Hartford Disability Denial of Insurance Agent with Fibromyalgia and Chronic Fatigue is Reversed
A Utah Federal Judge reversed a Hartford long term disability insurance benefit denial on the basis that it was “unreasonable and, thus, arbitrary and capricious”. The judge’s opinion in this case is a great victory for disability insurance claimants disabled by Fibromyalgia or by Chronic Fatigue Syndrome. Additionally, the Judge that decided this case should be commended for seeing through Hartford’s bullshit review of the file and taking the time to actually understand the Plaintiff’s inability to work.
The plaintiff in this case was a 60 year old male, previously employed by Van Gilder Insurance Company as a health insurance salesperson. The Plaintiff initially filed and was approved by Hartford for Short term and long term disability benefits in Jun 2006. Approximately 3.5 year later, Hartford denied the claimant’s benefits in February 2010, which was a few months after the definition of disability changed from “own occupation” to “any gainful occupation”. Hartford relied on the following information in order to deny the long term disability claim:
- Six non consecutive days of video surveillance (one day had the claimant playing golf for 4.5 hours)
- Three different file medical reviews by doctors hired by Hartford
- Hartford sent a representative to the Claimant’s house to interview him
- Hartford had their hired doctors call and speak with three of the claimant’s treating physicians; and
- Hartford sent the video surveillance to the treating doctors asking if they though the claimant’s medical condition was consistent with the video surveillance. (One of the claimant’s treating doctors responded that he thought the claimant could work 40 hours a week based upon his activities in the videos.)
The claimant and his Utah disability attorney filed an ERISA lawsuit against Hartford. After several month of litigation the Plaintiff won! The Utah Court’s primary basis for reversing Hartford’s denial was that Hartford should have exercised their right to have the Claimant physically examined by a doctor of their choice. The judge stated,
The Court recognizes that physical examinations are not requisite in all cases for an insurer’s decision to be reasonable. But the Court also considers Defendant’s decision to conduct file reviews rather than a physical examination as another factor in the overall assessment of whether Defendant acted reasonably. Calvert, 409 F.3d at 295. In Calvert, the Sixth Circuit Court of Appeals stated, “while we find that [Defendant’s] reliance on a file review does not, standing alone, require the conclusion that [Defendant] acted improperly, we find that the failure to conduct a physical examination… may, in some cases raise questions about the thoroughness and accuracy of the benefits determination.” Id. The Court finds this reasoning applicable to the current case.
The Utah court discussed that Fibromyalgia and Chronic Fatigue are subjective medical conditions and stated,
Fibromyalgia and Chronic Fatigue Syndrome, are problematic for insurers and courts evaluating disability claims because proving the diseases is difficult given the subjective nature of the symptoms. See Welch v. UNUM at 1086, 87 (citing Walker v. Am. Home Shield Long Term Disability Plan, 180 F.3d 1065, 1067 (9th Cir. 1999) (“Because proving the disease is difficult… fibromyalgia presents a conundrum for insurers and courts evaluating disability claims”). Compare Jordan v. Northrop Grumman Corp. Welfare Benefit Plan, 370 F.3d 869, 872 (9th Cir. 2004) (“[F]ibromyalagia’s cause or causes are unkown, there is no cure, and, of greatest importance to disability law, its symptoms are entirely subjective.”); Hawkins v. First Union Corp. Long-Term Disability Plan, 326 F.3d 914, 919 (7th Cir. 2003) (noting that fibromyalgia “itself can be diagnosed more or less objectively by the 18-point test …but the amount of pain and fatigue that a particular case of it produces cannot be”); with Boardman v. Prudential Ins. Co. Of Am., 337 F.3d 9, 16 n. 15 (1st Cir. 2003) (“While the diagnoses of chronic fatigue syndrome and fibromyalgia may not lend themselves to objective clinical findings, the physical limitations imposed by the symptoms of such illnesses do lend themselves to objective analysis”).
Fibromyalgia disability claims are often challenged by disability insurance companies. In the past few years the condition has become more recognized and Court’s are coming down on disability insurance companies that do not give fair weight to the diagnosis. Our disability attorneys have represented hundreds of claimants disabled by fibromyalgia and understand the disabling effects it has on a person’s ability to work 40 hours a week.
The court discussed Hartford’s wrongful reliance on on 6 days of video surveillance. The court stated that Hartford had paid the claimant for more than three years and the video surveillance did not prove that either the claimant’s medical condition had improved or he was capable of working 40 hours a week. The video surveillance did not reveal any new information about the claimant and was not substantial evidence supporting the insurance company’s decision to terminate benefits. The court specifically stated that 4.5 hours of golf out of 6 days of surveillance “is not substantial information regarding Plaintiff’s ability to maintain a full time job.” The court also states that people receiving disability insurance should not be dissuaded from leaving their homes for fear of losing their benefits.
