At the Ortiz Law Firm, we recently had the honor of helping a dedicated Account Executive for UnitedHealth Group who was wrongfully denied long-term disability benefits by The Hartford. Our client had been unable to work for several years, due to numerous debilitating conditions, including ongoing pain from bilateral hip replacements, osteoarthritis, lumbar spondylosis, advanced facet arthropathy, lumbar radiculopathy, chronic pain syndrome, myofascial pain syndrome, and adjustment disorder with depression and anxiety.
Despite the overwhelming evidence of his disability, The Hartford denied his claim. They relied heavily on a “medical case manager” who sent a leading and narrow “clarification letter” to our client’s treating physician. While the treating physician appeared to agree with the reviewing case manager’s conclusions, a closer look revealed that his agreement was based solely on limited and incomplete information. In fact, the treating physician specifically noted that the claimant’s pain was real, possibly unrelated to the orthopedic records on which Hartford focused, and required further evaluation.
Adding insult to injury, The Hartford failed to consider the statements from the claimant’s mental health providers and disregarded the totality of his disabling conditions. To make matters worse, they misclassified his job as sedentary, even though his role as an account executive required significant physical activity, including community involvement, travel, and giving presentations.
We took on his case and immediately began gathering evidence to set the record straight. Our investigation revealed the flaws in Hartford’s decision, including the misclassification of his job. Using even the most basic Dictionary of Occupational Titles (DOT) analysis, it was clear that his role was consistent with the “Sales Agent, Insurance” classification, which is a light-duty—not sedentary—occupation. In addition, we emphasized that his policy defined disability as the inability to perform one or more of the duties of one’s own occupation—a definition our client clearly met.
With this comprehensive appeal, we left The Hartford no choice but to reverse its decision. Just 14 days after filing the appeal, we received a brief letter stating that the review was complete and our client’s claim was reinstated.
If you’ve had your long-term disability claim denied, let the Ortiz Law Firm fight for you. Call us today at (888) 321-8131 for a free case evaluation and let us help you get the benefits you deserve.