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Denied Disability Ruling Reversed for Ailing Firefighter

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Downers Grove, ILIt’s yet another example that disability applicants who are wrongly denied disability should continue to fight the good fight. In many cases, the courts will see through the holes drilled into a case by a pension board, and provide a worthy claimant his due.

That’s what happened recently in the case of an Illinois firefighter who injured his knee while on the job and could no longer perform his duties as a firefighter. After a pension board denied his disability claim allegedly in bad faith, an appellate court awarded him two years’ worth of full disability payments, together with 65 percent of his full salary for life.

As reported by the Chicago Tribune (3/21/13), Edward Lambert joined the Downers Grove Fire Department in 1997 and served with distinction until injuring his knee in 2008. The injury, which admittedly allows him to remain mobile, precludes him from safely and effectively fulfilling his duties as a firefighter.

Lambert duly applied for a disability pension. However, as with the case of many wrongly denied disability claims, his application was turned down by the Downers Grove Fire Department Pension Board in 2010, two years after injuring his knee. The Circuit Court of DuPage County upheld the decision of the pension board the following year.

Lambert appealed, and won - although the Downers Grove Pension Board voted March 12 to petition the appellate court for a review of their decision.

According to testimony in the bad faith insurance lawsuit brought against the pension board, Lambert initially injured his knee in 2005, re-injuring the knee three years later. Court filings revealed he underwent two surgical procedures in 2009, in an attempt to rehabilitate the knee.

The crux of the disagreement between the two sides appeared to center on basic movement and activities Lambert was capable of in the everyday world, compared against what he could safely undertake in his role as a frontline firefighter.

During a public hearing in March 2010, following his surgical procedures, Lambert testified that he was unable to squat, kneel, crawl or climb up or down ladders; felt pain when walking up and down stairs, and could not carry a hose or an air pack. He also said he was told by his employer to simply grit through the pain.

Four evaluations of Lambert’s knee in 2009 revealed he was 15 percent disabled as a firefighter, which meant he could reasonably fulfill no more than 85 percent of his duties due to the limitations of his knee. What’s more, three doctors performing independent examinations at the behest of the pension board all agreed Lambert’s knee, even after surgery, was too far gone to reasonably expect a return to full duties as a firefighter.

The pension board supported its argument that Lambert was still physically capable, through the evaluation of 30 minutes of surveillance video of Lambert outside his home performing menial tasks. As a result, the pension board ruled that while the accounts and evaluations by the doctors were found overall to be credible, the board found issue with Lambert’s claims of pain and limitations, and discounted the position of doctors claiming Lambert to be disabled. In the board’s view, evaluations were based primarily on Lambert’s own subjective descriptions of pain.

Lambert’s attorney countered that simply walking up and down a flight of stairs with a bag of groceries is far removed from carrying a limp human being down a ladder or carrying a stretcher in the heat of crisis. Such a limitation as a bad knee in the active throes of fighting a fire puts both Lambert and his fellow firefighters at risk, his lawyer said.

The 2nd District of the Appellate Court of Illinois agreed, reversing the original decision of the lower court by a 2-1 margin. “After the pension [board] had determined that the plaintiff was not credible, it used this determination to discredit all of the medical opinions presented at the hearing that indicated the plaintiff was disabled,” the appellate court’s opinion states. The Court found that the pension board disregarded the medical evidence in the original bad faith insurance decision, and took some information out of context.

Lambert would receive two years’ worth of pension benefits, which translates to about $110,000 as well as 65 percent of his salary as a firefighter for life, dependent on yearly independent evaluations.

As wrongly denied disability claims go, this one appears to have a happy ending.

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READER COMMENTS

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Thank You for publishing my story and bring to light the problems with wrongly denied disability pensions. My attorney made our case without reasonable doubt that I am disabled as a Firefighter and can no longer safely perform the duties as such. The Pension board has been Petty and Vindictive through this whole process and is now appealing the Appellate courts decision to the Illinois Supreme Court. I am looking forward to this whole sordid affair to be over so I can move on with my life.

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