Court Affirms Sun Life’s Disability Benefit Denial

In Schmitz v. Sun Life Assurance Company of Canada (Sun Life), the claimant, Jeff Schmitz, was fired by Banner Engineering in July 2008 on the grounds his work performance was poor. In October 2011, Schmitz was diagnosed with multiple sclerosis. He then filed for disability benefits under the policy which covered him during his employment with Banner. He claimed symptoms caused by his multiple sclerosis were what caused his poor performance resulting in him being terminated. Therefore, he argued, he was disabled at the time he was fired.

Sun Life denied his application and his appeal of the denial on the grounds that he was not disabled when he was employed by Banner or at the time he was fired. Schmitz filed an ERISA law suit in the Minnesota District Court located in Minneapolis. The District Court granted Sun Life’s motion for summary judgment on the grounds that the lawsuit had been filed after the expiration of the statute of limitations. Schmitz appealed to the U.S. Court of Appeals for the Eighth Circuit.

The Circuit Court agreed with Sun Life and the District Court and held that the ERISA lawsuit was barred by the statute of limitations that was clearly laid out in the disability insurance contract. After reviewing the District Court decision, the Circuit Court commented, “Because we conclude that Schmitz’s lawsuit was untimely, we affirm.”

Minnesota Law Concerning Proof of Loss Does Not Apply to this Case

Schmitz argued that his claim was timely under Minnesota statutes which say that claimant’s do not need to provide proof of loss until 90 days after the disability terminates. The Circuit Court held that the statute upon which Schmitz relied “does not apply to group insurance policies like the one at issue here.”

Although ERISA does not establish a statute of limitations for actions concerning disability benefits, when there is a “reasonable limitations period in their contract” it will be honored. After a careful and detailed analysis of the contract, the Court concluded that the last date for plaintiff to file his proof of claim was December 29, 2008, and the last day for filing an ERISA lawsuit was December 29, 2011. His lawsuit was not filed until March 2013, “well after the contractual limitations period had expired.”

The Issue is Limited to Schmitz’s Untimely Filing of his ERISA Lawsuit

Schmitz argued that Minnesota law requires the insurer to prove it suffered prejudice before denying a claim for benefits as untimely. But, the Court said, “That is not the issue presented by this case.” The issue was the timeliness of the filing of the lawsuit and “Minnesota law does not require a showing of prejudice in this context.”

The Circuit Court ultimately concluded, “Because Schmitz did not file his lawsuit until after the limitations period set by the insurance policy had expired, we conclude that his lawsuit was untimely and affirm the judgment of the district court.”

This case was not handled by our office, but it may provide claimants guidance in their pursuit of long term disability benefits when their insurer refuses to take action on their claim. If you need assistance with a similar matter, or any other issue relevant to your disability claim, please contact any of our lawyers for a free consultation.

Alabama Court Upholds Lincoln Life’s Disability Denial to Plaintiff

Susan Till v. Lincoln National Life Insurance Company (Lincoln) is a 74 page opinion in which the plaintiff, a radiology technician who suffered with severe back pain, raised many issues in her pursuit of long-term disability benefits. Till’s application for long term disability benefits was denied and, after she exhausted her administrative appeals, she filed this ERISA law suit.

The Alabama district court for the Middle District of Alabama meticulously analyzed each of the issues and reviewed all of the plaintiff’s medical records. For each individual issue, the court ruled that the plaintiff failed to meet her burden of proof. The court found that, “After careful consideration of the evidence, the parties’ briefs and the relevant law,” the court found in favor of Lincoln Life.

Lincoln Provided Plaintiff a Full and Fair Review and Did Not Unreasonably Disregard the Social Security Determination and Vocational Analysis

The plaintiff was awarded disability under Social Security and argued that Lincoln failed to consider this in denying her disability benefits. But, in Lincoln’s denial letter, it stated that it had “reviewed all documentation in the file.” This included all the evidence that supported her application for Social Security disability benefits and Social Security’s determination along with its vocational analysis. Lincoln also explained in its letter “that the Social Security benefits decision is based on a different plan and interpretation than the ERISA plan.”

After reviewing Lincoln’s denial letter and the entire administrative record, the court held that Till was not denied a full and fair review since, “The administrative record demonstrates that Lincoln reviewed the Social Security determination and the evidence upon which it was based.”

