A career firefighter suffered from several work-related injuries. He made heroic efforts to continue working by pursuing every treatment option, including multiple surgeries, to improve his conditions. However, his doctors had grave concerns that he would ultimately suffer a reinjury and recommended he cease work. He was eventually convinced to end his career and submit a claim for long-term disability benefits with Hartford Life and Accident Insurance Company (“Hartford”) based upon his numerous medical conditions.
Although Hartford initially approved his LTD claim, a new claims handler terminated his benefits a year later under the “any occupation” definition of disability. In terminating his claim, Hartford relied upon an outdated Attending Physician Statement form and ignored the current restrictions and limitations identified by our client’s treatment providers. These outdated restrictions were then used by Hartford to perform an Employability Analysis which identified other occupations Hartford claimed the firefighter could perform.
With the assistance of the disability attorneys and staff of McDermott Law, LLC, the firefighter submitted an internal appeal to the disability insurance company. The appeal included significant evidence (that Hartford had not pursued or considered) of the firefighter’s current functional abilities and establishing his lack of improvement since the date Hartford originally approved his claim. It also proved that the occupations identified in Hartford’s Employability Analysis were not suitable or appropriate, because they either required physical abilities beyond the firefighter’s capacity or they required education or training beyond his experience.
After reviewing the appeal, Hartford approved the firefighter’s claim. Given the harm caused by Hartford by the delay in paying the benefit, we nonetheless filed a lawsuit to pursue bad faith damages and a statutory claim for unreasonable delay. The lawsuit was successfully resolved before trial.
As always, contact the Denver long-term disability lawyers at McDermott Law LLC if you have questions regarding your insurance claim.