A former employee of Aria Health has initiated an ERISA suit after being denied disability benefits for an eye condition. At the time of the application for disability benefits, the plaintiff received a diagnosis of wet age-related macular degeneration of the right eye.
ERISA Suit Filed for Disability Benefits
When the plaintiff received her diagnosis of the eye condition in 2014, she expected to be covered by her long-term disability benefits. When she was diagnosed with the condition, she began to receive short-term disability benefits from February through July of that year. When her longer term benefits were denied, however, she filed an ERISA suit.
At the conclusion of her short term disability benefits package, the insurance company initiated long term benefits from August of 2014 through November of 2016. On November 1st, 2016, the plaintiff received a letter notifying her that her long term disability benefits claim was denied.
The ERISA lawsuit states that the plaintiff was legitimately unable to work due to a disability diagnosis and should not have had the disability benefits terminated. The insurance company stated that there was a lack of evidence to support the employee’s functional impairment.
The employee alleges that she was no longer able to work as a result of her condition and Aria improperly denied her claim. Furthermore, the employee says that the severity of her condition prevented her from holding any gainful employment and therefore should have been covered by the long term disability benefits plan.
Upon being notified that her benefits would not be provided to her, the employee filed an appeal immediately. In October of 2017, the employee was informed that the company chose to uphold their decision to deny the benefits.
Ultimately, the employee had to file an ERISA suit in order to recover the support she needed under the plan provided by the employer. The ERISA suit says that despite clear medical evidence from the employee’s doctor that her macular degeneration made her unable to work, the insurance company denied her application for disability benefits.
The original decision from the doctor came in 2014, and, according to the lawsuit, the doctor also provided additional details to support the diagnosis in 2016. The employee’s doctor determined that the plaintiff should not go back to work because of blurred vision, vision distortion with computers, decreased depth perception, and blurred vision in the right eye.
The ERISA suit alleges that in the denial of these owed benefits that the defendants are in violation of federal laws. ERISA regulates retirement and pension plans across the U.S., allowing those who believe plan administrators or managers are in violation to initiate legal action.
As argued in this ERISA suit and others, the improper denial of long term disability benefits may be raised as grounds for recovery through the courts. If you or someone you know believes that you have grounds to initiate an ERISA suit due to violations, you need to schedule a consultation with the lawyers at Bradley/Grombacher today- fill out the form on this page.
The ERISA suit is Abraham v. Unum Life Insurance Company, Case No. 2:18-cv-00004-MAK, filed in the U.S. District Court for the Eastern District of Pennsylvania.
Note: Bradley/Grombacher is not representing the plaintiff in this lawsuit.