33 min
What Happens When Your LTD Claim is Denied Twice? ERISA Disability and Life Insurance Litigation
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- Business
The claimant was a former social worker at Intermountain Health Care Inc. Her medical conditions included Chronic Fatigue Syndrome (CFS), hypersomnia, obstructive sleep apnea, severe depression, and anxiety. Her treatment for these conditions was documented, and during the appeals process, these conditions were considered in the evaluation of her claim for long-term disability benefits.
Hartford Life and Accident Insurance Company denied claimant's claim for long-term disability (LTD) benefits based on their assessment of her condition and the medical evidence provided. Hartford argued that the medical evidence, including APRN Jones's assessment, did not support the claimant's Chronic Fatigue Syndrome (CFS) diagnosis as preventing her from performing a sedentary occupation. Therefore, Hartford decided that based on the medical records reviewed, including those of her treating physicians, and the definitions of disability within the policy, the claimant did not meet the criteria for LTD benefits.
The claimant appealed the termination decision. In her appeal, she acknowledged receiving treatment for Depressive Disorder, Anxiety Disorder, and Panic Attacks during the period considered under the pre-existing condition limitation. She appealed the initial claim decision specifically regarding her "primary condition" of Chronic Fatigue Syndrome (CFS) and other disability conditions mentioned in the denial letter, specifically hypersomnia and obstructive sleep apnea.
This is the oral argument in the 10th circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.
By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.
If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.
The claimant was a former social worker at Intermountain Health Care Inc. Her medical conditions included Chronic Fatigue Syndrome (CFS), hypersomnia, obstructive sleep apnea, severe depression, and anxiety. Her treatment for these conditions was documented, and during the appeals process, these conditions were considered in the evaluation of her claim for long-term disability benefits.
Hartford Life and Accident Insurance Company denied claimant's claim for long-term disability (LTD) benefits based on their assessment of her condition and the medical evidence provided. Hartford argued that the medical evidence, including APRN Jones's assessment, did not support the claimant's Chronic Fatigue Syndrome (CFS) diagnosis as preventing her from performing a sedentary occupation. Therefore, Hartford decided that based on the medical records reviewed, including those of her treating physicians, and the definitions of disability within the policy, the claimant did not meet the criteria for LTD benefits.
The claimant appealed the termination decision. In her appeal, she acknowledged receiving treatment for Depressive Disorder, Anxiety Disorder, and Panic Attacks during the period considered under the pre-existing condition limitation. She appealed the initial claim decision specifically regarding her "primary condition" of Chronic Fatigue Syndrome (CFS) and other disability conditions mentioned in the denial letter, specifically hypersomnia and obstructive sleep apnea.
This is the oral argument in the 10th circuit court of appeals.
These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.
By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike.
If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.
33 min