Hartford’s decision to deny long-term disability benefits to a plant operator is upheld

(Group / ERISA Disability Policy) Robert Hulet, a plant operator, stopped working July 28, 2002, due to chronic left shoulder problems, which resulted in several surgeries. Mr. Hulet was covered for long-term disability benefits under a group disability policy issued by Hartford Life and Accident Insurance Company (hereinafter referred to as “Hartford”). Hartford paid Mr. Hulet long-term disability benefits for two years in accordance with the “own-occupation” definition of total disability in his policy. After two years, Mr. Hulet’s definition of total disability changed to “any-occupation” which is defined as:

During the Elimination Period and for the next 24 months you are prevented by:

  1. accidental bodily injury;
  2. sickness;
  3. Mental Illness;
  4. Substance Abuse; or
  5. pregnancy,

from performing one or more of the Essential Duties of Your Occupation, and as a result your Current Monthly Earnings are no more than 80% of your In-dexed Pre-disability Earnings.

After that, you must be so prevented from performing one or more of the Essential Duties of Any Occupation.

Your failure to pass a physical examination required to maintain a license to perform the duties of Your Occupation does not alone mean that you are Disabled.

In order to determine Mr. Hulet’s continued eligibility for disability benefits, Hartford took the following actions:

  1. Prepared an Employability Analysis Report;
  2. Contacted Mr. Hulet’s treating physicians;
  3. Hired an independent Orthopedic Surgeon to review Mr. Hulet’s medical records;
  4. Had a medical doctor review all of the medical records after Mr. Hulet submitted additional medical documentation to Hartford; and
  5. Consulted with a Rehabilitation Clinical Case Manager.

Based upon the review of the evidence in the administrative record, the US District Court for the Western District of Michigan concluded that Hartford’s decision to deny benefits under the policy’s “any-occupation” definition of disability was supported by substantial evidence and based upon a reasoned explanation. The court also noted that the Social Security Administration’s findings that Hulet was disabled fails to demonstrate that Hartford acted improperly in denying disability benefits to Mr. Hulet.

See Hulet v. Hartford Life & Accident Ins. Co., 2007 U.S. Dist. Lexis 75411 (W.D. Mich. Sept. 28, 2007).

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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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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.

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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.

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