Our Successful Cases
Social Security Disability
Rare Disease Denied by Social Security because they never heard of It
25-year old client who suffers from cholesteatoma, a relatively rare medical condition which can lead to significant hearing loss. She applied for Social Security Disability
benefits and was denied and a hearing date was later scheduled. She was shocked to learn that no attorney would take her case. Each attorney coldly explained that her claim
presented too many challenges.
She contacted David Allen & Associates. She expected to hear the same rejection script, but this time, things were different. She and her attorney worked closely together and,
ultimately, our client received a fully favorable decision. Social Security began making monthly payments.
Personal Injury
A Picture is Worth....
A 41-year old mentally disabled man was hit by a large vehicle when crossing a street near his home. After he received treatment for head injuries and an ankle fracture,
his guardian contacted David Allen & Associates to obtain personal injury reimbursement. The case was filed with the Sacramento Superior Court and eventually went to
Mediation. At the Mediation, attorneys for David Allen & Associates used a "day in the life" video to show the impact of the injuries on the life of the already disabled
man. His substantial recovery was placed into a special needs trust to cover his future care.
Drinking on the Job
A 45-year old man was hit by a drunk driver while riding home from work on his bicycle. He retained David Allen & Associates to pursue his personal injury claim. Suit filed
with the Sacramento Superior Court first underwent extensive discovery and motion practice to force the driver's employer's insurance to cover the loss. The case next went
to binding Arbitration. At Arbitration, attorneys for David Allen & Associates utilized expert testimony by a neurologist from UC Davis Medical Center to show the function
impairments suffered by the man as a result of his injuries. The Arbitration concluded favorably.
The man's teenage daughter sent David Allen & Associates a postcard from Hawaii to say thank you.
Long Term Disability
Disabled Woman Denied Benefits after Her Policy Purchased by Another Insurance Company
A 48 year old woman, disabled for over ten years due to fibromyalgia and chronic fatigue syndrome, was denied continued benefits after her long term disability
coverage was purchased by Hartford Insurance Company. She appealed the denial, but the company upheld the denial.
The woman retained David Allen & Associates to file an appeal with the Eastern District Federal Court. Ruling was made by the Honorable Garland E. Burrell, Jr.
on April 23, 2008 approving reinstatement of benefits and award of back payments, attorney fees and interest:
"Plaintiff and Defendant filed cross motions under Federal Rule of Civil Procedure ("Rule") 52 for judgment on the administrative record of this Employee Retirement
Income Security Act ("ERISA") action. Plaintiff contends Defendant, who administers Plaintiff's long-term disability insurance policy, improperly denied long-term
disability benefits. Defendant counters that Plaintiff's medical condition does not render her "totally disabled" and therefore she is not entitled to disability benefits.
This Order constitutes the findings of fact and conclusions of law required by Rule 52."
"CONCLUSION
Plaintiff has shown by a preponderance of the evidence that she is entitled to disability benefits since she is "totally disabled" under the Policy. Accordingly,
(1) Plaintiff's Rule 52 motion is granted and Defendant's Rule 52 motion is denied. Judgment on the administrative record shall be entered in favor of Plaintiff. Plaintiff
shall recover all benefits to which she was entitled under the Policy from the date such benefits were terminated in November 2005 to the present.
(2) Plaintiff's requests for attorney's fees and prejudgment interest are granted. The rate of prejudgment interest shall be determined individually for each benefit payment
according to the average accepted auction price for the last auction of fifty-two week United States Treasury bills settled immediately prior to the date each of her withheld
benefit payments became due, pursuant to 28 U.S.C. § 1961(a)."
An Appeal Ignored
A 56 year old man, disabled for two years due to cancer, chemotherapy, spinal injury, and chronic pain, was denied continued long term disability benefits when his status changed
from "Own Occupation" to "Any Occupation" under his insurance policy, despite the fact he was receiving Social Security Disability benefits. He appealed the denial of benefits,
but his appeal was misplaced by the insurance company.
The man retained David Allen & Associates to gain a response from his insurance company regarding his appeal and further work to obtain benefits as necessary.
The insurance company initially refused to reconsider the appeal.
Following filing of suit in the Eastern District Federal Court, the Honorable Lawrence K. Karlton ordered the insurance company to consider the appeal on January 14, 2008.
Attorneys at David Allen & Associates assisted the man with compiling records to supplement the appeal which was finally reviewed by his insurance company.
A New Diagnosis
A 61 year old nurse with a spinal injury and chronic pain was denied continued long term disability benefits when her coverage status changed from "Own Occupation" to "Any
Occupation" under her insurance policy. She was approved for Social Security Disability benefits. She appealed the denial of insurance benefits, but the insurance company upheld
the denial.
The woman came to David Allen & Associates for assistance in pursuing her appeal. After the case was filed with the Federal Court, the woman was diagnosed with a rare hereditary
condition which changed the scope of her disability. Her attorneys at David Allen & Associates filed a motion to have her new medical records added to the closed claim file and
reviewed as part of her disability claim. The court supported the request to have the records reviewed. The court case was stayed to allow the insurance company to re-evaluate
the claim with the new information.
Claim Processing Delay
A once-successful surgeon came to David Allen & Associates for assistance with the long term disability claim he filed nearly two years before. The insurance company had not
approved or denied his claim, but merely requested additional ongoing documentation. His attorneys at David Allen & Associates recommended some specialized testing and
submitted the results to the insurance company. A Mediation was arranged less than one year after he retained David Allen & Associates. At the Mediation, the insurance
company settled for full policy benefits in a lump sum payment.