A Technical Support Analyst Suffering From Severe Sleep Apnea Wins His  Appeal

“Mark “was a technical support analyst for a leading financial institution when he was diagnosed with severe obstructive sleep apnea.  Mark began to experience cognitive difficulties associated with his sleep apnea as well as deficits in concentration and memory, and extreme fatigue.  Mark had previously received coverage under the family medical leave act (FMLA) and upon its termination attempted to return to work.  However, Mark’s return to work was unsuccessful as he remained unable to tolerate the high executive level functions required to meet the demands of his occupation.  Mark met with Mr. Riemer and a strategic plan was implemented geared toward transitioning Mark from short term disability benefits to long term disability benefits.

Team Riemer submitted substantial medical documentation from Mark’s treating providers and despite the preponderance of evidence, the insurer denied Mark long term disability benefits contending he did not meet the definition of disability.  Team Riemer knew immediately that an appeal was necessary as the medical evidence supported total disability in accordance with policy provisions and quickly got to work.

Team Riemer had Mark undergo a neuropsychological evaluation to further document his cognitive dysfunction related to his sleep apnea; a functional capacity evaluation to document his fatigue and corresponding deficits in functioning; and a vocational evaluation to substantiate the fact that his impairments and resulting limitations precluded him from performing the demands of his occupation.  Additionally, statements of disability were obtained from Mark’s treating doctors, which further supported his inability to perform his occupation as well as updated medical records to show continued disability.   A comprehensive appeal was submitted with this new medical documentation and the Appeals Review Unit overturned the decision to deny Mark long term disability benefits.

Mark continues to receive long term disability benefits and Riemer Hess LLC remains of counsel to monitor his claim to ensure benefits remain payable.