SMDA received a favorable decision overturning Mutual of Omaha’s decision to terminate our client’s short term disability benefits. The firm represented a casino dealer who developed severe psoriasis of the hands as well as depression and anxiety stemming from her witnessing a gambler commit suicide by shooting himself at her table.
She filed a claim for benefits which was initially approved. Mutual of Omaha obtained a paper review of her file and terminated her benefits despite the in-house reviewers request that the Insurer obtain her prescription records.
The Court reversed the denial decision utilizing a De Novo standard of review finding that the client was in fact disabled and criticizing the Insurer for failing to obtain a medical examination while questioning the credibility of the claimant and her treating physicians. Gray v Mutual of Omaha, Case No. 11-15016 (ED Mich)