I often get calls from claimants who have failed to make timely claims for long term disability benefits. A recurrent theme in some of these phone inquiries is that the claimant failed to apply for LTD benefits because their overall mental and/or physical health hindered their ability to advocate on their own behalf. In many cases, the callers tell me that they were fired by their employers before they could file for disability.
Fortunately, just a few days ago the Sixth Circuit Court of Appeals decided a case on point. In Waskiewicz v. UniCare Life and Health Ins. Co., the Court of Appeals heard the case of Laura Waskiewicz, a Ford Motor Company employee who was absent from her job due to a "debilitating emotional breakdown". Ms. Waskiewicz did not inform Ford of her absence and was fired from her job. Since she was no longer an active employee at Ford, her application for LTD benefits under the company's plan was not accepted. However, Ms. Waskiewicz's doctor had written a letter stating that his patient's inability to work was due to her medical condition and that her disability had begun on the day of her first absence from work.
Ms. Waskiewicz contested the denial of her long term disability benefits in Federal District Court. After loosing at the District Court level, the case was heard by the 6th Circuit Court of Appeals which decided, in an unanimous decisions, that her failure to file for LTD benefits was excusable because she was unable to comply with the plan's deadline "due to the very disability for which she sought coverage". Appellate Judge Alan E. Norris writing for the three judge panel stated:
“An insurance policy can hardly be said to provide employee
disability ‘insurance’ at all if it protects against sudden disability but not
if the employer immediately discharges the employee because of the disability
before she gets a chance to apply for the benefits,” Judge Norris said. “Common
sense convinces us that the denial of benefits in this case runs contrary to
the spirit of ERISA, which is designed to protect employee benefits, not
subject them to arbitrary termination — in this case retroactive termination —
after the benefit has otherwise accrued.”
This case is undoubtedly a legal victory for disabled claimants. However, it must be pointed out that a successful outcome in a case such as Waskiewicz depends greatly in the ability of the claimant and his or her lawyer to obtain medical opinions corroborating that their patient was unable to file the claim on a timely basis due to a disabling physical or mental condition.
