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

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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.

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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.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

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