When Reliance Standard terminated Christa Waldrip’s disability benefits after two years, she faced an uphill battle to have them reinstated. Fortunately, she sought legal help from our team at Roy Law Group. With medical evidence and opinions from her doctors, we proved she was “totally disabled” in any occupation, not just her own. Read on to learn more about Waldrip v. Reliance Standard Life Insurance and how we secured the benefits Christa deserved.
Approved then denied by Reliance Standard
Christa Waldrip has multiple debilitating medical conditions, including carpal tunnel syndrome and multiple sclerosis. The severity of her conditions significantly hindered her job performance as a Production Supervisor in Washington State. Having a disability that impacted her ability to work caused her emotional distress and uncertainty in addition to her chronic pain and discomfort.
Christa filed a long-term disability claim with her employer’s disability insurance provider, Reliance Standard Life Insurance. To her relief, Reliance Standard acknowledged she could not carry out her regular job and granted her long-term disability (LTD) benefits.
This relief, however, only lasted two years. After the insurance policy’s definition of disability changed from being unable to work in her own occupation to any occupation, Reliance Standard terminated the benefits Christa relied on to support herself.
The challenge of meeting the definition of disability
Like all disability insurance policies, the devil is in the details. Qualifying for long-term disability benefits requires meeting your insurance policy’s definition of “totally disabled.”
According to Reliance Standard’s insurance policy, Christa would be considered “totally disabled” if she couldn’t perform the material duties of her regular job or “own occupation” for the first 24 months. The “own occupation” standard meant that as long as she couldn’t fulfill her responsibilities as a Production Supervisor, she would be eligible for long-term disability benefits.
Under most policies, it becomes significantly harder to be eligible for long-term disability benefits after the first 24 months.
After two years, her insurance policy’s definition of disability changed to an “any occupation” standard. At that point, Reliance Standard notified Christa that she was no longer eligible for benefits.
Under most policies, it becomes significantly harder to be eligible for long-term disability benefits after the first 24 months. Insurance companies often reject long-term disability claims during this period. Proving that you cannot perform the duties of any job in a full-time capacity, including sedentary work, can be extremely challenging.
Request for an Independent Medical Examination
During the appeal process, Reliance Standard insisted that Christa undergo an Independent Medical Examination (IME) by a doctor selected by Reliance Standard.
An IME is a medical evaluation used to determine a claimant’s ability to work and can be used as medical evidence in court. An IME doctor is supposed to be unbiased, but unfortunately, the results of an IME typically favor the insurance company, not the patient.
While acknowledging Christa suffered from chronic pain, Reliance Standard’s IME doctor determined she was “capable of performing full-time sedentary work.” This conclusion was at odds with multiple medical reports from Christa’s treating physicians. Unsurprisingly, Reliance Standard denied Christa’s appeal to have her benefits reinstated based on the findings of the IME report.
Determined to fight for her rights, she filed a lawsuit against Reliance Standard with the support of our team at Roy Law Group.
The outcome of Waldrip v. Reliance Standard
In the Ninth Circuit, where Waldrip v. Reliance Standard Life Insurance was heard, an employee must be able to sit for at least four hours in an eight-hour workday to be considered capable of performing sedentary work.
Reliance Standard’s IME doctor had determined that Christa could only sit “frequently,” meaning one-third (2.67 hours) to two-thirds (5.33 hours) of the workday. This determination was inconsistent with the doctor’s conclusion that Christa could perform sedentary work on a full-time basis.
Ultimately, the U.S. District Court of the Western District of Washington weighed the extensive evidence from medical records, physicians, and other sources and concluded Christa could not perform full-time sedentary work. Reliance Standard had to pay her the LTD benefits she deserved. This victory brought Christa immense emotional and financial relief at a critical time.
You are not alone
At Roy Law Group, we are dedicated to fighting for the rights of individuals like Christa who have been wronged by insurance companies like Reliance Standard. Our experienced legal team will continue to advocate for fair treatment and just compensation for our clients, ensuring they receive the support they need during challenging times.
If your insurance company has denied your long-term disability benefits, we understand the emotional toll this can take on top of the challenges of having a disabling medical condition. We can take care of all the details of fighting your denied claim so you can focus on taking care of yourself.
Contact Roy Law Group today for a free consultation to learn how we can help with your claim.