In Kristen Reetz v. Hartford Life and Accident Insurance Company, the Western District Court for Seattle, Washington, granted Reetz’s motion for judgment, reinstating her long-term disability benefits that had been terminated by Hartford. As the Court commented, “Ms. Reetz’s medical history, as well as the facts behind Hartford’s termination of LTD benefits, are long and complex.”
Ultimately, after a comprehensive review of the Plaintiff’s medical records, consideration of the reports of those professionals who reviewed the records, Plaintiff’s award of Social Security Disability benefits (SSDI), and an evaluation of an Employment Analysis Report (EAR), the Court ruled that the Plaintiff was entitled to reinstatement of her long term disability benefits from the date of the termination in April 2016. The Court found that Plaintiff was disabled from working in her own occupation or any similar occupation for which she might otherwise be qualified.
Summary of Relevant Facts
Plaintiff Reetz first received short term disability benefits from Hartford beginning on March 7, 2014, to June 5, 2014, when she was unable to work due to persistent pain caused by fibromyalgia and spondyloarthropathy. In June 2014, she had knee surgery. Hartford approved her claim for long term disability benefits finding that she was unable to work in her own occupation as a senior customer service representative.
On April 28, 2016, Hartford terminated Plaintiff’s long term disability benefits on the grounds that her medical condition had improved and she could now work in her own occupation. Plaintiff’s administrative appeal was denied and she filed this ERISA lawsuit. Since the definition of disability changed in June 2016, requiring Plaintiff to be disabled from working in any occupation for which she might be otherwise qualfied, the Court also held that under the new definition, she was still entitled to long term disability benefits.
Own Occupation Analysis
Plaintiff’s occupation as a customer service representative was classified as sedentary. She was required to sit for six to seven hours a day. All her treating physicians reported that she was unable to sit for more than 30 minutes at a time. Although Hartford granted her claim for long term benefits on this basis, it terminated her long term disability benefits after approximately 21 months, stating that her condition had improved and she should now be able to work.
The Court, in its comprehensive review of the multitude of medical records, found “no evidence of improvement.” In fact, the Court found that “the record evinces that Ms. Reetz’s chronic pain remained, at best, unchanged, and may have worsened.” With that finding, the Court ordered Plaintiff’s long term disability benefits from April 2016 to June 2016 be reinstated.
Any Occupation Analysis
Even though Hartford’s EAR identified 10 sedentary jobs it deemed the Plaintiff was qualified to perform, the Court disagreed. It stated that it gave “significant weight” to the opinions of Plaintiff’s treating physicians who opined that she was unable to sit for only 30 minutes at a time. This disqualified her from performing any sedentary level job that required sitting for at least six hours a day. Therefore, the Court found she was unable to work in any occupation for which she was otherwise qualified and ordered her long term disability benefits continued from June 5, 2016, on.
This case was not handled by our office, but we thought it could be of guidance to those who may be struggling to rightfully obtain their long term disability benefits that were terminated. For any issue with your disability claim, contact one of our attorneys at Dell & Schaeer for a free consultation.