Michael Bartolic handles ERISA § 502 claims in Chicago and the rest of Illinois against group long term disability insurance policies for disability benefits payable, and where appropriate, against the administrators of the plans who’s breach of fiduciary duty harmed the participant. Michael Bartolic has successfully obtained long term disability benefits for clients suffering from all kinds of conditions, including:
- Chronic Fatigue Syndrome
- Complex Regional Pain Syndrome
- Lumbar/Cervical Spine Deformities
- Alzheimer’s Disease and Other Forms of Early Onset Dementia
- Chiari Malformations
- Atrial Fibrillation
- Congestive Heart Failure
- Vertiginous Disorders and Chronic Dizziness
- Pulmonary Conditions
- Diminished Eyesight
- Loss of Use of a Limb
- Hepatitis C
- Anxiety, Depression, and other Mental Health Disorders
- And many more
Even in seemingly clear cases of disability, claimants going it alone without the help of an ERISA lawyer are almost always denied benefits. Disability contains 3 dimensions to the analysis: a medical component, a vocational component, and a contractual component. How these 3 aspects work together to determine if you are disabled can be complex, and provides the insurer with more bases to deny your claim. Oftentimes, the claimant was awarded disability benefits from Social Security and from the short term disability plan with little resistance only to face an uphill battle with the long term disability insurer. Clients often posit “how can the insurer not see that I am disabled?” The answer is because the insurer has a financial incentive to deny your claim, and your claim is essentially a bundle of paper to the insurer, not a person. Michael Bartolic adds value to long term disability claims by completing the disability puzzle for the insurer, and humanizing your claim, so the insurer sees you as a disabled person, rather than a file with “no objective evidence supporting disability.”
Not only rank-and-file employees claim benefits under disability insurance plans. Often even executives, partners, accountants, lawyers and doctors develop disabling conditions preventing them from being able to work. We understand the unique vocational demands and stresses applicable to the disability of executives and managers that often do not present themselves in other disability benefit claims. Michael Bartolic has represented C-level executives in obtaining disability benefits for various conditions. These cases require a more acute focus on vocational evidence, and the extent to which the condition or treatment may interfere with the attention and concentration needed to perform your demanding occupation.
ERISA regulates the amount of time the administrator can take to render a decision on your claim, and you will be given a short amount of time after a denial to submit additional evidence supporting your claim and appeal the decision. The sooner you involve us in the process, the greater the chances of success on any claim. Your insurer will use any and every tool at its disposal to deny your claim, and consults lawyers in the process. The only way for you the level the playing field is by consulting with an attorney yourself.
Termination of Benefits Under “Any Job” Standard
In nearly all policies, the standard of disability will change after some period of time, most commonly 24 months. Often, claimants obtain long-term disability benefits initially, and subsequently receive a notice from the administrator advising that benefits will be terminated because the claimant no longer meets the definition of disability under the plan. In these cases, the standard of disability is harder to meet and you need to arm yourself with legal counsel to combat the insurers’ tactics and own lawyers. Executives and professionals often face particular difficulty, as the vocational element of the dispute becomes more complex.
Mental Health and Other 2-Year Limitations
In cases where there is a mental health condition, the administrator may advise you it will terminate benefits pursuant to a mental health clause, or other benefit limitation in the policy, limiting payment to no more than 24 months. Every policy is worded differently, and a plan administrator’s decision on whether a mental health condition, such as depression, has caused a disability or contributed to a disability, should not be taken for granted. We recognize the unique interaction between mental health conditions and physical conditions prevalent among executives, managers, and other professionals. Other bases insurers use to limit benefits include self-reporting conditions, chronic fatigue syndrome “and related conditions,” etc. As soon as you get such a notice, whether or not benefits have already been discontinued, you need to consult a lawyer to prepare for the appeal, because the sooner you involve us, the less time (if any) you will spend without receiving your monthly benefits.
Michael Bartolic has helped clients maintain their disability benefits by showing the client would meet the standard of disability independent of any mental health condition, and demonstrating seemingly self-reported conditions were really diagnoses based on objective criteria.
Claims for Benefits
We assist our clients in claiming benefits under both employer provided group disability plans and individual disability insurance policies. While we understand you may be hesitant to consult a lawyer unless and until absolutely necessary to do so, the earlier you involve an attorney, the greater your odds of ultimate success. The Firm assists clients at the initial claim stage on a reasonable fixed fee basis, which are significantly lower than when we have to appeal a claim denial. Best of all, even if your claim gets denied, the Firm will credit any fees you already paid towards fees for appellate representation. It’s a small price to pay for peace of mind.