For a long time, Dr. Smith was a healthy Internist. For over 35 years she had a very lucrative private medical practice. At the age of 60, Dr. Smith’s staff noticed that she was becoming forgetful, missed appointments, prescribed incorrect medication once and had difficulty ordering routine tests for patients. More than once she got lost on her way to the hospitalInitially they thought she was stressed and over-worked but the incidents became increasingly noticeable and her staff was having a hard time covering for her. Along with her husband they encouraged her to see her physician. She was diagnosed with the early onset of Alzheimer’s and knew that she had to stop practicing at once to assure patient safety.
Commons Early Symptoms of Alzheimer’s include:
- Memory loss – short term and long term
- Forgetting recent information
- Losing track of important dates and names
- Asking the same questions over and over
Trouble planning and problem solving:
- Forgetting plans
- Can’t follow directions
- Getting distracted
- Difficulty with numbers, such as making change, or calculating a restaurant tip.
Daily tasks are a challenge
- Even familiar tasks are challenging
- Getting lost driving
- Forgetting simple work tasks
Times and places are language become confusing
- Losing track of time
- Forgetting how a person got to a present location
- Can’t find words
Dr. Smith had a group disability insurance plan through her medical practice. Her initial claim for long-term-disability benefits was filed by an attorney who didn’t fully understand the intricacies of ERISA Law. The claim was denied. So was the appeal. At the same time, Dr. Smith sought benefits under the United States Social Security Act disability benefits program. The Social Security Administration awarded benefits under its strict guidelines. Still that did not persuade the insurance company to change its mind and pay long-term-disability to Dr. Smith that she deserved and qualified for under her
She retained Jonathan Feigenbaum. Jonathan contacted the insurance company. He tried to resolve the claim without filing suit. The insurance company was stubborn. Dr. Smith had no choice but to file suit in Federal Court seeking an order under the Employee Retirement Income Security Act of 1974 (ERISA) to overturn the insurance company’s wrong decision. Prior to entry of judgment, the parties negotiated a settlement. The lawsuit settled on confidential terms, and both parties agreed to dismiss the suit prior to the Judge’s ruling.
Remember don’t give up, in many cases a “No” from your insurer is the beginning not the end.