ERISA Long Term Disability Case Citations and references

DISCLAIMER: Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case.

The Relationship Between ALLSUP and Prudential Insurance Company

Here's how one might approach the question of the relationship between ALLSUP and Prudential Insurance Company

The firm hired by Prudential, ALLSUP[1] to handle the social security claim reported directly to Prudential (A1236, A1443) went right to work representing Ms. xxx in her claim, gathering additional medical information and personal statements, including: [then listed records and reports Allsup generated and sent to SSA.

[1] ALLSUP was created to provide long term disability (LTD) insurance carriers with a means to recover overpayment benefits received by their insureds from the SSA. ALLSUP, Inc. v. Advantage 2000 Consultants Inc, 428 F.3d 1135 (8th Cir. 2005)

Meanwhile, the Firm Hired by the Plan

Was Telling Social Security "The Evidence is Overwhelming"

At about the same time as Dr. Ebanks was saying "there's not enough," ALLSUP, the company the plan hired to pursue the social security claim, was saying to the Social Security Administration: This case is so obvious that you should grant an award based just upon the written record. (A0192) In a May 7, 2007 letter to the Social Security Administrative Law Judge, they outlined the medical records and stated that Drs. Kivanc, Peyton, Soni and Seestedt all concurred in their opinions, based upon their examination and treatment of the claimant, that her severe problems including pain and fatigue precluded even full time sedentary work. They pointed out that all medical opinions supported a finding that the claimant was not able to engage in work like tasks on a "regular and continuing basis" meaning for the full course of an eight hour day or five day work week."

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Meanwhile - The Plan's Firm Keeps Telling the

Social Security Administration "This is Clear"

Meanwhile, two weeks later, ALLSUP sends more records it had gathered in support of the Social Security disability claim, submitted them and again asked the Social Security Administration to approve the claim "on the record." ALLSUP's submission included a "pain interrogatory" report from Dr. Basile, the urologist treating the interstitial cystitis, and from Dr. Herman, the gastroenterologist treating the irritable bowel syndrome.

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7 Reasons Why MetLife's Decision Was Unreasonable

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Reason #7: A Reasonable Person Would Have at Least Tried to Explain Why It Hired a Firm To Pursue Social Security Benefits For the Claimant, Was Supplied with all of the Documentation that The Firm Gave to The Social Security Administration to Support the Claim, But then Arrived at a Totally Different Conclusion as the Claimant's Condition Than That Advocated by The Firm It Hired

It's clear that ALLSUP was hired by the plan to do it a big favor-try to obtain Social Security Disability Benefits for Ms. xxx so the plan could pay her less. It's also clear that the mere fact that social security ultimately paid benefits[1] is not dispositive of the issue. It was unreasonable, however, and not the evidence of a reasoned and principled process for decision making to totally ignore and not attempt to explain away the medical evidence ALLSUP was giving the social security administration at the same time as the plan was terminating benefits. The plan shouldn't be able to have it both ways: (1) represent, through its agent, to the Social Security Administration, that the claimant met the social security definition of disability yet (2) deny that the claimant was disabled under the plan's less stringent definition of disability.