Amory, MS asked in Personal Injury, Business Law, Health Care Law and Public Benefits for Mississippi

Q: What kind of lawyer would i use for intercompany short term disability plan denial, admistrated third party sedgwick.

In 2022 I suffered a sudden onset of anxiety and depression after a bout with corona virus. With no known cause I began to go to doctors to try and seek out reason. After an MRI to evaluate my pituitary gland it was discovered that I had suffered at least two ischemic attacks(strokes) of the brain. Although no outward deficits were present, I had some mental instability. I worked all the way through this time seeking and receiving treatment and when it became time for my DOT physical the examiner would not pass me due to a dot mandate pertaining to strokes. I have to wait until a specified time symptom free in order to have an opportunity to retest for dot med card. Sedgwick states that I lost certification, but I did not know such mandate existed otherwise i would have taken short term immediately upon discovery of strokes rather than waiting until my dot card expired. I have sent all documentation and they still don't approve due to conflicting statements in plan handbook.

1 Lawyer Answer

A: Hello!

For your issue, it sounds like you would need to talk to someone like me who specializes in ERISA short-term and long-term disability claims. If I gather correctly, it sounds like your issue is that Sedgwick has denied the claim because the disability policy does not cover loss of license or certification (a common limitation in these types of insurance policies). Feel free to give my office a call or email and we'll take a look at Sedgwick's denial letter for free.

Hope this helps!

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