A Michigan disability attorney acting on behalf of a disability claimant recently filed a lawsuit against the Prudential Insurance Company of America (Prudential) at the District Court for the Eastern District of Michigan. In Deanna L. Nino vs. the Prudential Insurance Company of America, the plaintiff brought a civil action under the Employee Retirement Income Security Act (ERISA) to seek to recover long term disability income benefits under the Exel Logistics disability benefit plan.

The Nature of the Complaint

The plaintiff was employed as a Supervisor of the Material Management Division for Exel Logistics. As an employee of Exel Logistics, she was entitled to participate in the employee benefit plans called the “Be Secure Short and Long‐Term Disability Plans” that was sponsored by DPWN Holdings (USA), Inc., the parent company of Exel Logistics. The plans were underwritten and administered by Prudential.

The plaintiff stated in the lawsuit that she has an established history of chronic, intractable low back and radicular pain that radiated into her right lower extremity and foot. In fact, chronic spinal pain had forced the plaintiff to step down from a managerial position in April 2009 to assume a lesser role as a team member within the Material Management Division.

As a result of the chronic pain that the plaintiff was experiencing, she was forced to stop work on October 2nd 2009. The plaintiff also stated in the lawsuit that since that date she has not engaged in any substantial gainful activity. As a consequence of her disability, the plaintiff received short term disability benefits from October 9th 2009 to April 4th 2010 from Prudential.

Denial of Long Term Disability Benefits By Prudential

After April 4th 2010, the plaintiff applied for long term disability benefits with Prudential. On April 5th 2010, the plaintiff was informed by Prudential that:

Based on the mild findings on your MRI and normal EMG findings, there is minimal evidence to support your level of reported pain. At this time, the medical documentation on file does not support your inability to perform a sedentary occupation. After a thorough review of the above information, we have determined that you do not meet the definition of disability as defined above. Therefore, we have denied your claim.

The plaintiff subsequently appealed this decision by Prudential in April 2010 but was denied her appeal in her claim for disability benefits.

A second ERISA appeal was submitted by the plaintiff on December 20th 2010. To support her appeal, the plaintiff also submitted additional medical documentations inclusive of a Functional Capacity Evaluation that found the plaintiff to be capable of performing less than sedentary work.

The plaintiff was also determined by the Social Security Administration as being disabled on March 25th 2011 under the Social Security Act since October 2nd 2009 due to spinal pathologies and major depressive disorder. In spite of all the overwhelming evidence, the plaintiff was unsuccessful in her second appeal and was informed as such on June 6th 2011:

“Based on the totality of the medical records and other documentation in her file (including physical exams and diagnostic testing), there is insufficient documentation to substantiate that she is/was significantly impaired and precluded from performing her occupational duties.”

Claim for Relief filed by Michigan Disability Lawyer

Having exhausted all avenues of administrative appeal, the plaintiff is seeking a judicial review of her case. The plaintiff the Court to award her the following relief:

  • Enter judgment in the plaintiff’s favor against Prudential and order the immediate payment of the plaintiff’s disability income and other employee benefits, including group life insurance policy, retroactive to the date that benefits were denied.
  • An order to Prudential to pay the plaintiff 2.553% in post‐judgment interest on all benefits that have accrued prior to the date of judgment.
  • An order to Prudential to continue paying the plaintiff benefits in accordance with the terms and conditions for the receipt of benefits.
  • An award of attorneys’ fees
  • Any relief to which the plaintiff may be entitled, along with the costs of litigation.