A California art director who suffered from Covid-19 and related symptoms won his disability insurance claim from the Guardian in federal court.
Jason Kim became disabled after contracting Covid-19 in early 2021. By March 2021, he was unable to continue working due to a myriad of symptoms.
However, because he became covered under the long-term disability insurance policy within 12 months of becoming disabled, Guardian conducted a pre-existing condition review. It found that he suffered from depression and anxiety prior to becoming covered under the LD policy.
In 2021 Mr. Kim experienced a wide variety of symptoms including psychosis, brain fog, cognitive impairments extreme pacing, chills and fever, short-term memory damage, and an inability to communicate. He was also diagnosed with hyperkinetic movement disorder, tardive dyskinesia, and tardive akathisia. It is not clear whether these symptoms and conditions are a result of Covid-19, however they came about around the same.
Guardian denied his claim for long term disability benefits due to the pre-existing condition limitation. Guardian claimed that his condition was caused by or contributed to by a pre-existing condition, namely depression and anxiety.
The Court Rejected the Pre-existing Condition Argument
The medical records showed that prior to January 2021, Mr. Kim had not seen a therapist in several years. The symptoms he began suffering from in January 2021 were far more severe than anything he had experienced before and included many new symptoms. As such, the court noted that his depression and anxiety were minimal, and categorically different from the symptoms he suffered in January 2021.
Moreover, the court noted that Guardian’s own reviewing doctor opined that there was no connection between Mr. Kim’s disability and his pre-existing conditions.
Thus, Mr. Kim’s disability claim was not considered pre-existing and the Court moved on with determining whether he was disabled and entitled to benefits.
Mr. Kim Is Disabled under the Long-Term Disability Insurance Policy
Multiple physicians concluded Mr. Kim was disabled, including Guardians’ reviewing doctors and his own treating doctors. It was also noted that Guardian never argued he was not disabled, so that fact is undisputed.
Given the medical evidence and undisputed disability, the court found Mr. Kim was disabled under the terms of the LTD policy. The court awarded him the past due LTD benefits.
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