Lincoln Provided a Full and Fair Review and Did Not Disregard the Actual Requirements of Plaintiff’s Job Description

The plaintiff argued that Lincoln erred in that, instead of considering her actual job requirements, it relied on the job description given in the Dictionary of Occupational Titles (DOT). She argued that the DOT information is outdated and should not be relied on. The court noted that, “Plaintiff has not demonstrated that Lincoln disregarded her actual job description during its initial claim review or during the two appeals…Therefore, Plaintiff has not shown that she was denied a full and fair review by Lincoln’s alleged disregard of her actual job description.”

Lincoln’s Decision Denying Benefits Was Reasonable and not Arbitrary and Capricious

In response to plaintiff’s allegation, Lincoln argued that its denial was based on, “the evidence in the record and the opinions of the two independent reviewing physicians.” The court recounted the reports of each treating physician as well as the opinions of reviewing physicians and decided against plaintiff. The court noted that Lincoln’s denial letter explained why it was relying on the opinions of its reviewing professionals and the lack of objective evidence in the file confirming abnormal physical exam findings of her spinal problem and its diagnosis. Finally, “The court concludes that Lincoln had a reasonable basis on which it relied to deny Plaintiff’s benefits, and its decision was not arbitrary and capricious.”

This case was not handled by our office, but it may provide guidance to those who are struggling to provide evidence to their insurers to support their disability claims. If you have questions about this, or any other disability issue, contact one of our disability lawyers for a free case evaluation.

Ohio Court Upholds Unum’s Denial of Accidental Dismemberment Benefits

Collins v. Unum Life Insurance Company of America is a case with an unfortunate result for plaintiff Daniel Collins who fractured his ankle when he fell in the employee parking lot. Initially surgery was performed and various screws put in place to hold the tibia and fibula together and securing the medial malleolus. For about three months, he had no complaints and the fracture appeared to be healing appropriately.

Then, he began having complaints about pain. About six months after the fall, he developed a Charcot ankle, which is misalignment of the ankle joint. His treating physician noted that he suffered from pain due to the fracture “among other issues.” He had more surgery, but continued to have pain. A breakdown of the tibia indicated that he might need a “limb-salvage procedure.”

After numerous problems and more surgeries, approximately one year after the fracture, surgeons amputated Collins leg just below his knew. The pre and post-surgical diagnoses included, among other things, Charcot neuroarthropathy with ankle deformity, ankle fracture and diabetes mellitus. A few months after the amputation, Collins applied for dismemberment benefits under his employee benefit plan and his claim was denied. Unum based its denial on its determination that “Plaintiff’s diabetes partly contributed to the need to amputate Plaintiff’s foot.” Plaintiff’s administrative appeal was denied and he filed this ERISA lawsuit.

Unum’s Accidental Dismemberment Exclusion

The Unum policy which provided plaintiff dismemberment coverage specifically had an exception and did not provide coverage for dismemberment that was “caused by, contributed to by, or resulting from…disease of the body.” The policy also gave discretion and authority to Unum to process and interpret claims under the policy.

The District Court Upholds Unum’s Denial Based on a Sufficient Record Showing the Diabetes Was A Contributing Factor to the Need for Amputation

Plaintiff’s medical history showed that he was responsible for not controlling his diabetes. As a result, he had ankle problems both before and after his fall. A board-certified pathologist, who reviewed plaintiff’s medical records at the request of Unum, determined, with a reasonable degree of medical certainty, that “both the underlying illness and the injury were necessary for the development of the joint pathology that led to the amputation.” In evaluating these facts, the court held that “Unum’s decision to deny Plaintiff’s benefits application was not arbitrary and capricious based on the policy’s bodily disease exclusion.”

This case was not handled by our firm, but we believe it can be instructive to those struggling to obtain benefits under their insurance’s dismemberment coverage. If you have questions about this case, or any matter relevant to your dismemberment or disability coverage, contact one of our experienced attorneys at Dell and Schaefer for a free consultation.

Appeals Court Upholds Hartford’s Termination of Disability Insurance Benefits

In Rassekh Sobh v. Hartford Life and Accident Insurance Company, Hartford paid the plaintiff benefits beyond his own occupation period as a Technical Operations Lead for Chase Bank and into the any occupation period. During that time, plaintiff had two back surgeries and claimed he was disabled. His medical records and reports from his treating physician supported his claim and he received disability benefits for many years from 2009 to 2014. His treating physician, Dr. Dryer, waffled between supporting his disability claim, failing to respond to Hartford’s request for an opinion and reporting plaintiff could work in a sedentary job.

