Cheryl Watson, a licensed clinical social worker and research coordinator at the Hektoen Institute, faced an uphill battle to secure long-term disability benefits. After years of enduring fatigue, cognitive difficulties, pain, and other symptoms, Watson stopped working in March 2013. Diagnosed with conditions including fibromyalgia, chronic fatigue syndrome, and degenerative spinal problems, she applied for benefits under her employer-provided plan administered by Reliance Standard Life Insurance Company.
Initial Denials and Litigation
Reliance Standard initially denied Watson’s claim, asserting that her symptoms were not disabling under the policy’s criteria. Even after the court remanded the case for further review, Reliance Standard granted only limited benefits, citing a 24-month mental or nervous disorder limitation and terminating payments after June 10, 2015. This prompted Watson to return to court, arguing that her physical conditions independently rendered her disabled.
The Court’s Decision
The court evaluated Watson’s extensive medical history, testimony, and independent medical examinations. While Reliance Standard emphasized the normal findings of some medical examinations and attributed her symptoms to depression, the court found otherwise:
“Just as Reliance Standard points to examples of normal reports, the Court could also find other visits where Watson reported pain, weakness, and decreased range of motion. Moreover, the fact that Watson may have been able to perform some daily activities or did not always complain of pain is not disqualifying; “the symptoms of [fibromyalgia] can wax and wane so that a person may have ‘bad days and good days.'””
The court concluded that Watson’s physical impairments, including chronic pain, fatigue, and cognitive problems associated with fibromyalgia and other diagnoses, were disabling. It emphasized that her conditions prevented her from reliably performing the material duties of her sedentary job. The court ruled in Watson’s favor, awarding her long-term disability benefits retroactive to June 2015, along with prejudgment interest.
Schedule a Free Case Evaluation with a Long-Term Disability Attorney
If you are struggling with a long-term disability claim due to physical or cognitive impairments and feel that your insurer has wrongfully denied or limited your benefits, contact the Ortiz Law Firm. We specialize in advocating for people like Cheryl Watson, making sure their voices are heard and their rights are protected. Let us help you get the benefits you deserve. Call (888) 321-8131 to get help with your claim today.