Disability Claim: Epilepsy
Can an insured be disabled solely from the side effects of medication under a disability insurance policy? The Answer is yes.
Our client was in his 40’s when he had to leave work because of numerous seizures diagnosed by his physician as epilepsy. His disability insurer, Lincoln National life, initially agreed to pay his disability benefits. However, once his physicians were successful in controlling the seizures with multiple antiseizure medications Lincoln terminated his monthly benefit. Lincoln’s termination was supported by the opinions of 2 board-certified neurologists who reviewed our client’s medical records and concluded that he had no work limitations other than to avoid working at heights, around bodies of water and around machinery in case he was to have a breakthrough seizure.
Stennett & Casino sued on behalf of our client and succeeded in convincing the court that the evidence supported the client’s disability. We pointed out that the treating physician who saw our client over several years had a better basis on which to support her opinions than Lincoln’s physicians who had never examined or talked to our client. Though the antiseizure medication succeeded in controlling the seizures that success came with adverse side effects including fatigue and cognitive slowing. The treating physician indicated that his patient would be required to take 3 naps a day of 15 to 45 minutes and his work efficiency would be slowed by his cognitive issues.
Lincoln National’s physicians disregarded the fatigue and cognitive complaints as being merely “subjective” and not supported by any objective testing. However, the court noted that “seeing plaintiff’s physical demeanor and response to questions was critical to determining his reaction to medications and ability to perform work.” Thus the court accorded greater weight to the treating physician who observed his patient’s fatigue verses the physicians who merely conducted a “paper review” and “did not observe plaintiff at all”.
To see the entire court opinion go to Viani v. Lincoln Nat’l Life Insurance Co., 2022 U.S. Dist. LEXIS 146913.