Video Surveillance, Independent Medical Exam, Peer Review and Failure of Dr. Dryer to Respond

Hartford eventually conducted video surveillance of the plaintiff attending his gym over a two-day period of time. On both days, he walked to the gym without any assistance and stayed between 44 and 55 minutes. Hartford sent a copy of the video surveillance to Dr. Dryer for an opinion. When Dryer failed to respond, Hartford commissioned an independent medical exam (IME) by Dr. Dinenberg, a board certified orthopedic surgeon, who also conducted a peer review of plaintiff’s medical records. An Employability Analysis (EA) was also performed.

Dr. Dinenberg determined that plaintiff could work in a sedentary job and the EA discovered several different occupations for which he was suited. As a result of the reports, Hartford terminated plaintiff’s long term disability benefits. Plaintiff filed an administrative appeal.

Administrative Appeal

In response to plaintiff’s administrative appeal, Hartford sent the medical records for another peer review. The physician agreed plaintiff could engage in sedentary work. Meanwhile, Dr. Dinenberg was finally able to contact Dr. Dryer who agreed Sobh could perform sedentary work. Based on these opinions, and the video surveillance, Hartford upheld its decision to terminate benefits and plaintiff filed the ERISA lawsuit in the Florida district court which sided with Hartford and Plaintiff Appealed.

Eleventh Circuit Unpublished Appellate Opinion

The appellate court opinion came down on the side of Hartford and upheld the district court’s decision. The Eleventh Circuit court specifically stated that, “Here, the lack of response from Dr. Dryer, in conjunction with the surveillance video, the opinion of Dr. Dinenberg, and the Employability Analysis sufficiently substantiated Hartford’s decision to terminate Sobh’s benefits.”

The court concluded its analysis by holding, “In light of this evidence, we find no error in the administrator’s decision to terminate benefits. At the latest, Sobh was no longer disabled as of October/November 2014, and Hartford properly discontinued his benefits.”

This case was not handled by our firm, but we believe it can be instructive for those who have been under long term care by a physician who ignores requests by an insurer to respond to requests for disability opinions. If you have questions about this, or any other aspect of your disability claim, contact one of our experienced disability attorneys for a free consultation.

California Judge Allows Lawsuit for Intentional Infliction of Emotional Distress Due to Manner in Which MetLife Investigated Disability Claim

Kresich v. Metropolitan Life Insurance Company (MetLife) is a federal case out of the Northern District of California favorable to a plaintiff who was harassed, accused of lying and oppressed during the processing of his disability claim. Because of MetLife’s conduct, the plaintiff sued for intentional infliction of emotional distress (IIED). Despite MetLife’s vigorous argument that the claim was preempted by ERISA and the plaintiff could not pursue his tort action, the court disagreed and found in favor of the plaintiff. Relying on precedent, the court stated “Plaintiff’s IIED claim stems not from the handling and disposition of his claim, but from independent allegations of harassment and oppressive conduct. There is no alternative enforcement mechanism under ERISA by which Plaintiff could bring such a claim.”

Background

Kreisich was a vice-president for Kaiser Permanent Controller when he had to quit work due to severe and chronic back pain. Pain medications caused him side effects so serious that he was unable to work. He filed a claim for disability with his insurer, MetLife. Even though MetLife eventually determined he was entitled to long term disability benefits, he filed suit in state court alleging that during the claims processing, MetLife:
• Intentionally delayed scheduling independent medical exams (IMEs).
• Intimidated him into attending multiple IMEs knowing the exams would cause him additional pain and emotional distress.
• Ignored his correspondence.
• Demanded time extensions.
• Accused him of lying about his pain and exaggerating it.
• Purposely misstated and misrepresented statements made by the plaintiff and his treating physicians.
• Put pressure on him to drop his claim, return to work and accept a smaller settlement than one to which he was entitled.

Plaintiff alleged that by these acts, MetLife “engaged in extreme and outrageous conduct by unnecessarily prolonging review of his claim and causing severe mental distress.”

