How Do I Appeal a Disability Insurance Denial from The Hartford?
When it comes to filing Hartford disability appeals, there are some crucial things to know. The appeal process begins just after receiving a disability insurance claim denial in which The Hartford company has rejected your claim. But then what?
Before rushing in and making your own response to the denial, disability insurance attorneys Gregory Dell and Rachel Alters have some important details to help you choose the proper path forward. They’ve handled hundreds of ERISA appeals involving Hartford, with continuing increases due to the company’s 2018 acquisition of the long-term disability division of Aetna.
What to Expect
Once you receive a denied disability claim from Hartford, a strong appeal response is essential. Knowing what to expect can equip you to launch an effective appeal from the very beginning, which is crucial for this reason: You only get one shot. Disability lawyer Rachel Alters explains that if your appeal is denied and it goes to court, that appeal is basically your only trial in front of the judge.
“All the judge sees is the administrative record,” says Alters. “They don’t get any new testimony; you can’t file anything new. They don’t get to meet the claimant. So everything you want to show the judge as to whether the insurance company was “arbitrary and capricious” needs to be in that appeal. If it’s not, you’re out of luck.”
Attorney Gregory Dell notes that a good number of people do call them after they’ve filed their own appeals, without the aid of a disability insurance law firm. “We’re still able to help them,” he says. “But those people are at a significant disadvantage compared to the ones that contact an attorney beforehand to do the appeal.” There is no second chance for getting the vital information into the record.
Even if a related new event occurs that impacts your case in a significant way, the law still prohibits new details being added after an ERISA denial and ERISA appeal. Gregory Dell gives an example that someone could turn in their appeal, get a decision, and then lose their leg in a catastrophic accident. But the court cannot consider that new evidence because the appeal record is closed. That’s why it is very important to submit a phenomenal appeal, he stresses.
Most Important Element in a Hartford Disability Appeal
Most experts, such as those at disability insurance law firm Dell & Schaefer, agree that one of the most important elements of an ERISA appeal is doctor support. A very good written statement of doctor support must contain his conclusion that you have an inability to work. This can be the inability to work in your “own occupation” or in “any occupation,” according to Rachel Alters. It needs to specifically support your restrictions and limitations, and it could also add a vocational rehab expert to corroborate your physician’s statement.
A disability insurance lawyer knows what insurance companies are looking for because they do these types of appeals each and every day. They know the specific language that Hartford is looking for, and they can ensure that medical records coincide with what the attending physicians are writing in their statements. It’s also important that the medical record contains consistent documentation over a period of time, ideally six months.
Disability claimants have 180 days to file an appeal. So if they begin working with an attorney right away, the chances are much greater that the appeal files will contain sufficient and continually progressive medical records and documentation. Doctors are often given a standard “physician’s statement” form to fill out, but if any mistakes are made or the form is filled out improperly, it will be too late to amend them after filing.
Disability lawyer Rachel Alters explains that she can help a doctor document the disability in ongoing medical records prior to filling out the official statement, and then review it all before the appeal goes to The Hartford. As she notes, doctors are trained to treat patients, not fill out forms. That’s part of the role of a disability insurance law firm. Attorney Gregory Dell adds that 95 percent of the time, the doctors appreciate the fact that their patients have a professional helping them with the intricacies of an ERISA appeal.
What Is a Vocational Report?
Almost as important as having solid medical support for an ERISA appeal is including a vocational report. The insurance company will first be looking at whether you can do your “own job” and then it turns into whether you are capable of performing “any job.” A vocational expert examines the claimant’s job description and medical records in order to produce a detailed report stating what you are realistically capable of doing as an occupation.
The vocational expert uses the ONET (Dictionary of Occupational Titles) to pinpoint the duties involved in the claimant’s job and then compares it with the MRI reports or any other medical proof that documents the disability. Rachel Alters notes that the ONET is also what insurance carriers use to establish job criteria, so it’s vital to get a detailed report.
These vocational reports can take 60 to 90 days and cost a few thousand dollars, explains Gregory Dell. This means that a person fighting a disability insurance claim denial on their own may not have the ability to pay that type of expense. Claimants are often already in a financial bind because their claim has been denied. But a disability insurance law firm such as Dell & Schaefer takes cases on a contingency basis, so the claimant pays nothing unless they win.
Another crucial item to include in an appeal is a solid personal statement. A comprehensive statement from the disabled claimant basically serves as his or her “day in court.” It’s the closest thing to taking the stand and explaining how you feel, why you can’t work, and what your day is really like. The claimant who is living that every day is the best possible witness.
As attorney Gregor Dell points out, it’s not a machine reading that appeal – it’s a human being. If they feel for you or have an understanding of what you’re really doing, that strengthens your appeal and the chance to receive your deserved disability insurance benefit. The lawyers will also collect statements from family members, former co-workers and others in your sphere, which helps bolster your claim and your LTD (long-term disability).
These important tips for appealing an insurance disability denial can apply to just about any company. However, Hartford is very specific and detailed, and they have certain requirements that trained attorneys know about. So, if you have an appeal with Hartford anywhere in the United States, the attorneys at disability insurance law firm Dell & Schaefer are available any time for a free initial consultation.