In one of our long-term disability cases, Hartford conducted surveillance of our client walking to a grocery store, and terminated benefits contending the activity was above the client’s reported limitations. The client suffered from post spinal fusion surgery for lumbar degenerative disc disease, with radiculopathy radiating down to the knee. The client was also taking prescribed narcotic pain medications. We interviewed the client on video talking through the surveillance footage, showing the grocery store was blocks from home. We included a map of the route to visualize how short the distance was. The video also showed our client sitting and frequently needing to change positions, wholly consistent with results of a functional capacity evaluation and opinions of the client’s doctors. The result: claim paid. In another long-term disability case we turned around, Hartford referred to surveillance showing our client carrying a shopping bag and portraying the client as able to lift and carry heavy items. We performed a video interview of the client while watching the surveillance footage and the client narrating it. We showed the client explaining the shopping bag had a single item in it: a bottle of perfume purchased for a niece’s birthday. Combined with tests, medical opinions, and records, we had the client demonstrate the ability to carry a bag with a perfume bottle in it, but struggling with heavier objects due to Rheumatoid Arthritis. Outcome: claim paid. If Hartford denied or terminated your long-term disability benefits, call Bartolic Law.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)