According to the physical demands analysis submitted by his employer, the claimant's job at Tower Hill Insurance Group required him to:Sit for a maximum of two hours at a time, for a total of seven hours a day.Stand or walk for thirty minutes at a time, for a total of one hour a day.Perform tasks that did not require lifting anything heavy.Claimed Disabling Conditions:Knee Injury: The claimant sustained a knee injury on May 15, 2016, which led to knee replacement surgery on July 19, 2016.Polymyalgia Rheumatica (PMR): The claimant claimed that his disability was primarily due to stiffness, pain, and fatigue resulting from PMR.Reasons for Claim Denial:Due to these medical conditions, the claimant applied for long-term disability benefits under his insurance policy with Hartford Life & Accident Insurance Company. Unfortunately, his claim was denied due to the policy required the claimant to prove that he was continuously disabled throughout the entire Elimination Period (from May 15, 2016, to August 27, 2016). Hartford determined that Benson was not disabled during this entire period based on the medical evidence. The insurance company relied on the opinions of two doctors who conducted a file review of the medical evidence.Appeal Process:The claimant then filed an appeal, arguing that Hartford's final decision to deny his long-term disability benefits was based on a different rationale than the initial denial. Specifically, he claimed that the initial denial was based on his failure to prove disability on a specific date (August 28, 2016), while the final decision was based on his failure to prove that he was disabled throughout the entire Elimination Period. The claimant contended that this change deprived him of the opportunity to challenge the new rationale effectively.This is the oral argument in the 11th circuit court of appeals.These public domain recordings are brought to you by Ben Glass Law, a national long term disability and life insurance firm headquartered in Fairfax, VA.By making these recordings into a "podcast," we've made the listening easier for claimants, attorneys and claims adjusters alike. If long term disability or life insurance benefits have been denied, we'd love to review your denial letter and give you a strategy for moving forward. This is a free service and you can go here to begin submitting your denial letter.

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