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Long Term Insurance Benefits Denied to Seriously Ill Social Worker

Long Term Insurance Benefits Denied to Seriously Ill Social Worker

Nature of the Case

S.W. was a dedicated Social Worker who loved her job. She suffered from chronic pancreatitis and had undergone 3 unsuccessful surgeries in an effort to alleviate pain and symptoms of the illness. After the surgeries, S.W. was diagnosed with fibromyalgia and plantar fasciitis. After that diagnosis, S.W. began to experience other new symptoms and faced irritable bowel syndrome, carpal tunnel syndrome, fatigue, pain while sleeping, cognitive impairments and depression.

S.W. continued to work for as long as she was physically able. When she was first diagnosed with pancreatitis, she took a leave of 13 months, but returned to work for seven years after, in spite of living with constant pain. Finally the pain made work impossible and S.W. went on disability. Even while disabled, she continued to worsen, when a tumor was discovered on her neck. Although the tumor was removed, S.W. experienced several side effects including numbness to her face, an injured cornea and impaired speech.

S.W. was then denied the benefits she needed to survive financially.

The Resolution

Bogoroch & Associates determined to:

  • Show the progression of S.W.’s illnesses
  • Gather all appropriate medical reports
  • Prepare an accounting of lost benefits
  • Clearly demonstrate that the insurer had treated S.W. unfairly, demonstrating a high degree of bad faith

The case proceeded to a mandatory meditation where all issues were raised by both sides. It became clear very quickly through the medical evidence that while S.W. may have had disparate and multiple illnesses, they were all very real and very debilitating.

A fair and reasonable settlement, plus legal fees was agreed upon. More importantly, S.W. was placed back on disability for at least another year, when her case would be assessed again. The matter was dealt with quickly by the Bogoroch team – in 9 months – and S.W. was able to focus on rehabilitation and her health for the following year

*Please note that the settlement amounts will vary from case to case and are not reflective of what your case may be worth.