Article from: www.thenewspaper.com/news/49/4951.asp
5/5/2016AIDS Patient Sues Photo Enforcement Firm
Former employee sues American Traffic Solutions after his HIV-related disability claim in denied.
An AIDS patient in Maricopa County, Arizona filed a federal lawsuit against American Traffic Solutions (ATS) last month. Scott Darnell, 54, claims the photo ticketing firm refused to cover his disability despite being promised such benefits as a former operations supervisor for the ATS speed camera program in Chicago, Illinois.
"He managed the violation inventory to ensure contract compliance; managed progressive disciplinary procedures with employees and approved timecard and/or work schedules; handled operational questions and concerns; handled escalated customer issues; coordinated departmental functions; and developed strong, positive work relationships with staff, customer and vendors," Darnell's attorney, Kristin Kalani, explained. "He staffed the program, oversaw all of the training of leaders and associates, and networked with business partners such as the Chicago Police Department and various staffing agencies."
Under the terms of the ATS employee welfare benefit policy, an individual qualifies for lifetime disability if he is "unable to perform the material duties of any occupation for which he is, or may reasonably become, qualified based on [his] education, training or experience" due to a long-term illness. Those who qualify are paid 60 percent of monthly earnings under the insurance plan.
Darnell claims he is owed $3000 per month under the policy, as his salary was $60,000 per year on his last day of work on February 27, 2014. According to court filings, his immune deficiency problems began in September 1989 and accelerated to the point that he was hospitalized on March 6, 2014. The ATS policy covered his short-term medical disability claim, but a dispute ensued over medical records. On December 18, 2014, the photo ticketing firm's insurance denied Darnell's long-term coverage claim, stating there was no evidence that he could not perform the sedentary duties of a supervisor. Over the course of a year, Darnell appealed the decision and had various doctors examine him on behalf of the insurance company.
"In my opinion, [Darnell] is not able to work because of cognitive decline from brain damage secondary to AIDS and meningitis," Dr. Richard Sall, a medical consultant, concluded on August 25, 2015.
The next day, another consultant came to the opposite conclusion.
"I cannot find any objective evidence of physical or cognitive impairment," Dr. Imad Durra wrote. "It is true that the claimant has a potentially serious medical illness, which is uncontrolled HIV, but this does not automatically mean that he has impairing conditions."
Dr. Sall later amended his findings to state that Darnell was unable to work beginning on July 9, 2015, when Darnell was hospitalized a second time. Darnell claims that the review of his case was rigged and that he is owed benefits under federal employment law. He says ATS is liable because the firm has a fiduciary duty to monitor the benefits plan. He is suing for the full amount of benefits, plus interest and attorney's fees.