Opinion ID: 855794
Heading Depth: 2
Heading Rank: 5

Heading: Final Appeal Decision

Text: In February 2009, after reassessing Neaton’s occupational prospects, Hartford rendered its final appeal decision upholding the termination of Neaton’s LTD benefits. Explaining the decision, Hartford marshaled three pieces of evidence. First, Hartford relied on Dr. Petronic-Rosic’s opinion that Neaton would need three to four days of recovery after each surgery “for reasonable healing” if he were working from home. Second, Hartford estimated that Neaton would require surgery “on a 2 month or greater basis.” To reach that estimate, Hartford noted that during the 16-month period from May 2007 through October 2008, Neaton underwent six surgeries.9 And third, Hartford relied 9 A summary of Neaton’s treatments: Date Type Citation January 2009 Moh’s R. 17-9 at 196-203 October 2008 Moh’s R. 17-9 at 257-62 August 2008 Moh’s and C&C R. 17-9 at 234, 263-71 July 2008 C&C R. 17-9 at 361 June 2008 Moh’s R. 17-9 at 272-75 May 2008 Moh’s R. 17-9 at 276-79 March 2008 C&C R. 17-9 at 237 January 2008 Moh’s R. 17-9 at 280-86 -9- on the results of an occupational research survey to conclude that Neaton’s job could be performed from home. Based on those assumptions, a Vocational Clinical Case Manager determined: It is reasonable, given the common practice of employers, the sedentary nature of [Neaton’s] occupation, and that the occupations identified can be full-filled [sic] by working from home, [to find that Neaton] would reasonably be accommodated for a recovery period of 3 to 4 days bi-monthly, with additional allowances that could include Saturday and Sunday as recovery days. Hartford adopted this analysis and concluded Neaton was capable of performing the duties of his own occupation in a home environment. With his administrative appeals exhausted, Neaton filed suit.