Kaiser's Disability Plan Denied Claim on Selective Evidence, Man Claims
LOS ANGELES (CN) - Kaiser's disability plan failed to pay long term disability benefits to a covered employee, he claims in a complaint filed in the USDC Central District of California.
Everett McMahon has sued Metropolitan Life Insurance Co. and Kaiser Permanente Welfare Benefit Plan for past and future payments, under the Employee Retirement Income Security Act.
The plaintiff claims that the plan ignored the documented medical history and diagnoses available for the opinion of a doctor who had not seen the plaintiff. "METLIFE ignored the obvious, combed the record and took selective evidence out of context as a pretext to deny plaintiff's claim," the compliant says.
The plan did not have the plaintiff independently examined, and classified the plaintiff as a "sedentary" employee, based "strictly upon physical requirements" without considering the "non-exertional requirements," "such as sustained concentration and attention to detail, along with working with the public to provide assistance and care," for plaintiff's usual occupation as a psychology assistant, or for any other occupation, according to the complaint.
The plaintiff is represented by Frank N. Darras, Lissa A. Martinez, Susan B. Grabarsky; Phillip S. Bather of DarrasLaw in Ontario. Calif.