Hartford Admits Decision to Deny LTD Benefits to Claimant with Chronic Lyme Disease Was Wrong

Dell & Schaefer filed an appeal with Hartford for a 36 year-old claimant seeking total disability benefits due to Lyme disease and its related physical and cognitive symptoms, such as severe pain, post-infectious autoimmune neuropathy and dysautonomia. As a result of his tick-borne illness and related symptoms the claimant has been unable to perform one or more of the essential duties of his occupation as an Information Security and Business Continuity Manager. “There are very few lawyer across the country that have as much knowledge as Attorney Rachel Alters regarding lyme disease and she did an amazing job to prove our client was disabled,” stated Gregory Dell, managing partner.

Disability Companies Challenger If Chronic Lyme Disease Exist

The ongoing controversy in the medical community regarding chronic Lyme gives insurance companies ammunition to deny LTD claims based on the chronic form of the illness as some physicians do not believe it exists.

Unfortunately, patients stricken with chronic Lyme suffer very serious physical and cognitive issues that have little or no other explanation other than resulting from Lyme disease. There is a vast amount of literature supporting chronic Lyme and the treatment of the same.

Lyme disease is a bacterial illness caused by bacterium called “spirochete.” Certain ticks found on deer harbor the bacterium in their stomachs. Lyme disease is spread by these ticks when they bite the skin, which permits the bacterium to infect the body.

There is currently a controversy about whether Lyme disease can survive antibiotics and become a chronic illness. About 30,000 Americans contract Lyme each year. If the disease is caught early, it is usually cured with a dose of antibiotics. If not caught early, the tick-borne illness can cause a number of problems ranging from rashes to fatigue, migratory joint pain, cardiac issues and neurologic disorders. Patients who continue to have symptoms of Lyme after receiving antibiotic treatment find it very difficult to find physicians to treat their symptoms as well as insurance companies to cover the cost of treatment. If an individual is stricken with Lyme disease and suffering from long-term effects of the illness, it is important to seek out medical treatment from physicians who believe that chronic Lyme does exist.

Often times the laboratory data used to test for Lyme disease is also unclear and inconsistent. It is possible to test negative for Lyme in its early stages as there could be an insufficient number of IgG bands to prove a positive result. In certain situations, a positive IgM test alone, without a positive IgG test does not support a diagnosis of Lyme and would not make the patient a candidate for antibiotic treatment.

In our case, Hartford based its denial of our client’s long-term disability benefits on its incorrect assertion that he did not have chronic Lyme disease, was not disabled and able to perform one or more of the essential duties of his occupation. According to our client’s treating physicians, his laboratory tests, and supporting medical literature, there was no question that he was suffering from the chronic and debilitating effects of Lyme disease as well as the debilitating effects of Syringomyelia (syrinx), post – infectious autoimmune neuropathy and dysautonomia.

Claimant Treated With World Renown Lyme Disease Specialist

Our client treated with a Board Certified Internist with additional training in Pathology and Critical Care Medicine, practicing in Pawling, New York. His physician has been actively involved in diagnosis and treatment of Lyme disease and related disorders since 1988, and has cared for many persons seriously ill with chronic and neurologic Lyme disease. He has published articles on Lyme disease in peer-reviewed scientific journals and has presented poster abstracts and talks at national and international conferences on Lyme disease and other tick-borne diseases. His work has focused on the serious morbidity and (occasional) mortality that can eventuate from this aspect of the illness.

The claimant’s treating doctor’s medical opinion was that he was unable to perform the essential duties of his occupation or any occupation due to several physical and cognitive complications secondary to his diagnosis of Lyme disease. Hartford made a final decision to deny benefits based exclusively on the speculative opinions of their hired physicians, who merely conducted paper reviews of our client’s medical records and failed to examine him in order to determine whether he was indeed disabled. Had Hartford’s physicians examined him, they would have surely realized that he was not malingering and his tick borne illness was in fact debilitating.

Claimant Underwent Neuropsychological Evaluation Demonstrating Cognitive Impairments Due to Chromic Lyme Disease

Hartford failed to consider and even blatantly ignored the vast amount of medical evidence supporting our client’s disability. Hartford also ignored his complex job description as well as his physicians’ opinions that due to pain, tremors, numbness and tingling in his extremities, difficulty ambulating and severe cognitive impairment, there is absolutely no way he could perform the essential duties of his regular occupation. Our client is so ill that at times he is unable to get out of bed for an entire day.

In order to prove the neurological effects of Lyme disease, our client underwent a neuropsychological examination. According to the neuropsychologist, the Claimant was diagnosed with Lyme Disease in 2/2011 and testing was positive for numerous tick-borne diseases; he underwent a course of IV antibiotics for his medical condition. He also had a history of cervical spine disc disease secondary to an accident with C5/6 cervical fusion. According to the neuropsychologist, the testing results found variable orientation with poor mental control. Visual and verbal auditory memory was moderately to severely impaired and overall Performance IQ was in the borderline range. He demonstrated difficulty with functional calculation ability and basis writing and spelling. Self report found he was moderately to severely depressed and there was no indication of attempts to exaggerate or malinger responses. Based on the above-described impairments, and within a reasonable degree of neuropsychological certainly, these deficits were causally related to a combination of physical and psychological deficits associated with Chronic Lyme Disease, as well as Chronic Pain secondary to cervical injury. In his professional opinion, our client was not capable of return to full-time competitive employment as an Information Security and Business Continuity manager, based on his current level of cognitive impairment.

After reviewing the objective evidence provided by attorney Alters of Dell & Schaefer in support of our client’s disability, Hartford reversed its decision to deny his LTD benefits, paid his past benefits and reinstated his monthly benefits. Attorney Alters will continue to manage his claim in order to help prevent future claim denial.

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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.

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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.

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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
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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.

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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.

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Reviews   *****

Glen P.

Simply The Best. I chose Dell & Schaefer after watching several videos that Greg had made and I also checked his reviews. I contacted him through his website and within 1 hour Greg called me on a Sunday afternoon. We discussed my medical issues and how they were rapidly damaging my abilities to continue my dental practice of 32 years. He told me that he would handle my case himself. I asked for names of dentists that he had represented. I spoke to 3 and they all said hire Greg ASAP. I had 3 specialists who recommended that I stop practicing but I had a tough time dealing with losing my practice of 32 years. I was dealing with depression and anxieties due to my reduction in hours along with knowing that my disability insurance company had a bad reputation of denying legitimate claims. Greg had a way of calming me down and he told me he had dealt with my company hundreds of times. He was not at all intimidated. He said that he was going to help me and was confident that we would win. Greg guided me through the entire process and it was completed in the time frame he said it would be. He and Vanessa returned all my calls and emails rapidly.

I would think of questions on weekends or late at night and he would always return my emails and calls. Once everything was into the insurance company they had an inexperienced claim consultant on my case that was challenging my disabling conditions. Greg fired off a letter giving them 5 days to make a decision. They moved my case up the ladder to a “lead” consultant and within 2 days we had the approval letter. He was also able to collect a period of partial disability, my business overhead expense policy, get me deemed totally disabled get my three insurance premiums refunded to me. We also received all past due benefits for the maximum monthly payment for the past 8 months since I stopped working. Greg continues to handle my claim and thankfully he will always be on my claim until my policy expires.

My family will be thankful to Greg, his assistant Vanessa and their entire team forever.

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