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HARTFORD REVERSES LONG TERM DISABILITY DENIAL ON A PARTIAL DISABILITY CLAIM

March 1, 2012

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We were recently successful in having partial disability benefits reinstated for a client insured by the Hartford. Ms. S was diagnosed with Parkinson’s disease. She enjoyed her job and wanted to continue her work. However, her disease left her incredibly fatigued and unable to perform her occupation on a full-time basis. Her insurance policy contained a residual disability (or partial disability) provision, under which she was considered disabled if she could not perform her regularly scheduled work hours. Hartford denied the claim, based on the report of a reviewing physician who concluded she could perform sedentary work. The reviewing physician missed the mark all together—he failed to even discuss her fatigue and what effect that could have on her ability to work full-time.

Ms. S contacted the Law Office of Shawn McDermott to request our assistance in preparing her ERISA long term disability appeal. Attorney Heather Petitmermet prepared and submitted a thorough appeal to Hartford on her behalf. Under ERISA regulations, claims administrators are required to render claims determinations within 45 days. At the expiration of 45 days, we had not received a decision from Harford. Ms. Petitmermet called to follow up on the status, and was unbelievably told that Hartford had failed to assign the case to an analyst upon receipt of the appeal; no one had even looked at the file yet. Given Hartford’s clear lack of compliance with the regulations, Ms. S chose to proceed with a lawsuit. Eventually, Hartford voluntarily reversed its decision and benefits were reinstated.

People often don’t realize that they may be entitled to some disability benefits even if they are still working, if their work earnings are diminished due to their condition. It all depends on the terms of your plan or policy. If you need assistance with a partial disability claim filed with any disability insurance carrier, regardless of your location, contact the disability attorneys at the Law Office of Shawn E. McDermott. We can help you review your policy to determine if you may be entitled to partial disability benefits.

Categories: Colorado, Disability, ERISA Claims

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