MetLife removed the case to federal court and argued that plaintiff’s state claim was preempted by ERISA and he should not be allowed to pursue it. The court carefully analyzed precedent and determined IIED claims that do not depend on whether or not disability benefits have been awarded are not preempted.

Preemption Analysis

The court pointed out that “ERISA provides a uniform regulatory regime over employee benefit plans.” This means that issues concerning whether or not a claimant is entitled to benefits must be brought under ERISA and decided according to ERISA rules and regulations. MetLife argued that based on this requirement, Kresich’s claims could only be decided under ERISA.

The court clarified that plaintiff’s claims did not concern whether or not he was entitled to benefits, which would be preempted by ERISA, but was independent of the processing since his claim for damages “remained regardless whether his claim for benefits was paid.” The court analyzed many similar cases where tort claims were allowed to proceed against the insurer. If not, then plaintiffs “would be subject to such treatment with no available recourse, and a plan administrator could investigate a claim in all manner of tortious ways with impunity.”

Since, in this case, the plaintiff “seeks damages from Defendant’s alleged harassing and oppressive conduct that existed wholly independent of the Plan…[and] his IIED claim does not depend on whether or not he was denied benefits” the plaintiff was allowed to pursue his IIED claim for damages against MetLife.

This case was not handled by our office, but it may provide claimants guidance in their pursuit of tort claims against their insurers when the insurer has engaged in wrongful conduct during the processing of the claim for disability benefits. If you need assistance with a similar matter, please contact any of our lawyers for a free consultation.

States Advance Policies to Help Immigrants Stay Healthy While Feds Are at a Standstill

Young girlCongressional inaction on immigration reform is effectively leaving a huge void, and states have been stepping up to fill that void with public policies that reflect reality. Last week, we saw another example of the consequences of this federal inaction. The United States Supreme Court, reduced to eight Justices due to Congress’s failure to hold hearings on President Obama’s appointment to fill the Scalia vacancy, failed to reach a majority opinion and instead affirmed the Fifth Circuit Court’s ruling in United States v. Texas. This failure left intact a preliminary injunction blocking the Deferred Action for Parents of Americans (DAPA) and the expansion of the 2012 Deferred Action for Childhood Arrivals (DACA+) programs. These programs promised temporary relief from deportation for an estimated four million immigrants—long-term residents who are raising families, running businesses, and contributing to the vibrancy of our communities.

Importantly, the deferred action policy that has been in place for the last four years is not affected by this ruling. President Obama stated that with DACA+ and DAPA he has pushed to the limits of his executive authority.Immigrant organizations and their allies will continue to fight for comprehensive immigration reform.

In the meantime, states and local governments are leading the way to craft policies that affect immigrants that are both compassionate and commonsense. On the healthcare front, a growing number of states and local governments are doing their part to provide immigrants with the health coverage they need in order to grow and thrive. Immigrants work, play, pay taxes, go to school, raise their families, ride the bus, and live their lives alongside non-immigrants everyday. Given that, many states have correctly reasoned that providing public health care coverage for all people improves the immunity and safety of the entire community by reducing communicable diseases. These states have decided that immigrants should have access to immunizations, vaccinations, doctor’s visits, and hospitalizations if they need it, as well as the long-term benefits that health coverage provides.

Five states and the District of Columbia provide public health insurance to undocumented children, and counties and cities throughout our country have created programs that increase access to primary and specialty health care for low-income uninsured individuals, including undocumented adults. Illinois is a leader on this front. Through its All Kids program, Illinois was the first state to provide health insurance to low-income children regardless of immigration status. As a result, Illinois has one of the lowest uninsurance rates for children in this country—and it continues to lead by building a campaign to provide statewide health coverage for the remaining uninsured, including undocumented adults, as well as exploring other ways to increase access to health care. California’s governor and legislature just asked the federal government for permission to allow undocumented adults to purchase unsubsidized private health insurance on their state-based marketplace. California and New York provide health coverage to DACA status individuals. Advocates in New York are proposing innovative coverage options for uninsured immigrants, and New York City launched a pilot of its program to increase uninsured immigrants’ access to health care. Minnesota’s Health Care Financing Task Force recommended expanding eligibility of its public insurance program, Minnesota Care, to include undocumented immigrants.

