Hartford ordered to re-evaluate denial of disability benefits

James Linnen, a powerhouse operator for Goodyear, Tire and Rubber Company, was insured under his company’s group disability plan issued by Continental Casualty Company. Mr. Linnen began collecting long-term disability benefits for narcolepsy and cataplexy in 2001. In 2004, Hartford Life and Accident Insurance Company purchased Continental and reviewed Mr. Linnen’s disability status.

After the treating physician admitted Mr. Linnen was capable of sedentary work, Hartford terminated Mr. Linnen’s benefits in April 2005. Hartford found alternate occupations Mr. Linnen could perform such as cage boss and order parts clerk. Hartford upheld its decision in appeal and Mr. Linnen sued, seeking benefits under the Employee Retirement Income Security Act. (ERISA)

Judge David S. Dowd Jr. of the Northern District of Ohio reviewed Hartford’s decision to terminate benefits and ruled that Hartford used the wrong standard in assessing if Mr. Linnen was entitled to long-term benefits. The policy states the claimant must be unable to “engage in any substantially gainful occupation for which you are, or may reasonably become, qualified by your education, training or experience”.

Judge Dowd ruled the term “substantially” alters the definition and Hartford should have assessed whether Mr. Linnen was able to obtain “substantial gainful employment” before terminating benefits. However, if employment is available that pays nearly the same wages and benefits, benefits could possibly be terminated.

See James Linnen v. Hartford Life and Accident Insurance Co., No. 05:06CV0141, N.D. Ohio; 2006 U.S. Dist..

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I found Dell & Schaefer when I googled lawyers that handled long term disability claims with Prudential. I sent an email on their site and by the next morning I received a phone call from them. They were very professional and friendly, easy to talk to. They inquired of my situation. Prudential LTD decided to cancel benefits after two years of which I learned is quite common. I was disabled after a car accident started collecting SSDI six months after my accident. My doctors said I was disabled, ssdi doctors declared me disabled but Prudential without ever seeing me said I was able to work. They sent me a list of jobs that they felt I could do. Not one company name just a list of five jobs. They paid me disabilty for two years without question. Then bam cut you off!

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