Insurer miscalculated benefits for lawyer who had heart attack 1 day before $65K raise, judge rules
Image from Shutterstock.com.
A tax lawyer who had a heart attack over Labor Day weekend—a day before he received a $65,000 raise—was entitled to disability benefits based on the higher paycheck, an Illinois federal judge has ruled.
Ten Pas, a tax partner at the firm then known as McGladrey, had a heart attack Sunday, Aug. 31, 2014, at his summer cabin in Wisconsin. The next day, Labor Day, he underwent cardiac angioplasty. He was discharged Tuesday and went to work Wednesday. He had also done some work remotely over the holiday and before his return to the office.
At the office, he experienced numbness and was later admitted to the hospital. He had a stroke.
Lincoln National Insurance Co. administered McGladrey’s long-term disability plan. The insurer determined that Ten Pas’ first day of disability was Aug. 31, 2014, and calculated benefits on his salary before the raise, which was $25,000. The policy paid 60% of salary, which came to $15,000 per month.
Ellis ruled, however, that Ten Pas was entitled to benefits based on his post-raise salary of $30,000 per month. The 60% payout was $18,000 per month.
Under the policy, employees are considered actively at work on a Saturday, Sunday or holiday that is not a scheduled workday, Ellis said. That meant Ten Pas was still “actively at work” over the Labor Day weekend, and he did not become disabled until the first regularly scheduled workday that he could not perform his regular duties.