Millions of immigrants are rooted in this country and deserve to be able to come out of the shadows and fully participate in every aspect of society. States and local governments are pushing the envelope to craft health care policies that reflect this reality. Hopefully, people working in the highest levels of the branches of our federal government will be inspired to do the same.  

Despite Ongoing Budget Impasse, Progress Against Poverty in Illinois

John Bouman at a budget rally in SpringfieldGovernment, at all levels, has a critical role to play in securing justice and opportunity for people in poverty or otherwise at risk. So as Congress remains highly polarized and gridlocked, it is important to take advantage of opportunities for progress at the state level. This is where critical decisions affecting at risk populations increasingly are being made.

From afar, Illinois might not look like a shining example of a state picking up where the federal government has become incapacitated. After all, the state legislature and the governor are locked in a record-long budget impasse that is eroding the state’s social and human service infrastructure and, in the process, causing some our state’s most vulnerable citizens to suffer.

But despite the ongoing budget impasse and its devastating consequences, Illinois achieved many substantial anti-poverty victories during the most recent legislative session. This spring, the Shriver Center advocated for several bills in the Illinois General Assembly that will advance justice and improve opportunities for low-income people. When signed by the governor and enacted into law, each of these bills will help low-income individuals and families take one more step away from poverty.   

Protecting Domestic Workers. Domestic workers play a critical role in the Illinois economy.  They care for the elderly, clean homes, and nurture children, ensuring the health and prosperity of Illinois families and freeing others to work outside the home. Their work ultimately makes all other work possible. Despite the value of their work, domestic workers have historically been excluded from protections under laws extended to workers in other industries. This has led to a workforce, predominantly composed of women supporting their own families, that is isolated and vulnerable.

The Domestic Workers’ Bill of Rights, HB 1288, establishes a definition for domestic work and extends worker protections to domestic workers, including the right to the state minimum wage, to be paid for all work hours, to one day of rest per week for workers that work for one employer more than 20 hours a week, and to protection from sexual harassment on the job. This bill, which will benefit an estimated 35,000 domestic workers in Illinois, will ensure that domestic workers are treated with the dignity they deserve.  

Providing a Lifeline to Victims of Human Trafficking. Victims of trafficking, torture, and other serious crimes desperately need a safe place to live, adequate food, immediate attention to their physical and mental health needs, and an opportunity to stabilize their lives as they cooperate with law enforcement, adjust their immigration status, and obtain work authorization. The current processing time for visas ranges from 5 to 16 months, leaving these immigrants vulnerable to further exploitation and harm.

The Shriver Center, in partnership with Heartland Alliance, advocated for SB 3007, which provides access to critical services for immigrant survivors of human trafficking while they await a decision on their visa applications. SB 3007 provides access to state-funded SNAP, cash assistance, and Medicaid for up to one year while the victim is preparing his or her visa or asylum application. SB 3007 has passed both houses of the legislature and awaits the Governor’s signature. The first program of its scope in the nation, this bill is expected to provide a lifeline to roughly 700 people annually.

Ensuring That Children Benefit from Child Support. Child support can be an important source of income for low-income families. However under current Illinois law, a family receiving cash assistance through the Temporary Assistance for Needy Families (TANF) program gets only $50 of a child support payment, no matter the amount the noncustodial parent actually pays. The rest of the child support payment is kept by the state and the federal government. SB 2340 will increase the amount that these families receive from child support payments paid by noncustodial parents to the maximum permitted by federal law. This will encourage on-time child support payments and let children see that both their parents are doing their best to care for them. Once signed into law, the changes will go into effect on January 1, 2017.  

Helping Cash Assistance Recipients Get the Education They Need. Although education is essential to moving people out of poverty, 35.9% of TANF recipients have less than a high school education. Most TANF recipients are required to engage in work activities at least 30 hours each week. But, under current law, obtaining a high school diploma or GED certificate is classified as a non-core activity for adults over 19 years of age. SB 2906 amends the Public Aid Code to add attendance in high school and GED programs to the set of activities that count as a core work requirement activity for TANF recipients. Once signed into law, this bill will allow the Illinois Department of Human Services and TANF recipients to prioritize these important activities and ensure that more recipients complete their high school educations.

