Disability Insurance Claim: (SDCERS) City of San Diego’s Claim of a Pre-existing Condition Reversed

/, Success Stories/Disability Insurance Claim: (SDCERS) City of San Diego’s Claim of a Pre-existing Condition Reversed

Disability Insurance Claim: (SDCERS) City of San Diego’s Claim of a Pre-existing Condition Reversed

By | 2011-02-16T15:58:48+00:00 February 16th, 2011|Disability Insurance Claims, Success Stories|0 Comments

The City of San Diego provides Disability Retirement Plans to employees that differ from private sector plans.  San Diego City employees are provided with two levels of Disability Insurance Benefits:

  1. Industrial Disability Retirement – If your disability is work related, you are entitled to greater benefits from the date of disability regardless of your age.
  2. Non-Industrial Disability Retirement – If your disability is not related to your employment, you are entitled to benefits beginning at age 55.

The criteria for a member to be considered for Industrial Disability Retirement is to be permanently incapacitated by bodily injury or illness caused by their job; are unable to perform the usual duties of their job; and are required to retire. If awarded, an industrial disability retirement benefit is the higher of the following amounts:

  • 50% of your highest one-year salary; or
  • If you are service eligible, your service retirement benefit.

The employee is also offered federal tax benefits available to disability retirement recipients.

However, if the employee has at least 10 years of creditable service and is found to have become permanently incapacitated by a non-work related injury or illness;  is unable to perform your usual job duties and is required to retire; they may be eligible for a Non-Industrial Disability Retirement. If awarded, the retirement will be the highest of the following amounts:

  • 33 1/3% of your highest one-year salary; or
  • 1.5% x number of years of service x highest one-year salary; or
  • If you are service eligible, your service retirement benefit.

There are no federal tax benefits associated with a non-industrial disability retirement.

As you can see, the employees have a tremendous amount of future earnings and tax implications at stake.

Case History and Ruling

Our client began her employment with the City of San Diego approximately 20 years ago as a sanitation worker.  Her job was considered heavy labor in that she had to lift and drag garbage cans weighing anywhere from 50 to 100 pounds on a frequent basis. The job also required her to climb in and out of the truck and climb up and jump off the rear step of the truck. These activities were done repetitively in the course of the day.

Within five years of the date that the client began employment, she suffered an on the job injury to her lower back which continued to be problematic all through her employment.  In addition, the repetitive jumping and climbing caused her to suffer injury to her feet requiring several surgeries.  Both injuries disabled her from returning to her position with the city. The client made a claim with the city for disability retirement benefits dating back to 2006.  The city denied her claim alleging that the back injury was not disabling and the injury to her feet was due to a pre-existing condition (flat feet).

Stennett & Casino took the case through judicial hearing and through cross examination of the city’s doctor and reports from the treating doctors were able to prove that both the back and feet injury were disabling and both were related to her employment. The client received an award of $104,000.00 in past due benefits. that differ from private employer plans.  They provide two levels of Disability Benefits.  If your disability is not related to your employment, you are entitled to benefits beginning at age 55.  If your disability is work related, you are entitled to greater benefits from the date of disability regardless of your age.

Leave A Comment