A Georgia disability attorney has filed a federal lawsuit in the district court serving the Northern District of Georgia Atlanta Division against Liberty Life Assurance Company Of Boston (Liberty Life). The Plaintiff, Barbara D., worked as a Senior Director of Chain Development for L’Oreal USA, Inc. (L’Oreal). Due to this employment, Plaintiff was eligible for an employee welfare benefit plan that was provided by L’Oreal, but was administered and funded by Liberty Life.

In Barbara D. v. Liberty Life Assurance Company Of Boston, Plaintiff has filed this lawsuit to obtain the long-term disability benefits that she is eligible for under the terms of the plan.

Facts of the Case Against Liberty Life

Plaintiff worked as a Senior Director of Chain Development for L’Oreal. This was a demanding position, requiring the Plaintiff to work long hours, engage out-of-state travel up to ten days at a time, physically set up tear down events, spend long hours on her feet, and engage in strenuous activities.

In June 2007, Plaintiff was diagnosed with multiple sclerosis (MS). In December 2009, Plaintiff was diagnosed with narcolepsy and cataplexy. After the MS diagnosis, Plaintiff continued to work for an additional three years, but the job requirements proved more difficult for her to complete due to the complications from MS, and later, narcolepsy and cataplexy. This led to cancelled and rescheduled meetings and reducing her travel schedule.

By March 2010, Plaintiff had more difficulty performing her job duties, especially her business travel. In April 2010, Plaintiff’s treating physician for MS, Leslie K., M.D. (Dr. K.), noted that the Plaintiff was not doing well and advised for the Plaintiff to take time off of work. Plaintiff tried to continue working, but finally took a leave of absence in June 2010. Plaintiff has not worked since July 1, 2010 due to her continuing disability.

In July 2010, Plaintiff submitted a claim for short-term disability benefits as defined by the terms of the plan. Liberty Life initially approved her claim and paid benefits.

Liberty Life Terminates Short-Term Disability Benefits And Denies Long-Term Disability Benefits

Via letter dated November 10, 2010, Liberty Life denied Plaintiff’s claim for benefits. Liberty Life closed her claim effective October 16, 2010. The denial was based on Liberty Life’s conclusion that Plaintiff had not provided enough evidence to prove her disability.

Plaintiff appealed the denial, but Liberty Life upheld the denial via letter dated March 8, 2011. However, Plaintiff continued to receive short-term disability (STD) benefits from L’Oreal, who disagreed with Liberty Life’s determination that Plaintiff was not eligible for disability benefits.

When Plaintiff’s appeal for STD benefits was denied, it was already past the 180-day Elimination Period, making the Plaintiff eligible for long-term disability (LTD) benefits. As a result, Plaintiff requested for Liberty Life to send her the appropriate forms to file a benefits claim under the plan on March 15, 2011.

However, Liberty Life responded via letter dated April 11, 2011 that Plaintiff did not fulfill the Elimination Period under the plan and that Plaintiff was ineligible for benefits under the plan. As a result, Liberty Life never sent the forms to the Plaintiff so she could apply for LTD benefits.

Plaintiff again requested Liberty Life to send the LTD forms on May 6, 2011, as well as requested Liberty Life identify its role in the administration of the plan. Liberty Life again denied Plaintiff’s claim for LTD benefits on May 20, 2011, and never sent the forms or addressed its role in the administration of the plan.

Plaintiff again requested Liberty Life to identify its role in the administration of the plan and to send the appropriate LTD forms. This time, Liberty Life requested that the Plaintiff’s attending physicians forward their medical records to Liberty Life and that the Plaintiff complete the forms required to submit a benefits claim under the plan.

On September 21, 2011, Plaintiff submitted all necessary documentation, along with support, including the opinion of Dr. K. regarding Plaintiff’s medical condition, a condition that Dr. K. would be permanent for the rest of Plaintiff’s life.

Despite all of the medical evidence, Liberty Life again denied Plaintiff’s claim for LTD benefits on October 17, 2011. The reason was due to the Plaintiff’s administrative right being exhausted and that no further review would be conducted regarding Plaintiff’s claim. Due to exhausting her administrative remedies, Plaintiff has filed this lawsuit against Liberty Life.

Georgia Disability Lawyer Files Lawsuit Against Liberty Life

The lawsuit claims that Liberty Life committed the following wrongful acts against the Plaintiff:

  • Wrongfully denied Plaintiff’s claim for LTD benefits
  • Didn’t comply with the appeal requirements as stated in the plan
  • Didn’t consult with a health care professional on the initial determination of the Plaintiff’s claim for LTD benefits
  • Based its initial determination solely on a consultation, in violation of the terms of the plan
  • Didn’t consider the test results from OMI Diagnostics supplied by the Plaintiff in the supporting evidence of her claim

Plaintiff Seeks Following Relief From The Court

Liberty Life’s actions against the Plaintiff causes the Plaintiff to seek the following from the Court:

  • Plaintiff is entitled to the benefits as defined in the plan
  • Plaintiff is entitled to past due benefits in the amount of $4,750.00 per month from July 1, 2010 and all premiums paid by the Plaintiff during her disability
  • Plaintiff is entitled to all accrued interest on past due benefits
  • Plaintiff is entitled to receive $110.00 per day that Liberty failed to provide necessary documents as part of her ability to file a claim
  • Plaintiff is entitled to all reasonable attorneys’ fees and associated court costs
  • Plaintiff is entitled to all other relief that the Court finds just and proper