On the Ortiz Legislation Agency, we just lately had the glory of serving to a devoted Account Govt for UnitedHealth Group who was wrongfully denied long-term incapacity advantages by The Hartford. Our shopper had been unable to work for a number of years, attributable to quite a few debilitating circumstances, together with ongoing ache from bilateral hip replacements, osteoarthritis, lumbar spondylosis, superior side arthropathy, lumbar radiculopathy, power ache syndrome, myofascial ache syndrome, and adjustment dysfunction with despair and nervousness.
Regardless of the overwhelming proof of his incapacity, The Hartford denied his declare. They relied closely on a “medical case supervisor” who despatched a number one and slim “clarification letter” to our shopper’s treating doctor. Whereas the treating doctor appeared to agree with the reviewing case supervisor’s conclusions, a more in-depth look revealed that his settlement was primarily based solely on restricted and incomplete info. In actual fact, the treating doctor particularly famous that the claimant’s ache was actual, presumably unrelated to the orthopedic information on which Hartford centered, and required additional analysis.
Including insult to damage, The Hartford failed to contemplate the statements from the claimant’s psychological well being suppliers and disregarded the totality of his disabling circumstances. To make issues worse, they misclassified his job as sedentary, though his position as an account government required vital bodily exercise, together with neighborhood involvement, journey, and giving displays.
We took on his case and instantly started gathering proof to set the document straight. Our investigation revealed the issues in Hartford’s resolution, together with the misclassification of his job. Utilizing even essentially the most primary Dictionary of Occupational Titles (DOT) evaluation, it was clear that his position was in line with the “Gross sales Agent, Insurance coverage” classification, which is a light-duty—not sedentary—occupation. As well as, we emphasised that his coverage outlined incapacity as the lack to carry out a number of of the duties of 1’s personal occupation—a definition our shopper clearly met.
With this complete enchantment, we left The Hartford no alternative however to reverse its resolution. Simply 14 days after submitting the enchantment, we acquired a quick letter stating that the overview was full and our shopper’s declare was reinstated.
Should you’ve had your long-term incapacity declare denied, let the Ortiz Legislation Agency battle for you. Name us immediately at (888) 321-8131 for a free case analysis and allow us to enable you to get the advantages you deserve.
