The Long Term Disability Lawyer recently represented a disabled 50 year old worker from California in Federal Court who became severely disabled while covered under a long term disability insurance policy issued and administered by Hartford Life.
Hartford Life and Accident Insurance Company, commonly referred to as Hartford Life, is an insurance company based in Sacramento California. It’s a division of The Hartford, one of oldest and largest insurance companies in the US and a leading provider of group long term disability insurance policies. Like many other insurance companies, the Hartford often attempts to discourage, delay and deny paying a claim for disability benefits when one of their policyholders becomes too ill or injured to work.
Our client, who was formerly employed by GlaxoSmithKline as a Senior Executive Sales Representative, is disabled due to cervical neck pain, cervical degenerative disc disease, cervical spinal stenosis, migraines, chronic back pain, radicular symptoms, decreased range of motion and weakness, adjustment disorder, anxiety and depression. These impairments and their symptoms make it impossible for our client to perform any work activities on a consistent basis.
Despite the fact that our client in completely unable to work due to his disabilities, Hartford Life chose to deny his claim for disability benefits.
However, the Social Security Administration had issued a fully favorable decision on our client’s claim for Social Security disability benefits under Title II and Title XVI of the Social Security Act, finding that our client was “disabled” during the relevant time period. The standards for qualifying for disability benefits from the SSA is much higher than those of the insurance companies. In order to qualify for SSA disability benefits you have to be able to prove that you are unable to work any job – a fact that Hartford Life was aware of.
Hartford Life notified our client on October 30, 2008, informing him that he had exhausted all administrative remedies and that Hartford Life would no longer consider any further claims or evidence. Hartford Life, in this final denial, totally ignoring the ruling of the Social Security Administration, discounted the opinions of our client’s treating physicians and the well documented limitations from which our client suffers including the effects of his impairments on his ability to engage in any work activities.
Our client had now exhausted all available administrative remedies; his only remaining option was to file a lawsuit in Federal Court to obtain the disability benefits rightfully owed to him.
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The Law – The Employee Retirement Income Securities Act (ERISA)
This claim is governed under federal ERISA law. ERISA stands for the Employee Retirement Income Security Act of 1974. ERISA is a federal law that regulates the handling of Employee Benefit Plans and the remedies of the beneficiaries of these Plans. ERISA applies to all employees benefit plans established or maintained by an employer engaged in commerce or by an employee organization representing employees engaged in commerce.
Practically all long term disability plans offered by a private employer are governed by ERISA. A claimant challenging a disability denial under an ERISA governed plan or policy must bring the claim pursuant to ERISA regulations and procedures. All state law claims that may have been considered are preempted by federal ERISA law because the plaintiff is covered under an insurance policy issued through his employee benefits plan.
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Don’t Wait Until You Have to File a Lawsuit
The ERISA rules that govern disability Insurance claims are complex. The insurance companies know this and use ERISA’s rules and regulations to make the claim process as difficult as possible. Don’t make the mistake of thinking you can handle the insurance company’s administrative appeal process all by yourself. Don’t wait to hire a California long term disability lawyer until you have to file a lawsuit. The sooner an experienced disability benefits attorney is on the case, the greater your chances of success in obtaining the full benefits you deserve.
We recently spoke with a person who decided on a DIY appeal. He told us he just needed a lawyer to file his lawsuit. It turns out the evidence he submitted consisted of a one page letter asking the insurance company to reconsider its decision because he “really was disabled.” He was astonished to learn that this one page letter was the only evidence the judge could consider in his case other than what the insurance company chose to include when they denied him. In other words, he had blown any chance to present his case in court. Don’t let this happen to you – contact the Hartford Life insurance denial attorneys at disabilitydenials.com before you file an appeal.
Marc Whitehead & Associates have been representing clients in disputes with The Hartford and other insurance companies for over 25 years. We helped thousands of disabled workers and veterans get the disability benefits they deserve. If you are disabled and have encountered difficulties getting your claim for benefits approved, we urge you to reach out to Marc Whitehead & Associates.
