- 3 -
the same benefits as above, with the exception that the waiting
period is reduced from 130 days to 60 days. Enrollment in plan B
requires the submission of a medical history statement and is
subject to Standard’s approval. The employee cost of plan B is
approximately $5 per month; the City pays the rest. During all
relevant times, petitioner was enrolled in plan A.
On October 15, 1985, while working for the City, petitioner
tripped on an unrepaired crack in the sidewalk and struck his
head on the pavement, sustaining permanent injuries to his head,
back, and right eye. Nevertheless, petitioner returned to work
with the City. In November 1988, as a result of these injuries,
petitioner applied for disability benefits under plan A.
Standard, however, rejected his claim.
In December 1988, petitioner applied to change his long-term
disability insurance coverage from plan A to plan B. As
requested by Standard, petitioner submitted a medical history
statement. Standard denied petitioner’s request, and petitioner
remained covered under plan A.
On April 26, 1989, petitioner suffered another work-related
accident. This time, petitioner, while trimming high tree
branches, fell and suffered head, back, and neck injuries. As a
result of the accident, he was unable to perform his regular
duties for the City. After the accident, petitioner’s work
schedule was as follows: (1) From April 27 to May 2, 1989,
Page: Previous 1 2 3 4 5 6 7 Next
Last modified: May 25, 2011