Graham Harrison, Tourette's syndrome, was that it prevented work on a full-time basis.  He applied for partial disability benefits under a disability insurance of his employer with prudential insurance company of America had.  His treatment by a psychiatrist and specialist for Tourette Syndrome had recommended that he work to less than full time resources have led his schedule to place for his condition, the for chronic anxiety, a broken sleep patterns and agitation.  His doctor felt that a four-day week with a mid week break him immensely would benefit.

Prudential pointed that Please back benefits.  Prudential's position was that, since he had suffered his records with Tourette Syndrome for many years the youngest documented no major change, which would justify a change in the pattern of his work.  Prudential also felt that if he could work four days there was no reason that it five days not could work in the week.

On the first prudential relied on the opinion of the "Medical Director" Jill C. Fallon, m.d., a physician, was board certified in occupational medicine but had absolutely no training in neurology or Tourette Syndrome.  This doctor not even tested the plaintiff.

Prudential have us also with the wrong definition of disability in the claim to deny.

Mr Harrison appealed the refusal of benefits, and additional reports from its included well qualified doctors.  On appeal, prudential of the file showed this at the time, Albert Kowalski, m.d. one from his doctors.  Not only had Dr. Kowalski not board certification in neurology or Psychiatry, he had absolutely no experience in the treatment of Tourette Syndrome, and in fact had no clinical practice since 1987.  Dr. Kowalski did not examine the claimant.  Despite the lack of qualifications and current experience in patients see was really Dr. Kowalski of the opinion that should have improved condition of the claimant in the course of time.

About Dr. Kowalski opinion prudential denied the claim.  To deny the complaint, prudential again cited the wrong definition of disability.  The plaintiffs appeal again and this time consulted with yet an expert in Tourette Syndrome.  He was evaluated by Oliver Sacks, m.d. clinical professor of Neurology at the Albert Einstein College of medicine and associate professor of Neurology at New York University School of medicine.  Dr. sacks had was author of numerous books and articles on Tourette's syndrome.  It was Dr. sacks opinion, that Mr Harrison could maintain its efforts and function very effectively for only two days at a time and then one must be a day break to recover.  He can not on a "standard" five-days-week feature.  From this letter prudential their original decision reversed made and benefits to the claimant.  Prudential but still inappropriate Directive provisions and indeed quoted language which appeared nowhere in the plan.

Two months after approval of the claim of prudential re review of the claim started.  This time, prudential took the position that the applicant's disability psychoneurotic at least in part by a mental disorder or personality caused and that benefits are limited to 24 months.  Prudential advised the plaintiff that its request would most likely end in the next month.

The problem with Prudential's denial of the benefits of this time was that it no 24 months limitation in this policy.

Prudential is also the file Stephen N. Gerson, m.d.  Dr. Gerson board certified in psychiatry and geriatric psychiatry, but listed important professional activity as a "Web management".  There was no evidence in the file, that Dr. Gerson had no experience in the treatment of Tourette Syndrome.  He did not examine the claimant.  It was Dr. Gerson believes that the various doctors and the applicant simply took a "preference" for the work of any five-day week.  Shortly after prudential terminated benefits again.

Mr Harrison action under ERISA.

The Court reversed denial-of-prudential's.  The Court found that "in the worst light, such behavior [misquoting policy provisions] a conscious attempt by prudential to the production of one gives reason for plaintiff benefits."

The Court also ruled that the decision to terminate benefits was not supported by sufficient evidence.  The Court said that some of the information of prudential had ended, that one had passed termination of the doctor's advantages.  The Court ruled that prudential had not left to stop benefits after it had previously approved benefits on the same information to all the new information.  The Court was also for the use of doctors, that does not have experience in Tourette Syndrome and never that of the applicant checks, critical of prudential.

Fairfax, Virginia is lawyer Ben glass doctor, dentists, lawyers and businessman in long term disability benefit claims.

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