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One other approval, this time in Melbourne, Florida. Consumer got here to us affected by lymphedema, lipomatosis, historical past of a failed laminectomy, sleep apnea, in addition to different situations. One of many distinctive facets of this case was that the denial letter said that the shopper was not disabled from any occupation and that the coverage transitions from proving incapacity to carry out your individual occupation to any occupation after only one yr, whereas the any-occ transition in most LTD insurance policies happens at 24 months. The insurance coverage firm decided that the shopper was capable of work at a sedentary place, and throughout the document gathering and peer evaluate part of the insurer’s investigation, our shopper obtained a brand new analysis from her treating physicians of Dercum’s illness, a uncommon dysfunction characterised by a number of, painful growths of fatty tissue known as lipomas. Though the insurance coverage firm supplied the medical information establishing the brand new analysis and remedy to their reviewing doctor, it didn’t change his opinion.
Cremeens Regulation Group PLLC gathered and obtained substantial and detailed medical proof to submit a 122-page enchantment, which resulted within the insurer’s determination to overturn its determination to disclaim the advantages and approve the shopper’s incapacity insurance coverage advantages on the administrative stage, with out having to file a lawsuit.
If in case you have been denied incapacity insurance coverage advantages, please give us a name to see if we can assist you too!
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