The Hartford Reverses Termination of Benefits on Appeal for Client in Florida
Our client, located in Florida, came to our firm after his long-term disability (“LTD”) benefits were terminated. The Hartford determined that our client was not disabled from his own occupation as a procurement engineer or from any occupation and thus, benefits were no longer payable. He had been paid benefits for 20 months before The Hartford terminated his claim.
Our client suffers from multiple conditions including a history of prostate cancer (with ongoing treatment), chronic neck and back pain, and small fiber neuropathy. When The Hartford conducted the review that led to its termination decision, The Hartford looked only at our client’s diagnosis of neuropathy. Such a limited view of his overall functionality led to the incorrect claim determination.
In his appeal letter, we discussed each of our client’s medical conditions in detail. Because of the complexity of the condition related to our client’s prostate cancer, we conducted a sworn statement with our client’s physician. This allowed the physician to discuss, in detail, how our client’s ongoing cancer treatment (despite no sign of active cancer), produced side effects that are disabling.
In addition to including comprehensive evidence discussing his medical conditions and the restrictions and limitations they caused, we also pointed out where The Hartford’s review fell short. For example, The Hartford conducted an occupational analysis, but failed to account for the actual level of training and education of our client. This was a critical mistake.
Also, The Hartford sent a number of forms to our client’s treating physicians, often overwhelming them with requests for responses. In multiple instances, our client’s doctors had been sent three forms to fill out in a three-month period. Each of the forms was slightly different and some were misleading. One form that had been sent to his doctors listed options for his level of functionality including sedentary, light, medium, and heavy. There was no option for less than sedentary capacity. Our appeal letter pointed out the multiple issues with these forms and corrected any misconceptions about his treating physicians’ opinion regarding his disability.
Finally, our appeal letter pointed out that The Hartford had been dishonest when speaking with our client. When it first began reviewing our client’s claim, The Hartford contacted him to let him know and indicated a decision would not be made until September. Our client informed The Hartford he would be moving and would require time to set up care with new physicians. He indicated that this new care would be established by September when The Hartford would be reviewing his file. Seemingly acting opportunistically, The Hartford terminated our client’s benefits in July instead of September knowing he was in the process of moving.
Our firm worked closely with our client to create and execute a plan for his appeal. Due to the complexity of his medical issues, we knew we would need to seek out the guidance and knowledge of his treating physicians. The sworn statements we conducted allowed us to get an in-depth understanding of our client’s conditions.
This type of individualized attention to your case is what we pride ourselves in. Call our firm if you are looking for an attorney to help with your appeal.