You can read the Court’s 19 page full opinion by clicking here (PDF).
Resources to Help You Win Disability Benefits
Disability Benefit Denial Options
Submit a Strong Hartford Appeal Package
We work with you, your doctors, and other experts to submit a very strong Hartford appeal.
Sue Hartford
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Hartford.
Protect Your Benefits
Get Your Hartford Disability Application Approved
We help claimants throughout the entire application process.
Prevent a Hartford Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.
Negotiate a Hartford Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Hartford Reviews
(656)
Policy Holder Rating
5
0%
4
0%
3
1%
2
50%
1
48%
Timely Payments
1.9out of 5
Handling Claim
1.9out of 5
Customer Service
1.8out of 5
Dependable
1.8out of 5
Value
1.9out of 5
Showing 8 of 656 Reviews
Hartford
Truly Horrible and Immoral Company with No Customer Service
My experiences with Hartford have been nothing short of cruel. They started off by claiming that having Glioblastoma, which has an expected life span of about fifteen mont... read more >
Hartford
Sent my Direct Deposit to a Strangers Bank Acct
I went on short term disability and The Hartford put my direct deposit into someone else’s bank account. Somehow they messed up a number or two and they are refusing to ... read more >
Hartford
Former Hartford employee has had life insurance and accidental death policy's revoked for one late premium payment
Dislike how they are constantly interrupting the lives of their disabled EE's whom are entitled to benefit which they paid into out of there pay check every pay period onl... read more >
Reply
Hartford
Bad Faith
They kept asking my doctor for the same information that they did not need to process my claim. He kept sending in the same information, and they kept asking for it. My do... read more >
Hartford
Denied by Hartford after 20 years of Payments
Hello,I am a Multiple Sclerosis patient. I also have Lymph-edema, Asthma, Blood-clot problems, Bi-Polar 1 Depression, and Head & Neck Injuries. And now, due to MS, Spast... read more >
Hartford
This company is a scam!
The Hartford does not pay claims. The Hartford only collects premiums. The Hartford doesn’t care if you are terminally ill. I’ve been employed at my employer since 201... read more >
Hartford
Hartford Stopped Payments
Worst company ever. Their analysts will go against your treating provider every single time. Horrible experience, just horrible.
Answered Questions by Our Lawyers
(72)
Showing 8 of 72 Answered Questions
Q: Does Hartford reduce their monthly LTD payments after 30 months?
A: Usually there's a change in definition after 24 months. The fee reduction would come from any offsets due to s... Read More >
Q: Can The Hartford offset my LTD on my VA disability compensation or back pay?
A: Tim, the Policy will define what other sources of income can offset or reduce your monthly benefit. Not all Po... Read More >
Q: Can Hartford lower my long term disability check if I take my money out of my Vanguard account?
A: Thank you for your question. Hartford may be able to reduce your monthly benefits and seek an overpayment if y... Read More >
Q: Relocation
A: Thanh:Moving within the USA should not impact your claim. You must make sure that you continue with your m... Read More >
Q: Is it possible to write me a strict authorization form for The Hartford?
A: It would be best for you to tell Hartford to send you a release for any specific items that they want. You can... Read More >
Q: Denied by Hartford for Long-Term Disability Benefits
A: Darlene: You certainly want to appeal their denial. I suggest you contact our office and speak with one of the... Read More >
Q: Disability company dropped my monthly benefits
A: Since you went back to work full time you would not qualify for further benefits. You could file a new claim i... Read More >
Q: The Hartford stopped monthly benefits for repayment due to an overpayment. Once monthly benefits end do I still have to repay remaining overpayment balance?
A: Yes, you will still be responsible for the overpayment even if your Hartford benefits end. Read More >
Helpful Videos
(908)
Showing 12 of 908 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips
Does Hartford Pay Disability Insurance Claims?
At Dell & Schaefer, we get questions about Hartford long term disability policies on nearly a daily basis. As one of the biggest names in insurance, Hartford is a well-oiled machine when it comes to processing (and, sometimes, denying) disability claims. Learn more about what it's like to appeal Hartford's denial of your claim for long term disabili... Read More >
How Does Hartford Long Term Disability Work?
The most common questions for a disability attorney involve understanding how disability coverage actually works. When it comes to The Hartford long-term disability insurance policies in particular, there are a lot of searches for that type of information. It’s a broad question, but one that we’re well-equipped to answer at disability insurance law firm Dell... Read More >
What Happens If My Hartford Short Term Disability Claim is Denied?
Understand your rights once your Hartford short term disability income claim has been denied. In this featured article and video gain insights into:Hartford DeadlinesAdministrative Appeal - What Is It?Administrative Appeal ProcessBenefits of Hiring A Disability Insurance AttorneyGREGORY DELL: Hi. I'm attorney Greg Dell, here with Stephen. A... Read More >
How Long Does a Hartford Short Term or Long Term Disability Claim Last?
