Hartford Life Abused Its Discretion by Failing to Advise of Need for an FCE

In McKenna v. Hartford Life & Accident Insurance Co., the Minnesota federal court remanded to the Hartford plan administrator for reconsideration of its termination of McKenna’s long term disability benefits. The court held that since Hartford failed to inform McKenna, who was representing herself, of “what type of objective evidence she needed to provide with her appeal,” and she did not understand that a functional capacity evaluation (FCE) would be helpful to her case until after the denial when she obtained counsel, she had shown “good cause” for failing to obtain the FCE before Hartford closed her file. The court then remanded to Hartford with instructions to consider the FCE, “along with the rest of the administrative record, before making its final benefit determination.”

Underlying Facts

McKenna’s initial application for disability benefits was approved when Hartford agreed her fibromyalgia prevented her from performing the duties of her own occupation. After two years, the definition of disability changed, requiring McKenna to be unable to perform the duties of any occupation. Initially, Hartford granted her long term disability benefits under the new standard, but after reviewing some of her Facebook posts and conducting video surveillance, Hartford informed McKenna that it was terminating her benefits since there was “no objective clinical physical exam findings to support any restrictions or limitations.”

McKenna then retained counsel who had her undergo an FCE which was conducted by Dr. Phillip Haber (Haber Report). When her attorney attempted to submit the Haber Report, Hartford refused to accept it, saying it was untimely. She then filed this ERISA lawsuit in which she requested the court to reinstate her benefits or, at a minimum, remand to Hartford with instructions to reevaluate her entire medical record including the Haber Report.

Court Analysis

The court noted that it is acceptable to ask a claimant who has fibromyalgia to present objective evidence as to the extent of the disability. According to Hartford, “One method of objective proof of disability is a functional capacity evaluation, a reliable and objective method of gauging the extent one can complete work-related tasks.” Prior to terminating her benefits, Hartford failed to inform her of this even though one of her treating physicians said that an FCE “was necessary to fully assess her capabilities.” The court granted McKenna’s request and remanded to Hartford with instructions to “evaluate the Haber Report and consider the expanded record before issuing its claim decision.”

This case was not handled by our office, but it may provide claimants guidance in determining evidence that can be submitted on administrative appeal in support of their long term disability claim for benefits under the “any occupation” standard. If you need assistance with a similar matter, or with any issue concerning your disability case, please contact any of our lawyers for a free consultation.

Leave a comment or ask us a question

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   *****

Tina R. (Colorado)

I found that during the time my claim was being processed, my attorney (Ms. Alters) and her assistant (Ms. Arriaga) were both very professional, quick to respond, and did not seem pressed for time in a way that let me feel that I was important to them. They were both very straightforward in expressing their thoughts and suggestions as well as helping me understand anything I did not understand. They took the time necessary to explain anything that was confusing to me. I felt as if I knew them personally and appreciated their help very much.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us