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Discovery in Long Term Disability Insurance claims-the door opens a little wider

For years, long term disability insurance claimant’s were prevented from conducting even the most basic discovery. The court’s having basically accepted the disability insurer’s arguments that they could only examine the records that the disability insurer reviewed in making the claims decision. However, that approach has changed since the Metlife v Glenn decision.

A recent decision issued by the US District Court in Detroit illustrates perfectly the subtle shift now taking place where the Court allowed plaintiff to actually depose the two physicians relied upon by the Standard Insurance Company to deny plaintiff’s claim for long term disability benefits.

Plaintiff’s counsel discovered that one of the physicians, Dr. Dickerson had been used over and over again to terminate disability benefit claims. A simple search of the case law provided at least a dozen other cases in which Standard used this expert. Counsel for plaintiff astutely asked:

Is Dr. Dickerson’s extensive association with Standard the result of him being designated an “approved physician” by the insurer’s management team? Is it because all or nearly all of his opinions favor Standard instead of the disabled person? Or is it because he is a “consultant physician” for Oregon Medical Evaluations, Inc. (OEM) which provides “services for insurance claims professionals, self-insured groups, attorneys and workers compensation programs.”? The answers to these and other questions such as percentage of income obtained or percentage of professional time spent in “consulting “for Standard and others are impossible to ascertain without formal discovery.

Plaintiff’s counsel also interestingly discovered that the second physician relied upon by Standard, Dr. Shirley Ingram:

From what can be ascertained from this information, Dr. Ingram has taken two remedial medical programs in the four-year period from 2003 to 2007. She was not practicing clinical medicine or seeing patients during the relevant period that Ms. McCandless was claiming benefits, 2005 thru 2007. Yet, Standard believes that she was the best physician to review Ms. McCandless’s claim.

The court agreed that this information merited further discovery to find out why the Standard relied upon these two experts in denying plaintiff’s claim for long term disability benefits rather than her treating physicians who all supported her claim for disability benefits.