Phil Tatlow has been handling more and more claims for Professionals, including, trial attorneys and physicians. In a recent case against United America Life Insurance Company, he represented a trial attorney for long-term disability benefits. He was able to obtain monthly benefits for as long as the attorney remains disabled as well as a substantial back pay award for his client after successfully proving that his client's obesity, arthritis and fatigue all combined to prohibit him from employment as a trial attorney, even though he may be able to seek employment in other legal positions. It was crucial to understand the terms of the plan, the essential job functions of a trial attorney as opposed to a general practice attorney. Phil obtained the support of a treating physician to rule out several essential job functions that the client's obesity and fatigue prevented him from being able to perform. Although the client had earned substantial income the year before, Phil was successful in arguing that because of the nature of contingent fee work, his client may be able to do some work in the legal field, but still remain disabled under the terms of the plan.
Professional long-term disability claims under ERISA are dificult because the insurance companies typically hire consultants to reveiw and comment on all evidence in the case in order to strengthen the odds of them winning in the event of a law suit. Many times the claimant does not know of the consultants opinions until after they receive the denial letter. Once the claim is denied it is too late to submit additional evidence. It is important for Professionals to hire an ERISA attorney at the earliest possible stage to combat the insurance companies and to increase the odds of obtaining LTD benefits. Although many Professionals are very intelligent and sophisticated, the complexity of ERISA laws and statutes, make it a difficult field to navigate.
