In 2004, a series of automobile accidents left our Client unable to work due to severe pain in her lower back (which radiated into her leg) caused by degenerative changes in her spine with nerve impingement. As a result, our Client was awarded disability benefits from the Social Security Administration as well as from Reliance Standard. After four years of disability, without any improvement in her spine, and a Functional Capacity Evaluation (“FCE”) which objectively verified our Client’s disability, Reliance Standard terminated her benefits based on the paper review of a single nurse.
On appeal, Reliance Standard sent our Client to an Independent Medical Examination (“IME”), and based on that exam, upheld the termination. It appears, Reliance Standard did not provide the IME doctor with the medical evidence which objectively showed our Client’s spinal degeneration and impaired functional capacity. Without the necessary records, the IME was defective, and worse, unfair. The IME doctor found “no objective findings that corroborate functional impairment physically.” Reliance Standard fully adopted this defective opinion in upholding the termination of benefits.
Kantor & Kantor sued First Reliance Standard on behalf of our Client. We then set out to depose the nurse, the IME doctor, and the two claims representatives who had wrongfully terminated her disability benefits. Reliance Standard tried to prevent the depositions from taking place. Kantor & Kantor convinced the Judge that the depositions were proper. Reliance Standard refused to accept the Judge’s determination, and filed a Motion for Protective Order, asking to prevent the depositions from taking place. Following oral argument, the Court sided with our Client in a decision that was published electronically on a national basis by Westlaw (2011 WL 2003228) and LexisNexis (2011 U.S. Dist LEXIS 54866). The Court’s decision can be found here. The Court found it important to get sworn testimony regarding Reliance Standard’s alleged “neutral review process,” what Reliance Standard’s doctors actually reviewed in making their disability determinations, and Reliance Standard’s “rate of claims denials.” Kantor & Kantor will now take the depositions Reliance Standard worked so hard to prevent from happening.