On the Ortiz Legislation Agency, we not too long ago had the consideration of serving to a devoted Account Government for UnitedHealth Group who was wrongfully denied long-term incapacity advantages by The Hartford. Our consumer had been unable to work for a number of years, as a consequence of quite a few debilitating situations, 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 anxiousness.
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 consumer’s treating doctor. Whereas the treating doctor appeared to agree with the reviewing case supervisor’s conclusions, a better look revealed that his settlement was based mostly solely on restricted and incomplete info. In truth, 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 harm, The Hartford failed to contemplate the statements from the claimant’s psychological well being suppliers and disregarded the totality of his disabling situations. To make issues worse, they misclassified his job as sedentary, regardless that his function as an account government required vital bodily exercise, together with neighborhood involvement, journey, and giving shows.
We took on his case and instantly started gathering proof to set the report 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 function was according to 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 shortcoming to carry out a number of of the duties of 1’s personal occupation—a definition our consumer clearly met.
With this complete attraction, we left The Hartford no selection however to reverse its resolution. Simply 14 days after submitting the attraction, we acquired a quick letter stating that the evaluation was full and our consumer’s declare was reinstated.
In case you’ve had your long-term incapacity declare denied, let the Ortiz Legislation Agency battle for you. Name us as we speak at (888) 321-8131 for a free case analysis and allow us to assist you get the advantages you deserve.
