The former AT&T employee suffered from chronic fatigue syndrome for years. Her condition was previously tolerable but in 2008, she began feeling weak, had trouble thinking, and had suicidal attempts.
The woman underwent several medical evaluations in which two doctors found out that she was unable to function due to her moderately severe depression. Both physicians increased her medication and recommended to AT&T that the woman needs an extensive medical leave to allow for her medical treatment for depression and anxiety.
Later on, the woman claimed for a disability benefit, which the AT&T denied. The company claimed that even though the woman’s condition had not improved since 2006, she had not provided any objective evidence of her claim. Incidentally, such ground is actually a common tactic of most insurers to deny lawful coverage.
The woman subsequently appealed the decision, but lost. Therefore, she was required to get back to work in a couple of months, but instead of returning to work, the woman decided to retire and then filed a lawsuit.
In her lawsuit, the woman claimed that the insurer violated the Employee Retirement Security Income Act (ERISA) since she was qualified for benefits under AT&T’s disability benefit plan. Fortunately, the court sided with her, saying that AT&T and the insurer abused their benefits discretion when they terminated the woman’s long-term disability benefits. Moreover, the court concluded that the actions of the insurer were “illogical and without support.” Therefore, the court ruled that the law had been disregarded in this case. Eventually, the woman won her disability benefit claim.
Chronic fatigue syndrome is a life-altering disability characterized by severe and constant tiredness that is not relieved no matter how much a person rests. It can be directly caused by other medical condition. Typically, the condition occurs in women between the ages 30 and 50.
Sooner or later, more people are going to suffer not only from chronic fatigue syndrome but from other disabling illnesses as well. Therefore, this litigation hopefully would be noted by people experiencing such illegitimate denials from an insurer company. Know your legal rights, a Los Angeles long term disability lawyer advised.
