs on June 19, 2001. His injuries were serious enough that he began a long-term disability benefits received by Standard Insurance Company (Standard), a company that provided his company's employee welfare benefit plan. In April 2007, the standard of Nevitt's surface that do not qualify for mental disorders because of the limitations of the plan.

Nevitt has exhausted all his administrative remedies and filed with the District Court of the United States in the region north of the Atlantic Division. He asked that the trial summary. The standard response to motion for summary ruling on their behalf. Nevitt responded by filing a cross complaint for a summary trial, so the move to standard, published a review of a trial. Nevitt after the strike is standard with other movements. (This is typical.)

Let's look at the background of the administrative data. After his fall, Nevitt began regular migraine headaches, pain in the neck and both arms experiences. His cognitive abilities are impaired. In August, he saw his primary care physician, neurologist and physiotherapist. He was forced to reduce the number of hours worked, and eventually underwent MRI in September. MRI showed that he had herniations in both C-4 C-5 and C-6 C-7 wheels and a distortion of the spinal cord. Other damage was also visible on MRI.

On November 15, 2001, Nevitt filed a claim for partial disability benefits. He was not ready for a full year to ensure that the standard Nevitt has a pre-existing condition. The internal medicine consultant, reviewed his medical records. There are no pre-existing condition is found. The doctor said that the situation should improve Nevitt gradually over time.

If the situation has improved in Georgia, Nevitt, his neurologist recommended that he consult neurosurgeon. He was in May 2002. Neurosurgeon, that he needed surgery to repair and MRI showed herniations spondylitic promoted. Nevitt was ready to go to the knife, so the neurosurgeon referred him to a pain management specialist and board certified in rehabilitation.

In December 2003, Nevitt has stopped completely. An independent medical examiner, said his workers comp claim to verify. The doctor who conducted the study, reported that he can return to work if his job duties changed. Nevitt returned to the neurosurgeon who recommended surgery again, but the neuropsychologist diagnosed, it Nevitt post-concussive injury, concluded that the cognitive impairment of Nevitt's ability to practice law. He noted that he was emotionally upset by Nevitt's cognitive abilities. As a result, he recommended pharmacological treatment of depression.

Nine months later, in August 2004, a standard ordered an independent medical examination. The doctor concluded that there was no neuropsychological Nevitt of its limited ability to work. He lives in the doctor disagreed and continued to affect his work.

Continue for another year. In August 2005, a standard data Nevitt asked the neurologist to investigate. Neurologist, concluded that it is not competent to carry out disabled Nevitt. It is recommended for the treatment of migraine Nevitt. At the same time, a standard data Nevitt asked a psychiatrist to investigate. He concluded that he suffered from major depression at the time, but he can return to work and emotional support. His doctor did not agree and continued to restrict his return to work.

In October 2006, Standard Order an independent medical examination. After seeing a neurologist Nevitt, ruled that the complaint Nevitt was disproportionate to his injury. There is no reason why it is not working desk, fully implemented.

Standard Long-term disability benefits terminated Nevitt in April 2007. They said that its benefits are only 24 months of anxiety and depression contributed to his disability. He called on October 12, 2007, referring to his pain and cervical pain, migraine headaches, and brain damage. These defects are independent and not subject to the restrictions on mental illness. The sworn statements by his doctors to share details of his decline, functional capacity testing and simulation work, as there is no evidence that his disability is related to the mental condition. The claims specialist who decided that he no longer qualified for long-term disability and additional support material to investigate the violation.

File was sent to investigate the administration of the standard of independent review. Nevitt submit additional documentation. The report of the neurologist said that he expected his migraines 5-7 working days lost each month. The second report is a professional consultant Nevitt said he could no longer practice law because of the restrictions. The standard is also presented in the report, the neurologist did not agree that it is only necessary to prevent migraine Nevitt a day or two events. He could not understand how to disable it for practicing law.