By | August 7, 2015

A recent case out of the Northern District of Illinois reminds us of the hundreds, maybe thousands, of disability insurance cases we have had against Hartford insurance company. Although we did not handle this particular case, we believe our video and discussion about this recent case be helpful to those who have had their long term benefits terminated.

Hartford, as it is notorious for doing, terminated long term benefits after 24 months. Many of Hartford’s long term disability policies have a change in the definition of disability after 24 months which requires a claimant to be disabled from any occupation where he or she has experience, education or training. In this case, Hartford actually suggested the claimant, a nurse, could become a deputy sheriff or building inspector.

Another issue arose for Hartford when the medical records documented that the claimant suffered from neck, back and shoulder pain as well as cognitive impairment. Hartford focused on the cognitive impairment and argued that her benefits should be terminated on the grounds that she had reached her 24 month benefit limit applied to conditions caused or contributed to by a mental health condition. Hartford essentially ignored the physical conditions and tried to make this claim into a mental nervous condition due to the claimant’s chronic pain.

Fortunately, the nurse’s medical records documented that her cognitive impairment was due to her chronic pain and side effects of pain medication. A neuropsychologist had conducted tests and concluded that her pain caused her impairment and prevented her from doing any type of job. A psychologist or psychiatrist can also perform testing which verifies a person’s level of cognitive impairment, if any.

In this case, the court found that the nurse did suffer from depression and cognitive impairment, but they were both secondary to the pain. The pain came first: the depression and impairment were caused by the pain. Neither were due to any mental health condition. Accordingly, Hartford was ordered to reinstate her long term disability benefits.

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