Hartford reverses disability benefit denial after previously paying 62 year old sales rep for 6 years

Our client, a 62 year old former pharmaceutical sales rep, had been receiving long term disability benefits with Hartford Insurance Company for nearly six years due to chronic back pain, which had resulted in six surgeries in a span of several years, when Hartford abruptly terminated his claim for long term disability benefits.

Hartford had initially determined that our client was unable to perform the material and substantial duties of his pre-disability occupation as a pharmaceutical sales representative. Then, two years later when our client’s occupational definition switched from “own occupation” to the much more broad “any occupation” definition of disability, Hartford again determined that due to his physical limitations and documented medical conditions, that he remained disabled as defined under the terms and conditions of the policy. Additionally, the Social Security Administration had approved disability benefits due to the disabling nature of his physical conditions and upheld its decision on reassessment.

However, despite the overwhelming medical evidence supporting his claim for long term disability benefits, the length of the claim history, and his advanced age, our client was not safe from scrutiny by Hartford. As our disability lawyers have seen on most Hartford disability denials, Hartford conducted video surveillance on our client and submitted him to an in home field interview. Hartford subsequently denied our client’s claim and relied upon the video surveillance, field interview statement, and medical records from one to two years earlier. The client subsequently contacted Disability Attorneys Dell & Schaefer to assist him with the ERISA Appeal of his disability benefit denial.

Attorney Stephen Jessup, prepared and filed the ERISA mandated administrative appeal on behalf of our client. In reviewing the claim and the extensive medical history, it became clear that the ultimate issue was not the sufficiency of the medical records, but rather Hartford’s actual review and reliance upon ancillary, non medical “evidence” used to deny the claim. Specifically, Attorney Jessup attacked Hartford’s reliance on and the contents of the video surveillance, the seemingly blatant manufacturing and cherry picking of dated documents and statements used by field interviewer, and the contents of the “any occupation” vocational review conducted by Hartford. In systematically attacking and countering the arguments relied upon by Hartford in terminating our clients claim, and by furnishing additional medical information and other items in support of the claim, Attorney Jessup was successful in forcing Hartford to reverse its termination of benefits.

This claim, and the hardships endured by our client during the appeal process, serves as a reminder to those on long term disability benefits that no matter the length of time one has been on claim, or their age (in relation to actual retirement claim or potential time left on claim) long term disability benefits are not guaranteed benefits. An insurance carrier is constantly reviewing claims for long term disability on a month to month basis, and with the state of the law in relation to ERISA based group disability policies, the insurance carriers will look for any reason they find “reasonable” in denying a claim for benefits.

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FAQ

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.

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.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

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