There are times when mental health disorders can escalate to the point at which it becomes necessary for someone to stop working for an extended period of time or cease working altogether at the direction of a treating physician. Sometimes mental health disorders coexist with other disabling conditions, but mental disorders can also be the primary cause that prevents a person from carrying out the material duties of his or her occupation with reasonable continuity.

Such is the case with John Messer of Madison County, North Carolina. Mr. Messer, with the help of his North Carolina disability attorney, has filed a civil complaint against Prudential Insurance Company of America (Prudential) under the Employee Retirement Income Security Act of 1974 (ERISA) in United States District Court for the Western District of North Carolina in the Asheville division.

Mr. Messer stopped working as a repair technician for Thermo Fisher on or about March 10, 2010 due to a combination of mental health disorders including severe depression, severe persistent anxiety, and possibly obsessive-compulsive personality disorder. During the course of his treatment, Mr. Messer obtained the opinions of his treating family physician – Dr. Marianna Daly, treating psychiatrist – Dr. Mary Berg, and treating therapist –Judy McClung, MA, LMFT. All three of them noted that Mr. Messer was unable to perform the material duties of his occupation since May 10, 2010 and would be unable to perform his duties indefinitely as result of his mental health. With the three concurring on Mr. Messer’s mental health preventing him from working with reasonable continuity, Mr. Messer filed a short term disability claim with Prudential which was subsequently approved for payment through August 15, 2010.

In a letter dated September 21, 2010, Prudential notified Mr. Messer that he would not be receiving any further short-term disability benefit payments and that his long-term disability benefit claim had been denied. Prudential alleged that “the medical documentation fails to provide evidence of a functional impairment of sufficient intensity and severity as to preclude you from working.”

Naturally, Mr. Messer appealed Prudential’s decision. Prudential upheld its decision on November 22, 2010 stating, “[T]here was no evidence of a functional impairment or a psychological or cognitive impairment that would have prevented you from performing your regular occupation beyond August 15, 2010.”

Mr. Messer appealed Prudential’s decision a second time. Again, Prudential upheld its decision to deny Mr. Messer the remainder of his short-term disability claim and all of his long-term disability benefit payments via a letter to him on January 19, 2011.

Mr. Messer contends that he has met all the necessary requirements and conditions for submitting his claim for short-term disability benefits and long-term disability benefits. Mr. Messer alleges that Prudential has failed and neglected to pay all of the disability benefit payments he is owed as result of his being disabled.

Since Mr. Messer exhausted all of his administrative remedies to seek approval for his disability benefit claim, the only option available to him was to file an ERISA complaint against Prudential and his employer, Thermo Fisher.

Mr. Messer asks the court to find in his favor in order to compel Prudential to:

  • pay the remainder of his short-term disability benefits
  • pay long-term disability benefits to him
  • pay for all costs associated with the litigation
  • provide other such relief as the court deems just and proper