A MetLife long term disability lawsuit claims that benefits were denied to a plan holder in violation of the terms of the plan contract.

Plaintiff Ranjeet S. was reportedly eligible for MetLife long term disability through his employer Kaiser. According to his lawsuit, Ranjeet worked for Kaiser for over 16 years as a sterile processing tech from March 2001 to April 2017.

His job duties reportedly included decontaminating, cleaning, sterilizing, packaging, storing, and distributing equipment. He was also allegedly responsible for filling orders, making equipment rounds, restocking supplies, and “many other duties”.

Ranjeet claims that his job required standing for seven to eight hours, using his neck to look down for up to six hours, walking, performing strong grasping, bending, balancing, and lifting up to 50 pounds.

In April 2017, Ranjeet reportedly became disabled. He allegedly experienced three heart attacks, underwent twelve stent placements, as well as suffering a  history of brain surgery for pituitary problems, IT Band Syndrome, and other surgeries. His lawsuit notes that the issue of “greatest importance” was his diagnosis with chronic pain syndrome which allegedly developed due to chronic back pain, cervical spondylosis, and IT Band pain radiating down to his legs.

Due to his alleged disabilities, Ranjeet reportedly suffers from anxiety with heart palpitations, chest pain, headaches, and insomnia.

According to the MetLife long term disability lawsuit, Ranjeet’s doctor said that he could not do any “stooping, bending, kneeling, or squatting” and cannot lift over five pounds. He sometimes is required to walk with a cane when the pain is “intense”. Overall, Ranjeet’s doctor reportedly classified him as “totally disabled”.

Long-Term Disability Claims

Ranjeet claims that, after the three month elimination period, he was eligible for MetLife long term disability due to his disabled status. Under a disability plan, the elimination period is the amount of time between the beginning of a disability and the beginning of benefits.

The disability plan allegedly defines disability as “unable to perform with reasonable continuity the substantial and material acts necessary to pursue your usual occupation in the usual and customary way.” According to Ranjeet, he fits the definition of total disability and is therefore owed his MetLife long term disability.

However, despite allegedly being eligible for MetLife long term disability and providing documentation from his treating physicians, Ranjeet joins others in claims of wrongful denial of long term disability benefits. Ranjeet states that MetLife denied his claim for total disability “based on a record review only” and did not look at supporting documents or take an independent medical examination.

“Dr. Borden’s permanent and stationary report was never mentioned in the denial of the claim or in the letter denying Plaintiff’s claim,” the MetLife long term disability lawsuit claims.

Ranjeet says that his claim denial was a violation of insurance codes established under the Employee Retirement Income Security Act (ERISA). A number of ERISA settlements have been made over time in insurance claim cases.  The MetLife long term disability lawsuit claims that Ranjeet is owed $2,808 per month, including backpay from July 2017.

The MetLife Long Term Disability Lawsuit is Case No. 2:18-cv-10734 in the U.S. District Court for the Central District of California.

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