Hartford disability income policy holders expect Hartford to pay their Short Term & Long-Term disability insurance benefits, if continuously disabled, until the policy holder’s social security retirement age. That isn’t always the case. In this video and article learn about:What is the length of your elimination period and the length of your be... Read More >
If I Convert my Former Employee Disability Policy to a Private Policy Does ERISA Govern?
Many employer welfare benefit plans offer employees who quit their employment the option of converting their disability insurance plan to a private plan. When a claim for disability benefits is filed, there may be a dispute over whether the conversion plan is governed by ERISA. If so, then ERISA preempts any state law claims a plaintiff may have. If not, the conversion policy is a private&n... Read More >
Is the Hartford Disability Purchase of Aetna Bad for Aetna LTD Policy Holders?
In October 2017 Hartford Insurance company agreed to purchase the disability and life insurance division of Aetna insurance company for 1.45 billion dollars.In this video nationwide long term disability insurance attorneys Gregory Dell and Stephen Jessup discuss what impact they believe this sale will have on Aetna long term disability policy holders.Con... Read More >
Hartford Disability Claim Problems
Hartford is requesting long term disability claimants to provide additional documentation from their attending physicians and additional claimant statements more often than usual. Additional documentation is typically requested as a claimant nears 24 months of payments and there is a change in the definition from the own occupation to the any occupation.In t... Read More >
How Can I Protect Myself At A Hartford IME Exam?
In this video, disability insurance attorneys Rachel Alters and Cesar Gavidia discuss what you can expect at an IME exam requested by The Hartford disability insurance company. The information they discuss is applicable to an IME exam requested by most disability insurance companies.You need to take extreme precautions if your have been requested to attend o... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases
Nurse With Knee and Back Disorder Wins Hartford Disability Appeal
We represent a General Duty Nurse who was denied long term disability benefits as Hartford improperly determined that she was able to work her medium duty job on a full time basis. The medical and occupational documentation submitted with her appeal that we filed on her behalf, as well as the documentation and evidence previously submitted by her physicians, cle... Read More >
Executive Director with Meniere's Denied Long Term Disability Insurance Benefits By Hartford
Our client, came to us when he was unjustly denied his claim for LTD benefits by Aetna, now Hartford, asserting that his medical records did not demonstrate “a consistent inability to perform [his] sedentary occupation”. Aetna abused its discretion in reaching this determination as its decision was not only wrong but arbitrary and capricious and was not based on a fu... Read More >
A Hartford Disability Benefit Lawsuit Victory for Truist Banker with Lupus
Our client found us after she was denied continued disability insurance benefits by the Hartford. Unfortunately, by the time she found us, she had already filed an appeal, which was unfortunately denied. This left her with a final avenue of filing an ERISA lawsuit in Federal Court, a task we never shy away from.Her story was an interesting one. In fact, h... Read More >
Hartford Denies Disability Benefits To Home Depot Employee 3 Weeks Before Change of Disability Definition
Our client was a former in-store merchandising associate responsible for the movement of merchandise, display set up, signage installation, inventory and merchandising strategies who went out on disability due to mental health conditions as well as physical medical conditions related to chronic back pain, SI joint pain and hip pain that potentially required repl... Read More >
Hartford Denies Long Term Disability Benefits After Paying for 22 Years
It is crazy that Hartford denied long term disability benefits to our client after paying for 22 years. Client initially went out on disability on April 15, 1999, due to a diagnosis of HIV/Aids, chronic hepatitis B, lipodystrophy, wasting syndrome, neuropathy/pain and fatigue. His claim was with Aetna, but after Hartford purchased Aetna, Hartford began an u... Read More >
Hartford Overturns Denial of Disability Benefits on Appeal
Our client, a former clerk at a coal mine with severe lumbar back problems first, contacted our office and spoke with Attorney Stephen Jessup in 2015 after Hartford denied his claim for long term disability benefits following short term disability. Similar to the vast majority of people with employer provided disability insurance with Hartford, our client’s short term disability policy was ultimately payable... Read More >
Hartford Approves Disability Claim After Appeal Deadline
Prior to filing for disability our client worked as a registered nurse in a hospital setting, suffering from multiple chronic medical conditions that resulted in ever worsening pain throughout her back, neck and extremities. When her conditions began to limit her ability to safely and effectively perform her occupational duties she, on her own, filed a claim for disability benefits under her employer’s group... Read More >
Hartford overturned its previous denial of LTD benefits for Illinois Account Representative
Our client, Mr. K, formerly worked as an Account Representative for an international brokerage firm. In May 2017 a number of medical issues, including the debilitating effects of chronic congestive heart failure, arteriosclerotic heart disease of native coronary artery, chest pain forced Mr. K to stop working and submit his claim for disability benefits first under his employer’s short-term disability (STD) ... Read More >
Disability Lawsuit Stories
(765)
Reviews from Our Clients
