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Hartford Insurance Terminates Fibromyalgia Claimant – We Win The Appeal

Tuesday, March 16th, 2010

Our client was on claim with The Hartford for three years when they stopped paying her disability benefits, based on a paper review of her medical records and the results of an Employability Analysis. We represented her with an administrative appeal, and had her benefits reinstated.

Our client suffers from Fibromyalgia, degenerative disc disease, major depression, hyposomnia, hypothyroidism, and chronic headaches. She has been suffering from these conditions since 1998. She was employed with a major university as a top-level administrative assistant, responsible for maintaining a large portion of the University’s website that is updated minute-by-minute, with news and information for events, activities, alerts, bulletins and news stories pertaining to students, parents, alumni, faculty, and staff. Her job required her to be available seven days a week, after hours and on weekends, to provide 24-hour monitoring and updating.

Approximately eight years ago, our client began having problems keeping up with deadlines because of the Fibromyalgia related severe fatigue and muscle pain, along with the symptoms of other conditions, and the side effects of the numerous medications she needed daily. When she was no longer able to perform the tasks required of the position, she applied for her long-term disability benefits and was approved.

Our client received long-term disability benefits until June 2009, when The Hartford determined that she was no longer disabled and could go back to work full time. The Hartford paid for an extremely selective review of her medical records by an outside vendor, who could not possibly be neutral, since The Hartford was signing his check! The vocational analysis reported that our client had recovered and was able to perform her own occupation as administrative assistant, even though there had been no change in her medical condition since the time that The Hartford itself had determined that she was disabled.

In the administrative appeal, we attacked the selective review of our client’s medical records by the third-party vendor, the credentials of the reviewing doctor (or lack thereof), and highlighted all of the errors in the vocational analysis that The Hartford conducted.

By aggressively attacking each step in The Hartford’s process of terminating our client’s benefits and including more objective medical evidence and test findings that continue to support our client’s disability, we were successful in having The Hartford overturn their termination on appeal, and our client’s benefits have been reinstated.

Justin C Frankel

Written By:

Justin C. Frankel - Disability Insurance Attorney

Justin Frankel is a founding partner of the disability insurance law firm Frankel & Newfield and is a highly skilled litigator and advocate. He has published numerous articles on the challenges facing clients with private or individual disability insurance policies and those who own group or ERISA disability insurance policies.

Learn more about Justin | See Justin’s Publications



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