Long-term disability insurance is meant to be a safety net for workers should they become disabled before retirement. Unfortunately, as with many forms of insurance, insurers often wrongly deny claims or minimize payouts. Long-term disability denials are often results of insurance-friendly doctors finding that the disability was a result of a pre-existing medical condition. Such was the case for two New York City police officers who were diagnosed with cancer following their work at Ground Zero after the September 11 attacks.
Last month, an appeals court found that the two officers are entitled to benefits despite the fact that the NYPD had argued the cancer was caused by pre-existing conditions. The court also ruled that the wife of a third Ground Zero police officer who died of cancer is entitled to benefits.
The case involved a police officer who assisted in rescue and recovery efforts on September 11 and during the days after; she was then diagnosed with rectal cancer in 2002. Another police officer in this case who worked at Ground Zero had actually discovered a walnut-sized lump in his thigh months before the attacks, and by November 2001 the lump was the size of a softball and he was diagnosed with cancer. The third officer, who was on site September 11 and spent the days after at a site where debris was dumped, was diagnosed with lung cancer in 2002 and died in 2007.
The officers' doctors testified that the cancers were caused by, or worsened by, their efforts on September 11 and the days thereafter. However, a medical panel found that each officer's cancer was caused by a pre-existing condition, so the board of trustees of the NYPD pension fund denied their disability applications.
The court of appeals, however, has now ruled that all three officers were entitled to benefits under the "World Trade Center presumption" law. Under this law, public employees who participated in rescue and clean-up efforts related to September 11, and go on to develop certain diseases, are presumed to have become ill due to exposure to toxins at Ground Zero and the other involved sites.
Such public employees are, in general, to be given the benefit of the doubt and they are not required to submit evidence linking their conditions to September 11.
While the World Trade Center presumption applies only to a limited number of people, workers here in Wisconsin can still learn from this case. Disability benefits are often denied at first, and it is important to stand up for one's rights by filing an appeal. It is often beneficial to do so under legal counsel.
Source: Reuters, "New York court says Ground Zero police entitled to disability benefits," Daniel Wiessner, Dec. 13, 2012
- To learn more about long-term disability benefits and the laws that govern this type of insurance, please visit our Milwaukee employment law firm's Long-Term Disability Benefits page.