Bartolic Law has helped clients suffering from Crohn’s Disease and/or Irritable Bowel Syndrome get their long-term disability insurance claims paid. In one client’s case, the client had a job that required the client to stand and walk significantly and to constantly interact with others. The Crohn’s Disease symptoms were so severe, that if the client ate or drank anything before or during work, the client would have to take unscheduled breaks from work all day for trips to the restroom, lasting over twenty minutes at a time.
We had the client create a journal of frequency of bathroom trips and their duration, and also had the client’s family corroborate the frequency and duration of trips. We also had evidence of the client’s symptoms if the client did not eat or drink all day, which also rendered the client unable to sustainably work. We then had a vocational expert provide an analysis for the insurer explaining that the client would be off task at work too frequently to maintain competitive employment. This persuaded the insurer to pay the claim.
Crohn’s disease affects 780,000 Americans. The sickness can also cause life-disrupting complications. Another similarly debilitating condition is irritable bowel syndrome (IBS). The causes of these conditions remain unknown, although medical experts blame suspected factors like the environment, genetics, and immune system responses. An estimated 20 percent of Americans living with such conditions also have close relatives like parents, siblings, and children suffering from it. Crohn’s and IBS can have different early symptoms, such as diarrhea, stomach cramps, blood-stained stool and fever. Individuals may also experience exhaustion, appetite loss, weight loss and inflammation of the skin and liver.
Just like its cause, we still have no definite cure for this condition. However, several treatments may reduce recurrence frequency. Doctors use surgery, nutritional supplements, and other drugs to manage it. The treatments might assist in controlling inflammation, relieving symptoms, and resolving dietary problems. Specific prescriptions depend on complication levels, a patient’s response to past treatments, the disease’s severity, and inflammation locations. Further, the disease can cause disability, although doctors need to determine that based on a patient’s specific condition. If a medical expert determines a patient’s inability to work, the patient could qualify for disability insurance benefits.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)