Disability attorneys Gregory Dell and Rachel Alters discuss a case out of the Western District of Washington in which the district court found that Hartford acted arbitrarily and capriciously when it terminated the benefits of a woman suffering from fibromyalgia. The woman had been receiving benefits for nearly two years after Hartford had agreed she was disabled from working in her own sedentary occupation.
Hartford based its termination on techniques used by disability insurance companies: they hired a doctor, who never met or examined the claimant, but only conducted a paper review of her medical records and determined she could sit for four hours, so could work in a sedentary position. Hartford accepted the peer review opinion without explaining why it discounted the completely opposite and well-documented opinion of the claimant’s treating physician. Hartford also acknowledged that the claimant had been approved for Social Security disability benefits, but did not explain why it disagreed with Social Security.
The Court reversed Hartford’s denial of long-term benefits and held she was disabled not only from working in her own occupation, but also disabled from working in any gainful occupation, a decision Hartford had not yet made.
This case is an example of how insurers can terminate benefits at any time. Those who have been on claim for many years cannot get complacent. They need to continue medical treatment so there is documentation of their medical condition and how that affects their ability to work. Disability Insurance Attorneys Dell & Schaefer can help by making sure forms are correctly filled out, treatment continues, and that attending physician’s keep records that well-document the medical condition and how it interferes with the claimant’s ability to work.
Contact our office to speak with one of our disability Insurance attorneys regarding any questions you may have related to a disability insurance matter. We always offer a Free Consultation.