Citations/assistance requested: LTD Claim involving Fibromyalgia and C

[Guest rdrenfro]

A TPA, an insurer, who has discretionary authority under the plan to decide benefit claims, effectively denied a 47-year old participant's Group LTD Claim for "disability benefits" based on its restrictive determination that the chronic pain disorder associated with a physical disease (i.e., Fibromyalgia, Reflex Sympathy Distrophy, and Myofascial Pain Disorder with "trigger points") suffered by the participant qualified as a "mental disability" only, and not "mental and physical disability". This restrictive finding allowed the TPA to trigger contractual entitlement to 24 months coverage, as opposed to LTD benefits payable until age 65. I need help in finding applicable case law and other documentation that my tend to refute the TPA's analysis and conclusions to lend weight to a court's application of de novo review. Thanks for prompt replies.

------------------