Administrative Appeal by Dell & Schaefer Helps Disabled Man with Eye Disorders Get Approved for Short Term Disability Benefits with Hartford; Long Term Benefits Next

This Dell & Schaefer client came to us after being denied short term disability benefits by Hartford under the Omnicare, Inc. Short Term Disability (STD) Plan. Prior to hiring us, this client was forced to leave his previous occupation on May 31, 2014 due to severe eye disorders. His conditions included: Chronic Bilateral Advanced Stage Macular Degeneration, Bilateral Nuclear Sclerotic Cataracts, Bilateral Dry Eyes, and Bilateral Choroidal Neovascular Membranes. Additionally, he also suffered from Bilateral Carpal Tunnel Syndrome, status post release, and Hypercholesterolemia. These conditions prevented our eventual client from performing the essential duties of his prior occupation as a Clinical Manager for Omnicare and the same conditions left him earning less than 20% of his pre-disability earnings.

Hartford initially ruled that our client should be approved for benefits and paid him from early June 2014 through July 11, 2014. By way of a denial letter dated August 6, 2014, Hartford informed our client that it had made a decision to terminate his claim and that no benefits would be paid beyond July 11, 2014. In the aforementioned denial letter, Hartford stated that “(w)hile we understand that you may be experiencing subjective symptoms, this in or itself does not reflect a functional impairment of such severity that it would prevent you from performing the essential duties of your occupation as a Clinical Manager.” Hartford’s decision could not be further from the truth.

Claimant Hired Dell & Schaefer

After being unsure of what to do, the claimant finally contacted a Disability Insurance Attorney at Dell & Schaefer in Mid-December of 2014. Attorney Alexander Palamara quickly took on the case as time was of the essence as the Employee Retirement Income Security Act of 1974 (ERISA) only provides for 180 days to file an administrative appeal to challenge the denial. It must be mentioned that if a timely ERISA appeal is not filed, a claimant will likely lose any right they have under the policy for further benefits and they will be unable to file an ERISA lawsuit.

Administrative Appeal filed by Dell & Schaefer

Dell & Schaefer quickly secured the administrative record from Hartford as well as medical records from our client’s treating physicians. This documentation gave us the tools needed to prove to Hartford that its decision to deny additional benefits was blatantly false. A timely administrative appeal was filed. In the appeal, we first noted the various errors of Hartford’s reviews. We then showed the seriousness of our client’s eye conditions, the objective findings found in his medical records, the strong support of his treating Ophthalmologist, as well as occupational requirements of his prior occupation which required visual acuity which our client clearly lacked. We left Hartford with no alternative but to reapprove our client’s claim.

Four weeks after the administrative appeal was filed, Hartford sent a letter that stated that it had determined that our client continues “to be Totally Disabled as defined in the STD Plan through the exhaustion of his STD benefits.” A few weeks after that letter, a benefit check was received for the remainder of the Short Term Disability Benefit period of July 12, 2014 through November 28, 2014. Though our client is completely satisfied with the outcome of the appeal, we have already moved forward with securing Long Term Disability benefits for our client. Although such claim is currently pending, we foresee such benefits being approved in a very timely manner. If not, Hartford knows a fight will ensue for what is rightfully owed to our client.

If you have been denied Short Term Disability Benefits and will need Long Term Disability benefits, please do not hesitate to contact the Attorneys at Dell & Schafer for a free consultation.

Useful related information on our website:
Carpal Tunnel Syndrome disability claims
Eye Disorders disability claims

Questions About Hiring Us

Do you help Hartford claimants nationwide?

We represent Hartford clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Hartford disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Hartford. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Hartford.

How do you help Hartford claimants?

Our lawyers help individuals that have either purchased a Hartford long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Hartford:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Jim F.

My employer offered both Short Term Disability and Long Term Disability insurance as optional benefits among others. The premiums were significant, but since they could be payroll deducted I felt they could be reasonably managed and the security of continued income in the event of a medical disability was well worth the investment. As with the purchase of a first aid kit, most would prefer never having to use it.

I have been very fortunate to have had few illnesses or injuries throughout my life and more specifically my 45 year career as a healthcare professional. It wasn’t until early in 2012 that I was diagnosed with a chronic, progressive disease of the eye. Symptoms were minimal at that time, though regular visits to a retinal specialist, including regular therapy by ocular injection, were necessary to slow its progression, the symptoms did not appreciably interfere with my work. In spite of my treatments the condition continued to progress. In early 2014 the symptoms began to interfere dramatically with my day to day duties. My job required significant computer use and the reading of copious amounts of medical documentation. It became evident to me that I could no longer meet the expectation of my management and clinical position without working frighteningly long hours and enduring the relentless eye strain and other symptoms related to the illness.

Though I had always planned for eventual retirement from my full-time position, like most professionals I had hoped to be able to continue to practice my profession on a part-time basis throughout my retirement as long as I remained competent and able. That was not to be. Thankfully, I had the foresight to elect the disability benefit options offered by my company and have the premiums payroll deducted for many years. I notified my supervisor and HR representative that I had to stop working due to my condition and proceed with the disability application process.

All went very well and after using up my accrued vacation and sick time, my short-term disability benefits commenced. Since my condition is progressive and incurable I felt secure in knowing that once my short-term benefits were exhausted my benefits would continue under the long-term policy. However, much to my surprise, after receiving about a month of benefits I received notification from the insurance company that a decision had been made to terminate my benefits due to lack of objective medical evidence to support my claim, though significant documentation had been provided by my retinal specialist.

I was bewildered and unsure of how to proceed with an appeal of that decision. Since I had 180 days to do so, I decided to research the matter thoroughly. In spite of my being a veteran healthcare professional everything I had been reading on the subject cautioned about attempting to proceed with an appeal on my own. Legal representation was highly recommended.

I then began a review of local attorneys, hoping to find one that provided enough documentation on their website that indicated experience with non-social security disability related cases. I was also interested in seeing evidence of some experience with disability cases related to diseases of the eye and resultant vision impairment. I was unsuccessful.

So I expanded my search to include national law firms. It was then that I discovered Dell & Schaefer. After thoroughly reviewing their website, watching many of the video discussions, noting experience with vision related cases, particular documentation related to the insurance company that handled and then eventually denied my benefits, and reading a significant number of testimonials, I decided to request a free consultation as advertised. It was one of the best decisions I have ever made.

After that consultation, I was very confident that I was in very skilled hands which alone reduced my anxiety level immensely. Attorney Alexander Palamara and his Legal Assistant, Kathleen Bordes, immediately began managing my case, their professional expertise clearly evident.

They worked closely with my retinal specialist, my optometrist and the insurance company in compiling the medical documentation necessary for a successful appeal in an amazingly short period of time, keeping me fully informed all along the way. Shortly after being notified by the insurance company that my benefits would be reinstated and paid through the full term of my short-term policy I received a lump-sum payment.

Once the short-term disability appeal was successfully completed, Alex and Kathy immediately addressed the long-term policy benefits. Again in a remarkably short period of time I was granted those benefits, receiving a lump-sum payment for benefits to date and will receive a payment monthly going forward per the terms of my LTD policy.

I am extremely pleased with how my case was handled and the very favorable outcome. Alex and Kathy were a delight to work with and extremely professional in every way. Incidentally, the fee I paid to Dell and Schaefer for their incredible representation was very reasonable and very well earned.

I highly recommend the services of Dell & Schaefer to anyone who may find themselves in a similar disability-related situation.

***** 5 stars based on 202 reviews

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