Protecting Survivors of Domestic or Sexual Violence. Employees coping with sexual or domestic violence deserve to feel secure and safe in their employment, which is vital to their economic security. The Victims’ Economic Security and Safety Act (VESSA), originally enacted into law in 2003, established employment protections for survivors and their families. HB 4036 expands VESSA protections to all employees working in Illinois. Newly covered employees may take unpaid leave to seek medical attention, domestic violence or sexual assault services, counseling, legal assistance, and other activities needed to address the violence. Employers are also prohibited from discrimination based on an employee’s status as a survivor or a family or household member of a survivor. Once signed into law, the amendment would go into effect on January 1, 2017. 

Ensuring Consumers Can Make Informed Healthcare Decisions. The health care system can be confusing. Health care consumers need clear and accurate information so that they can make informed decisions about their health care. The Empowering Meaningful Choice in Medicaid Managed Care Act, HB 6213, ensures that Medicaid managed care consumers can access more up-to-date provider directories, see clear guides showing what drugs are and are not covered, compare plans by performance measures, and know who to call if they have problems getting care. HB 6213 has passed the House and Senate with unanimous support; a few amendments bringing technical changes need to be voted on before it's sent to the Governor for his signature.

Extending Health Coverage for Children. Children who have health coverage are more likely to have an ongoing relationship with a doctor, receive preventive care, early diagnosis, and treatment, and they have better health outcomes. In 2005, Illinois extended eligibility for public health insurance program to cover children from working poor families, including children who have no access to public or private insurance on the marketplace due to their immigration status. As of January 31, 2016, the Covering All Kids Health Insurance Act covered almost 41,000 children.

However, Covering All Kids was set to sunset on July 1, 2016. HB 5736, which passed both houses of the Illinois legislature, amends the law to extend coverage to October 1, 2019. This ensures that needy children will continue to have access to preventive and primary care and makes our communities healthier. 

Diverting Youth from the Juvenile Justice System. Seventy percent of youth arrested in the U.S. are living with a mental illness, and 50-70% of youth in the juvenile justice system meet the criteria for a mental illness. Youths living with mental illness deserve opportunities for treatment in the community--not ineffective and costly entanglement with law enforcement and the juvenile justice system.

SB 320, the Opportunities for Youth Diversion Task Force Act, will bring policymakers, community advocacy groups, community-based service providers, health care systems, law enforcement, and juvenile justice partners together in a task force to review evidence-based best practices for diverting youth to appropriate community-based mental health services. The task force will prepare an action plan and make recommendations to the General Assembly and Governor that will increase the number of youth experiencing mental illness diverted away from the juvenile justice system.

Impasse Continues. Looming over all of that progress, however, is the ongoing state budget impasse. Thanks to Governor Rauner’s hostage taking, Illinois recently entered its second straight year without a budgetand now wears the dubious distinction of being the only state in the country without a budget for the current fiscal year.

The lack of a budget has caused widespread suffering in Illinois. The human and social service infrastructure is crumblingstaff are being laid off, programs are shutting down, and people are going without services. The impasse is effectively undermining Illinois’ ability to fight poverty, and our state is growing weaker as a result.   

While the impasse has taken a devastating human toll, it has also reaffirmed an important lesson on the critical, proactive role that government must play in a functioning society. If our other victories this session demonstrate the potential for state-level government action in the fight against poverty, then the budget impasse illustrates what can happen when state government fails in that pursuit. 

Shriver Center advocates, in collaboration with the Responsible Budget Coalition and other organizations, have been on the front-lines of fighting for a responsible budget that includes revenue necessary to fund vital services. We will continue that fight until the State of Illinois has a budget that demonstrates its commitment to fighting poverty and promoting prosperity. 

 

Justice = Love

The following spoken-word essay was delivered at the opening of the Shriver Center’s 2016 benefit on June 14, 2016, by Michelle Mbekeani-Wiley, Community Justice Staff Attorney at the Shriver Center.

Michelle Mbekeani-Wiley

I would like to start this evening with words from a hero, who but not for his fearless compassion for humanity, we would not be here tonight celebrating the work of his legacy.

The most important thing that I know about living is love. Nothing surpasses the benefits received by a human being who makes compassion and love the objective of his or her life. For it is only by compassion and love that anyone fulfills successfully their own life’s journey. Nothing equals love.Sargent Shriver

Decades later the Sargent Shriver National Center on Poverty Law has found something that does equate to loveJUSTICE. That is to say, when we as human beings make compassion and love the objective of our lives, we fight for justice. Justice not just for those who look like us, live near us, or share our same struggle, but for society as a whole. Because, in the words of Sargent Shriver, “the War on Poverty asks everyone to get in the fight.”

