Case Study: Assisted small law firm recover additional ERISA-based Long Term Disability Benefits for their Worker’s Compensation client.

Posted by

Problem:

A small law firm had handled a Worker’s Comp case for a man who had a heart attack on the job. The man subsequently became too disabled to work. (He had had 4 by-pass surgeries and 9 angioplasties.) His employer processed his claim for disability benefits by off-setting his Worker’s Comp Award — effectively denying him any further benefits. The law firm had no experience in ERISA benefits law, and could not help it client further—but they were reluctant to merely send him to a larger, full-service firm with an ERISA partner.

Solution Provided:

Working with his counsel, I advised them to take the position that, while the heart attack for which he received the Worker’s Comp Award was caused by exertion at work, his underlying heart disease was not caused by his work, and it was inappropriate for the employer to off-set his award. Several hard-hitting letters were sent, not only making the legal arguments, but demonstrating how the employer had acted in bad faith during the course of handling his claim. The employer resisted the arguments, so a federal court case was filed. Hard-nosed negotiations ensued.

Results:

The case was settled at full value – with the employee receiving a lump sum representing the present value of all benefit payments he would have received up to his retirement age. The client was happy, and the law firm did not have to send its client to another firm.

Category : Case Studies