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Success Story: Jim Brooks

LTD Denied for Non-Compliance

Success Story Jim Brooks | Share LawyersForty year old Jim Brooks was not a stranger to hard work. A foreman at a cement mill operation, he had been working in construction since he was eighteen. His wife was an elementary school teacher, working during the day while Jim worked afternoons and evenings. It was sometimes difficult to see each other, but they were working towards Jim switching to the day shift to make things easier at home as their two children grew older.

Unfortunately, with such a busy schedule, Jim often ate fast food or ready-to-go meals while on shift, saving dinner leftovers to eat  during the day. As the afternoon shift didn’t end until 11:00pm every day, Jim would come home and go straight to bed, which wouldn’t leave him much time during the day to get much exercise outside of work. Jim was also a chain smoker who was trying to quit.

The long hours, less than optimal sleep, and stress from work had taken its toll on him. Jim had already had a heart attack, and had gone through a battle with cancer. At the advice of their doctors, Jim and his wife started a joint diet to help both of them make better choices and support each other along the way.

However, Jim remained stressed about providing for his family and continued to push himself to work long days and weekend overtime. Before Jim knew it, he was in the hospital again. He had had a second heart attack, which had been stress-induced. He was off of work for the foreseeable future, and the doctor told him that he would have to completely change his ways to make sure his heart didn’t fail him again. Work, it seemed, was out of the question.

Jim had benefits through his job, and so he went on short-term disability benefits, but found himself very weak and had difficulty being active for more than a few hours at a time.

Jim returned to his doctor regularly, and began rehab and physical therapy to bring his strength back up. He had regular check-ins, which he sometimes found difficult to go to, given his lack of energy.

The rehab was progressing slower than the doctors’ initially thought, and they recommended that Jim apply for long-term disability benefits to continue his recovery and make sure his family was provided for. Jim continued to go to the rehab appointments both during and after his long-term disability application had been submitted, and hoped that things would start to get better.

One of the days that Jim had a follow-up appointment at the rehabilitation clinic was a particularly difficult day for him. He woke up feeling weak and lethargic, had no appetite, and could barely get out of bed. He called the clinic to let them know he wasn’t coming, and told them he would call again to reschedule the appointment.

However, the insurance company took this absence as non-compliance with necessary rehab treatments, and concluded that Jim was not following the necessary treatments required to continue to receive his benefits. They denied his claim, and left Jim without a way to look after his family.

It was only on the recommendation from his wife’s co-worker, followed by a visit to the Share Lawyers Facebook page that he thought to call Share Lawyers for help. Jim didn’t think that he had a case, especially given his previous history with illnesses, but Share Lawyers not only empathized with his story, but worked with him to collect all the medical evidence and documentation needed to build a strong case against the insurance company. It took some time, but Share Lawyers negotiated a fair and substantial settlement on Jim’s behalf. When the case settled, Jim and his family were relieved because now they could focus on Jim’s full recovery and looking forward to the future.

*Names have been fictionalized to protect the privacy of our clients.