So we must ALL fight for justice when victims of trafficking do not have access to public benefits.

We must ALL fight for justice when there are barriers to quality and affordable housing.

We must ALL fight for justice when women are still denied equal pay, and WE MUST ALL fight for justice when race, gender and LGBT status become the basis of hate.

Here at the Shriver Center we fight for all of these things because we believe that justice is not a limited fund account and love is not a budgeted expense.

The only thing that limits our access to the bank of justice in this country is hate, greed, and apathy, they are the bank tellers. That is why when we collectively fight for justice and equality, we are not crying for a handout for the people we help, instead we are demanding the funds in their account, the account of basic human rights. And that is why we fight with them.

We fight with them because fighting with them is fighting for society.

Fighting with them is fighting for the creed of our constitution, though not crafted with many of us in mind; we are all nonetheless entitled to its promises.

We fight with them because fighting with them is fighting for Love, the foundation of humanity, without which we cannot stand.

So tonight I hope we can all revel in the power of love and the work it inspires us to do! We must remember that gender and racial justice do not belong to one side of the aisle; instead it should be the aisle, the area of space that we share and have in common because love does not have a political party. Love is what transcribed the document that consummated the marriage of this country’s union. All men are created equal. Those are our vows to each other. We must continuously strive to live by those vows. Dr. Martin Luther King Jr. said to, “Stick with love, because hate is too great a burden to bear.”

So tonight I ask you all to do two very important things:

  1. Stick with love, because it is the path to justice, and
  2. Walk this path, with this organization, this country, and most importantly humanity.

More than 500 supporters gathered at the Shriver Center’s 2016 annual benefit to celebrate the impact we’ve had on policies that create better opportunities for people living in poverty. We were proud to honor John G. Levi and Martha Minow with the Sargent Shriver Equal Justice Award for their outstanding contributions to social justice. Watch our video to learn more about our work and how you can join us in the movement to create a just society. 

 

 



 

A Remedy for Workers in Chicago: Paid Sick Leave Ordinance Heads to City Council

Workers who are sick should stay home from work. And if their children are sick, they should keep them home from school. Workers should not have to choose between their paycheck and their own health or that of a family member. Unfortunately, 42% of the private workforce in Chicago—just over 460,000 workers—are unable to access a single paid sick day, and are forced to make these impossible decisions.

Lack of access to paid sick time is an epidemic plaguing workers throughout the entire labor market, but it’s most prevalent among those paid low wages — those least able to afford missing out on even one day of pay. Nearly 8 in 10 workers in Chicago who earn less than $20,000 annually are unable to earn paid sick leave. For these workers, especially those supporting a family, a single sick day can be disastrous. Take low-income working mothers: two thirds lose wages when they must care for a sick child, and nearly one in five have lost a job due to sickness or caring for a family member.

Limited access to paid sick leave doesn’t only undermine the well being of workers and their families; it’s also a public health liability and a drag on the economy.

Paid sick days are especially uncommon in occupations that require frequent engagement with the public. Over 3 in 4 of the workers preparing food in Chicago, for example, lack access to paid sick days. No one wants to work while sick, but these workers have no other choice — and are forced to expose other workers and consumers to potential illness as a result. The consequences can be widespread: a study published in the American Journal of Public Health (AMJPH) found that lack of paid sick days contributed to an additional 5 million cases of influenza-like illness in the United States during the flu pandemic of 2009.

Businesses aren’t immune to the consequences of a no earned sick time policy, either. When workers show up to work sick, they often aren’t able to operate at full productivity. This phenomenon — known as “presenteesim” — costs American businesses $160 billion annually.

Recognizing the threats posed to the City of Chicago by limited access to paid sick leave, Aldermen Proco Jo Moreno, Toni Foulkes, and Ameya Pawar have offered up a remedy — an ordinance that would bring paid sick leave to all workers who work in Chicago. The ordinance would allow employees to earn one hour of sick time for every 40 hours worked, up to 5 full work days in a 12-month period. Workers would also be able to carry half of any unused sick time — up to 20 hours — into a subsequent year. The ordinance applies to business of all sizes and to employees who have worked for an employer for 80 hours within any 120-day period.

