Hartford Reverses Disability Insurance Denial – Pays Our North Carolina Parkinson’s Disability Insurance Client
Hartford called Parkinson’s Disease a “mental or nervous disorder” and limited payments to 24 months under a policy limitation for mental conditions!
Our disabled client lived in Charlotte, North Carolina and worked for a large multi-state corporation as an executive. He was very familiar with the human resources department and the company’s insurance benefits, so he was well aware that he had Long Term Disability insurance (LTD) through the company. Unfortunately, after being diagnosed with Parkinson’s disease in 2011, our client began experiencing balance issues and falling multiple times at work. He also found that his ability to multitask, remember simple instructions, and maintain mental sharpness was declining rapidly. This type of disability is called executive dysfunction. To make matters worse, he suffered from a type of arthritis called ankylosing spondylitis which grew progressively worse, making the muscle-related symptoms of the Parkinson’s even more pronounced.
In 2013, the Hartford terminated his LTD benefits after paying him for 24 months citing to the “mental and nervous” disorder limitation, which limited benefits for any mental health conditions such as depression or anxiety to 24 months only. The issue was that he was not disabled due to any mental health condition!
Hartford ignored the elephant in the room – the physical symptoms of Parkinson’s.
Hartford failed to address his severe physical disabilities. Our client had a constellation of co-morbid physical conditions – most notably Parkinson’s disease. He experienced difficulty walking and maintaining balance, had a sleep disorder, significant cognitive impairment, and depression all stemming from the Parkinson’s. But what word did the Hartford see? It only looked at the word depression and denied his claim and ignored the elephant in the room – Parkinson’s.
The key to beating Hartford – evidence to prove the physical disability.
The key to the reversing Hartford’s decision was explaining that the depression was caused by the Parkinson’s, and more importantly, showing how the physical symptoms from the Parkinson’s were disabling. Our team of disability lawyers, worked with the treating physician to document evidence that if our client’s true diagnosis was major depression; his symptoms should have improved over three years of treatment. In addition to the voluminous medical records, our disability attorneys used their knowledge of medical records to search medical literature and provide multiple medical journal articles that early Parkinson’s is often misdiagnosed as depression and that depression and cognitive impairment are important non-motor symptoms of Parkinson’s.
What’s more is that our client had a second, severe physical condition called ankylosing spondylitis, an auto-immune disease that is part of group of disorders falling under the label of arthritis. Ankylosing spondylitis disability comes from severe pain. The condition can cause the bones in the spine to fuse. It severely impaired our client’s ability to move, walk, and sit.
The Hartford chose to ignore not one, but two debilitating conditions! It was crystal clear that Hartford simply did not want to pay our client’s claim.
By providing mounds of medical literature, expert opinions, medical record evidence, and a focused appeal letter, the ERISA attorneys were able to put Hartford into a corner where it had no choice but to pay the claim. We continue to help this client by anticipating Hartford’s yearly reviews and beating them to the punch by providing additional evidence to prove that our client’s restrictions and limitations continue. The attorneys at Tucker Disability are happy to report that this client is still being paid.