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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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.

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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
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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.

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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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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   *****

Leza A.

Desperarate & feeling like I was on a raft floating farther… out to sea. By the time I was diagnosed (it was close to a year) with fibromyalgia. I was in so much pain “ALL” over my body, feeling desperate for relief of my pain and the feeling of foggy headed (foggy headed is one of the conditions of Fibro). I wasn’t getting better instead my pain was getting worse. I was thinking about my career that I worked so hard to get where I was. I more than missed and loved my career.

My husband used to say that I loved my career more than him (so wasn’t true) but, I would do things like cancel a trip (40th birthday trip) in order to get the job done at work/make it happen (New Home R/E Sales). My career was a “very” physical and also required to be mentally sharp at all times.

What I thought at the beginning of feeling ill was going to be out from work for maybe a few days to a week, didn’t happen. Then I got to the point of being out from work for a year and realizing this was going to be a challenging and long road. In dealing with the short/long term disability company was getting to the point I couldn’t handle it. So… I got on the computer when I had short breaks from being foggy minded (took weeks of searching). So the search for someone/company who could take the challenge to keep up with the demands of paper work from the disability company with my short/long term disability company and who was successful at fighting this kind of case and with my medical diagnoses of fibromyalgia (I had been denied after the first few months of short term disability). I found Dell & Schaefer Law Firm who had a successful out come with not only the disability company that I had but, also against working with a fibromyalgia case.

I am blessed to have come across Dell & Schaefer and then I was blessed to have/be working with Rachel Alters! I found it was/hasn’t been easy in any way to deal with a case of fibromyalgia but, I am so more than happy I have/am working with Dell & Schaefer “Rachel Alter”. If I was up to it (not with fibro) I would be dancing all night long celebrating (I loved to dance all the time before fibro)! The many… appeals, time and all the hard work it took, my/our case has been over turned! I was caught off guard when I received the call from Rachel Alter! When I answered it I was thinking we were needing more documentation or another specialists to state where I am with my illness but, I got the best news in years and I just started crying out of control with tears of happiness! Tears of happiness have not been a part of my life in many years. Yea!!!!!! FYI… This was a challenge for me to write due to not being able to sit or type due to my pain of fibromyalgia but, so worth sharing my experience with choosing Dell & Schaefer “Rachel Alter & Team” ! Again… I am so blessed to have contacted Dell & Schaefer!!! Thank You Dell & Schaefer “Rachel Alter & Team”… :-)

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