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“Jim” was a 62 year old chief executive officer of a nationally known nonprofit organization. Jim quickly rose through the ranks of various nonprofit organizations, but once he reached the pinnacle of his profession, he became afflicted with Bipolar II disorder. Although Jim could work at a less demanding occupation, he could no longer handle the stress and long hours required of his job as a CEO. Jim applied for partial disability benefits and found employment elsewhere as a consultant.
When the insurance company began questioning Jim in detail about the number of hours he could work, the nature of his consulting duties, and whether his new work showed he could still function as a CEO, Jim sought legal advice from Riemer Hess.
The issue was not whether Jim could perform some work. The issue was whether he could continue performing the material duties of his own occupation as a chief executive officer. That distinction was critical. Jim’s CEO role required sustained executive functioning, high-pressure decision-making, public leadership, long hours, frequent problem-solving, management of senior staff, strategic planning, board interaction, and the ability to remain emotionally and cognitively steady under pressure.
His consulting role was very different. It allowed more flexibility, fewer hours, less organizational responsibility, and reduced exposure to the intense stressors that had made his CEO position unsustainable.
Riemer Hess helped Jim respond to the insurance company’s questions in a careful and accurate way. We also prepared a detailed comparison between Jim’s former CEO duties and his new consulting duties. This comparison showed that his ability to perform limited consulting work did not mean he could return to the far more demanding role of CEO.
The claim strategy focused on explaining the difference between partial disability and total disability. At first, Jim remained capable of working in a reduced and less demanding capacity. That supported his claim for partial disability benefits. But as his Bipolar II symptoms worsened, even that reduced work became too difficult to sustain reliably.
Riemer Hess was able to convince the insurance company that Jim was disabled from his demanding occupation as CEO, even though he could still perform some consulting work. The insurance company awarded Jim partial disability benefits.
When Jim’s condition later worsened, Riemer Hess helped demonstrate that he was no longer able to maintain even the reduced demands of consulting work. The insurance company then awarded him total disability benefits.
