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The claimant was a high school special education teacher for Fairfax County high school students. Short-term disability benefits are funded by Fairfax County but managed by Liberty Mutual.

In this case, the claimant was denied short-term disability benefits for her job as a Fairfax County Public Schools Special Education Teacher. Liberty Mutual based its decision to deny benefits on the fact that the claimant’s physicians would not assign a definitive diagnosis to explain why she had unexplained fainting and “blacking out” spells and why she had numbness in her extremities, coupled with unexplainable fevers.

The claimant first did her mandatory pre-litigation appeal without the assistance of counsel. Liberty Mutual denied that appeal and the claimant retained counsel.

The primary arguments made in support of the claim focused on the specific job duties of this job (it was not just “teacher”) and included the following:

  1. Liberty Mutual did not dispute the fact that the Claimant suffered from the blacking out spells
  2. Claimant’s job duties included physical requirements
  3. Claimant’s job duties required driving to different classroom locations, which her doctor had said she was unable to do due to the inherently dangerous nature of unpredictable blacking out spells while driving.
  4. Claimants job duties of lifting and supervising students were made incredibly dangerous by the possibility of a fainting spell, as someone who suffers from unpredictable black out spells cannot safely be in front of a classroom of special needs teenagers
Short term disability benefit of $15,092.87. Should the claimant remain disabled under the terms of the policy she will be entitled to approximately $1.28 million in benefits until age 65.

Expected Lifetime Value of Benefits is $1,279,508

Ben Glass
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Ben Glass is a nationally recognized ERISA disability & life insurance attorney in Fairfax, VA.