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What is a Long-term Disability Denial Based on “Performing Duties of Your Occupation”?

Sometimes insurance companies deny long-term disability claims by arguing that you can still perform certain duties related to your occupation. For example, while unable to do heavy lifting, perhaps you can do light lifting of objects not weighing more than 10 pounds. However, the insurance company’s assertion about your disability may not be true, and an Arizona long-term disability lawyer can help you fight for deserved benefits.

Stephens v. Aetna Life Ins. Co. is an example of a case argument involving “performing duties of your occupation.” In this case, James A. Stephens sued Aetna based on its denial of long-term disability for his herniated discs injury. Aetna paid him the first 24 months of disability but, when he was still unable to do any type of work, Aetna denied further benefits. The reason Aetna gave was that Stephens could still perform some duties of his occupation. The work Stephens performed prior to the injury required lifting as much as 80 pounds. Both sides in the case submitted doctor’s reports in their favor and one report indicated that he could lift objects weighing 10 pounds, and could therefore do light work. However, Stephens had trouble with sitting for very long and pain medications to control the pain interfered with his work. After submitting evaluations from various doctors about his physical condition and from psychiatrists about his mental skills, intelligence and adaptability for other skills, the court ruled in favor of Stephens. It reversed and remanded the claim to the Plan Administrator for proper review of the medical evidence.

If you have trouble getting your insurance company to provide you with rightful benefits, consult a long-term disability attorney in Phoenix, AZ.

The Law Office of Paul J. Dombeck can explain the legal jargon of insurance denials and protect your rights.

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