Wednesday, May 14, 2008

HARTFORD RECIPE FOR LTD DENIAL

If you are receiving benefits under a Hartford disability policy then you should be aware of its recipe for denial. I have seen a consistent pattern of termination of benefits by Hartford. The strategy is to set a trap for the beneficiary that can be avoided if you are aware of the following.


Regardless of the form of your disability Hartford will send a functional capacity evaluation form to the treating doctor which will ask him/her to delineate the number of hours their patient can sit, stand, walk in an 8-hour work day. It will also ask many other questions regarding the patient’s functioning. Typically, the doctor will rely substantially on the patient’s statements of disabilities. The trap is this. The form typically does not conform to the individual disability that you may have. Thus though you may be able to sit for only 20 minutes in a work setting in front of a computer on a consistent basis, you may be able to sit for 2 hours in a car. Or, on a good day you may be able to do much more than on a bad day, which typically will follow a day of activity. Thus, the problem in a work setting becomes the inability to perform the same function day after day, 8-hours a day. The functional capacity form is typically filled out by the doctor and by the patient on the basis of the worst case scenario. Thus, the doctor may state that the patient can sit for only 20 minutes consecutively. What the doctor should be stating is that the patient is limited to 20 minutes sitting at a work station consecutively before their abilities to concentrate, etc. are interfered with by pain and discomfort. Or that their capacities vary and thus their limitations are based on an inability to perform consistent, day-after-day activities.


The trap is that once the physician sets out the limitations as being the ability to sit "only 20 minutes at a time," then Hartford sends a surveillance team to videotape the insured. Hartford will camp out at your residence at 6 a.m. and follow you for the entire day. They will do this for 2 to 3 days and if they are unsuccessful in finding you doing any activities they will come back another time and do it again. Inevitably, the insured will leave their home and perform errands such as shopping, going to the bank, going to church, etc. These errands will typically show the insured doing things beyond the limitations placed in the functional capacity evaluation forms completed by the treating doctor.


Once the surveillance is completed then Hartford will send an adjuster to the insured’s home for a 2 to 3 hour interview. During the interview they will obtain a signed statement from the insured listing all the limitations they have due to their disability. Then they pop out the video and ask the insured to identify themselves in the video and that indeed it reflects their abilities.
The video will show the insured getting in and out of cars, driving cars, sitting in cars for extended periods of time, doing extended shopping for a half day or more. These will be perceived as inconsistent with the limitations the insured and the treating physician placed and thus makes the insured’s claim of disability appear to be false.


The reality is that an individual who is disabled from the grinds of a 40-hour work week is not necessarily disabled from life. They still have to perform activities of daily living that are required, whether one is working, or not. The abilities to go to the grocery store and the bank do not correlate with the ability to work a full time job. However, Hartford’s strategy is to get the insured to at least appear to overstate their disability and then discredit them with the video. If you understand Hartford’s strategy you can avoid the trap. Don’t place unrealistic, definite time limitations on any of your capacities. Concede your ability to do what you can do, with the important aspect being the things you cannot do that prevent you from returning to work.

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2 comments:

Unknown said...

I was receiving LTD benefits from Hartford along with my SSD benefits, and they indead did this to me, I have Lupus and Fibromyalgia and am not completely unable to function, and have never denied this or lied to the Hartford at any time, but after being under surveilance twice 2 days 1 month and 2 days the next they sent out someone for the 2-3 hour "evaluation" and then popped up with 3 days of activity out of the 4, and even woth me stating that I was able to do sertain things and my DRS saying basically the same thing, but that if I were to attempt to work would be a GREATER risk of becoming sicker, yet their dr whom I have never seen said that he felt by what he seen in the videos I'd be able to work 40 hrs a week not even thinking about the fact that I am taking heavy doses of Narcotic pain meds daily and have been for almost 6 yrs, so hoping that I can appeal this and win is basically my task now as I have looked for a job and the list of jobs they sent me I have never heard of half of them and in the area I live in NC there aren't to many chgoices for someone with my experience(NONE) and my limitaions (lots) so anyone who reads this use the advise I wished I had of seen this last yr.

RV said...

This is an excellent post. We are also trying to expose the Hartford's (and other LTD carriers' practices).
Some info is at http://hartford-disability-denial.blogspot.com/.

An issue often not understood by potential consumers is what disability insurance to purchase. A lot of employees think that they are covered by employer provided disability which is governed by ERISA laws. One should realize that in almost all cases, a policy governed by ERISA is not worth the piece of paper it is written on.
For example, see this http://illnessandinsurancehell.blogspot.com/2009/10/erisa-schmerisa-or-lessons-i-have.html
and http://www.badfaithinsurance.org/
Also see ABC news coverage at http://www.dilawgroup.com/

My hope is that laws should be changed to it mandatory for the employer and disability insurance company to provide the employee a CLEAR understanding of
a)what is the percentage of claims that the disability insurance company has approved and continued with
b) what is the course to redressal of her grievances and again, what are the chances of success.
This empowers the consumer to make an informed choice of purchasing insurance through employer or on her own.

This may be a useful topic to cover in your blog.