Multiple Disabling Conditions: A Case Study
It is not uncommon for individuals to have multiple disabling conditions that contributes to their need to file a claim. But will your insurance company take each diagnosis into consideration when determining eligibility for benefits?
One such case is that of Sorensen v. Hartford[1]. Ms. Sorensen sued Hartford after being denied long-term disability benefits. She suffered from a multitude of conditions, including (but not limited to) chronic fatigue syndrome, fibromyalgia, chronic pain and dysphasia, cervical and lumbar spine degenerative disc disease, Hashimoto’s thyroiditis, prediabetes, irritable bowel syndrome, rheumatoid arthritis, depression and anxiety. For these conditions she saw numerous medical professionals, many of whom had contact with Hartford during the claims process, whether via interviews or submitting an attending physician’s statement. The Social Security Administration awarded Ms. Sorensen disability benefits for multiple conditions, both physical and mental.
After having their own doctors review Ms. Sorensen’s medical records, Hartford determined that Ms. Sorensen met the definition of disability based on a mental illness and awarded benefits for 24 months (because her policy had a mental illness limitation on benefits). However, in their findings, these reviewing doctors concluded that any restrictions and limitations of her medical conditions would not prevent her from working in “any occupation”.
Upon review, the Court found that Hartford had erred in its denial for several reasons. In part, the Court criticized Hartford for not completing an in-person medical evaluation, especially given that many of Ms. Sorensen’s health conditions were not “susceptible to objective verification” (such as fibromyalgia). Further, a Hartford reviewing doctor cherry-picked medical records, looking at five office visits rather than the entire medical file, and was never given a copy of the SSA’s decision granting Ms. Sorensen Social Security benefits in order to distinguish his conclusions.
If you feel that your insurer is not fully considering your disabling medical conditions, please feel free to reach out to one of our attorneys directly.
Every claim is unique and the discussion above is only a limited summary of the court’s ruling in this case. If you are concerned that your insurer is using any of the tactics above to evaluate your claim, an experienced disability insurance attorney can help you assess the situation and determine what options, if any, are available.
[1] Sorensen v. Hartford Life Ins. Co., No. 4:21-cv-00286, 2022 WL 2135811 (D. Idaho June 14, 2022).
