Claim: Erie woman wrongfully denied disability benefits during mental breakdown

By Jim Boyle | Jul 3, 2014

An Erie County woman says her company wrongfully denied her short-term disability

payments while she suffered a complete mental breakdown, according to a federal suit filed in the U.S. District Court for the Western District of Pennsylvania.

Donna Cramer, of Erie, says that GE Transportation, a division of General Electric and her employer for more than 40 years, followed the advice of its independent physician who misinterpreted notes from her personal doctor. She seeks full payment of approximately seven months of denied benefits from GE Transportation and Metropolitan Life Insurance Company.

According to the claim, Cramer worked for GE while diagnosed with chronic depression and anxiety. On June 27, 2012, she suffered a complete mental breakdown that forced her to miss work between June 28, 2012 and May 27, 2013, the suit says.

She filed for disability benefits and received payments for the period between June 28 and Nov. 5, 2012, but was denied from that point until her return to the job on May 28, 2013. After three appeals, the benefits administration board ultimately ruled against Cramer, saying she lacked medical necessity to support the claims.

The complaint says that GE arrived at the determination by misinterpreting an April 26, 2013 evaluation from its own third-party consultant, who said that Cramer worked as the caregiver for her two adult children. Cramer says the defendants disregarded a clarification that she submitted, which said that the consultant mistook her role as a parent for that as an active caregiver. She explained that Cramer's children live independently and do not rely on her financial support.

According to the claim, the consultant also wrongfully assumed that Cramer sought to retire when, in fact, the plaintiff had received multiple opportunities to accept a retirement package from GE but declined.

"I had the opportunity to retire approximately four years ago," wrote Cramer in an affidavit. "I elected to pass on GE's retirement package in order to continue working. I did not want to retire then and I have no desire to retire at this time. I love my job and I continue to need the income to pay my expenses."

The plaintiff is represented by Erie attorney Edward Betza of the Elderkin Law Firm.

The federal case ID number is 1:14-cv-00183-JFM.

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