The Need for Frequent Medical Treatment can be Disabling

In Neaton v. Hartford, 2013 U.S.App.Lexis 5814 (6th Cir. Mar. 21, 2013), the 6th Circuit found that the Hartford had improperly denied benefits to the Plaintiff.  The Plaintiff’s medical conditions required frequent medical treatment that prohibited him from working on a full time sustained basis.  The Hartford relied upon a non-examining medical doctor hired by the insurer to deny the claim.  The 6th Circuit cited the following cases in evaluating the Hartford’s decision making process:

  • Kalish v. Liberty Mut., 419 F.3d 501 (6th Cir. 2005):  “While it is not per se improper to rely on the opinion of a non-examining medical consultant, whether a doctor has physically examined the claimant is a factor that may be considered in deciding whether a plan administrator acted arbitrarily in giving greater weight to the opinion of its consulting physician.”
  • Smith v. Cont’l Cas. Co., 450 F.3d 253 (6th Cir. 2006): Improper to rely on non-examining medical consultant to determine severity and credibility of pain.

The Court further took issue with the vocational expert opinion relied upon by  the Hartford.  The Court cited Felisky v. Bowen, 35 F.3d 1027 (6th Cir. 1994) for the proposition that “a vocational expert’s opinion that a claimant can perform certain jobs is only substantial evidence to the extent that the vocational expert had a complete, accurate understanding of the claimant’s restrictions and limitations.”  The Court noted that the Hartford’s vocational expert offered opinions were unsupported and conclusory.  The Court took judicial notice per FRE 201 of Bureau of Labor statistics to assess the absenteeism issue.

The 6th Circuit reinstated and awarded retroactive benefits.  The decision is unpublished.



About tngainjurylawyer
Serious Injury Lawyer in Tennessee and Georgia.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: