An Ohio Federal Court recently ordered a claimant to be reinstated to active benefits, where she suffered from dumping syndrome, and chronic fatigue, following treatment for cancer. Hartford had terminated her claim at the transition of disability from own occupation to any occupation benefits.
Hartford, as is very typical of its claim handling, relied upon the opinion of a paid, paper reviewing physician, who noted that fatigue could be a typical limiting factor following cancer treatment, but failed to find any impairments in this claimant. Hartford also performed an internal vocational review, based upon the findings of its paid, paper reviewing physician, failing to consider the limitations set forth by the claimant’s treating doctors.
The Court was troubled by several aspects of Hartford’s claim handling, including that it appeared to make credibility determinations of the claimant without the benefit of actually examining her, and found that the decision was not the product of a deliberate principled reasoning process.
Thus, the Court ordered that benefits be reinstated to prior to the claim termination.