Long Term Disability Law Blog
John A. Stremlau and his disability lawyers filed suit against Prudential Insurance Company of America and Anheuser Busch Companies, Inc. in the United States District Court, Eastern District of Missouri under ERISA to petition the Court for recovery of disability benefits he is due via his employee insurance program with his employer Anheuser Busch Company, Inc. In the disability insurance lawsuit, Stremlau’s disability attorneys outline and provide evidence of claims that Prudential and Anheuser Busch breached their fiduciary duties by denying Stremlau his benefits and asks the Court to order Prudential and Anheuser to provide Stremlau with his disability benefits and compensate him for Court costs and attorneys’ fees.
Background of the Plaintiff John A. Stremlau
A resident of St. Louis, Missouri, Stremlau worked for twenty-three years at Anheuser Busch as a full time employee until December 1, 2008. Stremlau had worked for Anheuser since October 7, 1985 up until he became disabled in 2008, at which time his job title was “Labor Planner/Scheduler.” During Stremlau’s time of employment with Anheuser, he was covered under an employee benefit plan administered by Prudential Insurance Company of America.
According to the Social Security Administration and his treating physician, Stremlau is permanently and totally disabled and cannot work at any meaningful job. Stremlau’s disability stems from a variety of physical and mental problems that include:
- high blood pressure;
- diabetes (type 1 for 27 years)
- celiac spruce disease;
- severe degenerative disc disease;
- arthritis in his hips and elbows;
- stress, depression, and anxiety;
- surgery complications from various surgeries including rotator cuff surgery, keen ligament surgery, and meniscus surgery;
- depression and psychological distress;
- memory, concentration, mood and other cognitive impairments form the medications he must take to control his physical and mental issues
- behavioral impairments; and
- physical handicaps that limit his ability to sit, drive and stand for any length of time
Even though Stremlau has the medical records to back up his claim, Prudential and Anheuser initially denied his September 23, 2009 application for disability insurance benefits because he applied before the 12-month waiting period as specified in his employee benefits plan. So, on December 29, 2009, after meeting the 12-month stipulation, Stremlau requested benefits again and was denied again. He then appealed the Prudential disability claim denial on May 5, 2010 and was denied his ERISA appeal 90 days later.
After the denial of his appeal, Stremlau requested that Prudential and Anheuser send him a copy of the Prudential Plan and also requested additional time to supplement his file. He was granted the additional time, but Stremlau never received a copy of his Plan from either Prudential or Anheuser. These requests were made on July 29, 2010, in November 2009, and again in March 2010. In the meantime, Stremlau provided Prudential and Anheuser with verified medical records that state that Stremlau has been diagnosed with the many impairments, the effects of which include, to name a few, chronic pain, chronic sleep deprivation, diabetes complications, significant weight loss, severe weakness, limited mobility, inability to sit for long periods of time, inability to stand, bending and squatting limitations, inability to perform any tasks for gainful employment, various muscular and bone degenerative conditions, depression, and need for pain and anti-inflammatory medications. Basically, Stremlau’s impairments coupled with treatments for his numerous afflictions has made it impossible for him to function in any job.
After Prudential denied Stremlau his third appeal, Stremlau was forced to file a lawsuit seeking payment of his disability beenfits.
Background of Defendants in this Case, Prudential Insurance Company of America and Anheuser Bush
As for the defendants in this case, we find that they do not claim that Stremlau isn’t covered, but rather, they deny his claim because according to the insurer, documentation does not support the premise that Stremlau is disabled for the remainder of his life. Prduential claims that Stremlau was able to work in his regular job from December 2, 2008 until December 2, 2009 and that while he may not be able to do that job now, he can engage in some form of gainful employment. Prudential’s stance is that Stremlau can work in a sedentary position, and it ignores Stremlau’s physician’s opinion that Stremlau is weak, has muscle loss and is likely permanently and totally disabled as a result of celiac spruce disease.
Even after Stremlau provided corroborating documentation from his medical records of his impairments, Prudential and Anheuser have inferred that Stremlau can “maintain a balance . . . with periodic aggravations.” The defendants ignore Stremlau’s doctor’s opinion and instead focus on their opinion that Stremlau has managed to work with his many ailments for years and can continue to do so. Instead of offering proof that Stremlau can continue to work, Prudential and Anheuser, according to Stremlau’s disability attorneys, base their decision to deny Stremlau disability benefits on conjecture and speculation, not facts.
In addition, Stremlau and his disability attorneys point out in the subject complaint that Prudential and Anheuser disregarded that the Social Security Administration had stated that Stremlau is disabled. Consequently, Stremlau’s attorneys state in his complaint that Prudential and Anheuser have arbitrarily and capriciously denied Stremlau’s disability benefits based on an invalid review of his well-documented medical records.
Consequently, Stremlau’s disability attorneys have accused Prudential and Anheuser of acting in bad faith and breaching their fiduciary duty to Stremlau as well as operating under a conflict of interest as Prudential, being the decision-maker and the money-provider as to Stremlau’s disability benefits award has a bias toward denying Stremlau his $100,000.00 claim.
What Stremlau and His Disability Attorneys Are Asking For
When Stremlau ceased working due to his disability, he earned $58.900.00 per year. In his complaint, he asks for an amount in excess of $100.000.00 plus interest, attorneys’ fees, and a punitive award, since Prudential and Anheuser didn’t provide Stremlau with a copy of the Plan or policies, which precluded him from filing his disability claim as prescribed by that Plan. Federal law requires that a claimant have full access to a copy of his/her disability insurance plan in order to properly apply for disability benefits.