Many Chicago area employees have long term disability insurance coverage through work, either via an insurance policy the employer offers, or through a union pension plan. Most disability benefits are two-tiered. One part of the benefit pays you if you are unable to perform your own occupation. That benefit usually lasts between 1 and 3 years, the most common being 2. Thereafter, you may continue to receive disability benefits if you are unable to perform the material and substantial duties of any occupation. Individuals often wonder how do insurers and pension plans determine what other occupation they can perform. The administrators should be doing some sort of vocational analysis that considers your age, education, training, and experience in determining whether you qualify for jobs the administrator deems you physically able to perform. But that is not always the case.
Recently during a deposition I took, a representative of the Midwest Operating Engineers Pension Plan testified that the pension fund does not consider a participant’s vocational qualifications at all, relying solely on medical consultants’ opinions on whether the claimant is physically capable of performing any occupation. Pension funds have tried to review disability claims this way, and repeatedly have been admonished by courts for disregarding claimants’ vocational qualifications. See Demirovic v. Bldg. Serv. 32 B-J Pension Fund, 467 F.3d 208, 213 (2d Cir. 2006); Tate v. Long Term Disability Plan for Salaried Emps. of Champion Int’l Corp., 545 F.3d 555, 559 (7th Cir. 2008); Quinn v. Blue Cross & Blue Shield Ass’n, 161 F.3d 472, 476 (7th Cir. 1998).
At a minimum, the person or person reviewing your disability claim must consider whether you possess the qualifications to perform an alternative occupation that the administrator determines you can physically perform. But as individuals age, their ability to retool and transition to other forms of employment diminishes. This is especially so when individuals have fewer transferable skills from the previous work they had been performing. This is where a vocational expert can be invaluable.
If you have been denied disability benefits by an insurance plan through your employer or by a pension fund, contact a knowledgeable ERISA lawyer. Specifically, if you have claimed All Work Total Disability benefits from the Midwest Operating Engineers Pension Plan and your claim was denied, call an ERISA lawyer immediately.