Chicago residents, like Aldermen Moreno, Foulkes, and Pawar, have also recognized the importance of bringing paid sick days to all the city’s workers. In a non-binding referendum in 2015, 82% of Chicagoans who cast ballots voted in favor of allowing all employees to earn paid sick time.

If the voices of Chicagoans are heard and the ordinance is passed by the City Council, Chicago will join more than 20 other cities and 5 states that are benefiting from paid sick leave. After instituting its groundbreaking paid sick leave ordinance in 2007, San Francisco, for example, saw increases in job and business growth compared to 5 neighboring counties. In a survey conducted 3 years following implementation, over half of all workers in the San Francisco reported experiencing benefits, and two thirds of employers expressed support for the ordinance.

Everyone gets sick, and it’s a universally unpleasant experience. But falling ill shouldn’t derail one’s financial stability. A family shouldn’t lose food off the table because of a head cold; a working mother shouldn’t lose her job because her child caught the flu. Alderman Pawar has referred to paid sick leave as “just a baseline of decency.” We agree. The Chicago City Council should pass the paid sick leave ordinance. It’s good for workers. It’s good for business. It’s good for Chicago.

The ordinance is expected to be voted on by the Chicago City Council on Wednesday, June 22. Please contact your Alderman today and urge him or her to support the paid sick leave ordinance

 

The Truth About Marketplace Health Plan Rates

You may have heard stories about dramatic increases in private health insurance rates since the implementation of health reform. Although Illinois insurance carriers recently sent preliminary 2017 rates to regulatory authorities, we likely won’t know what the final prices and plans for next year look like until closer to the beginning of open enrollment. But we already know that misinformation about increased rates is being hyped by the media.

Fingers crossed behind backThis is a lie about Obamacare plans that we’ve heard before. What stories about these proposed rate filings often miss is that, even if premiums go up, financial assistance (through tax credits) to help pay for those premium increases as well. Simply put, the majority of consumers in the Marketplace won’t feel the premium price increases that the media often focuses on.

A new report from the U.S. Department of Health and Human Services (HHS) proves the point. The report found that, last year, the average cost of Marketplace coverage for people getting tax credits went from $102 to $106 per month—a modest increase, especially when you think about how costs for everything tend to rise.

In Illinois, 75% of Marketplace consumers receive tax credits based on their income. By design, tax credits increase if the cost of the benchmark plan (the second lowest-cost silver plan) goes up. So if all premiums in a market go up by similar amounts, consumers who get tax credits will not necessarily pay more, because their tax credits will go up to compensate.

In addition, if a Marketplace consumer isn’t happy with his or her current plan—either because the premium went up or for another reason—the consumer has the ability to, and in fact is encouraged to, come back and shop around. According to HHS, nearly 50% of returning HealthCare.gov consumers selected a new plan for 2016. In Illinois, that number was greater than 50%, and those consumers saved an average of $636 annually.

The stories we keep seeing about big rate increases happen only in a world that doesn’t exist. As the HHS report notes, “the average premium changes reported in insurers’ rate announcements assume a scenario in which no consumer leaves the Marketplace, no new consumers enroll, nobody switches plans, no new plans are offered, and no one receives tax credits.” We know from the past three years of Marketplace experience, these assumptions do not reflect reality. Beyond the fact that the majority of Marketplace customers receive tax credits, we know that consumers whose income or job situation changes will move between the Marketplace and employer-subsidized plans or Medicaid. Moreover, for better or for worse, the Marketplace is robust with choices (the number of plans in Illinois increased from 410 choices in 2015 to 480 choices in 2016) so people will often “vote with their pocketbook” and switch plans.


Of course any increase in premium prices for Marketplace consumers will be a hardship to many. Moreover, out-of-pocket costs (like high deductibles) continue to concern Illinois consumers. However, it’s important to step back and remember that before the Affordable Care Act, affordable, quality health care was completely out of reach for many consumers—for example the millions of people with pre-existing conditions. And for many more, health care plans excluded important services like maternity care or mental health treatment.

Now, Illinois consumers have the option to purchase quality health plans and have the financial assistance to help pay for them. The media need to acknowledge the immense benefits of these tax credits, if they are going to responsibly report on premiums.