Date Range |
Specific Violation |
Evidence Ref. |
Policy Section |
June 2024 - Termination |
1. Pre-disability Earnings Inclusion (Policy §II): Commission excluded from STD payments, affecting financial security |
Ex. 7A (Payroll records), 7B (STD Payment Statements) |
Policy §II |
July - December 2024 |
2. Access to Workday (Policy §III): Improper restriction of Workday access, hindering leave management and record review |
Ex. 7C (Workday Access Logs), 7D (Emails requesting access) |
Policy §III |
September - October 2024 |
3. Extension of Disability Leave (Policy §III): Extension requests not properly evaluated or facilitated, interrupting benefits continuity |
Ex. 7E (Emails requesting extensions), 7F (Denial notices) |
Policy §III |
August - November 2024 |
4. Failure to Notify TPA (Policy §III): Delays or lack of communication from the TPA, reducing transparency and impacting decision-making |
Ex. 7G (Complaint re TPA delays), 7H (TPA correspondence) |
Policy §III |
October - December 2024 |
5. Appropriate Care and Treatment (Policy §II): Medical recommendations ignored, jeopardizing safe return-to-work plan (cite erniewood link and doctor's advice) |
Ex. 7I (Physician's letter), 7J (Accommodation denials) |
Policy §II |
After July 2024 (7-day waiting period) |
6. Commission Pay After Benefit Waiting Period (Policy §II): Payments based solely on base salary post-waiting period, affecting financial compensation |
Ex. 7A, 7B |
Policy §II |
October - December 2024 |
7. Disability Extensions via Reasonable Accommodation (Policy §III): Accommodation requests denied or delayed, impacting continued leave eligibility |
Ex. 7E, 7F |
Policy §III |
Ongoing throughout Leave |
8. Review of Updated Medical Guidance (Policy §III): New medical evidence ignored, compromising care and recovery during disability |
Ex. 7K (Updated medical records), 7L (Lack of response from Cox) |
Policy §III |
Upon Denials |
9. Communication on Denials (Policy §III): Delayed or incomplete communication about denials, impairing ability to appeal |
Ex. 7F, 7M (Correspondence lacking denial reasoning) |
Policy §III |
Following Claim Decisions |
10. Access to Alternative Leave Options (Policy §III): Alternative leave options not facilitated upon claim denials, impacting income continuity |
Ex. 7N (Absence of communication regarding other options) |
Policy §III |
October - December 2024 |
11. Request for Reasonable Accommodation (Policy §II): Return-to-work accommodation requests denied or delayed, jeopardizing safe return to work |
Ex. 7O (Accommodation requests), 7J |
Policy §II |
Throughout Appeals |
12. Timely Appeals Process (Policy §III): Appeal information delayed or unclear, obstructing ability to contest denials |
Ex. 7P (Incomplete appeals info), 7Q (Lack of documentation) |
Policy §III |
Weekly During Leave |
13. Weekly Benefit Adjustments (Policy §III): Delays in resolving discrepancies in benefits, creating financial instability (Include wage theft documentation and time card alteration) |
Ex. 7R (Complaints regarding benefit errors) |
Policy §III |
Prior to 01/02/2025 |
14. Compliance with TPA’s Decisions (Policy §III): Cox overruled TPA’s medical recommendations on time for return work. |
Ex. 6A, 7S (communications indicating policy changes or different interpretation after being approved ) |
Policy §III |
During Time Off |
15. Mental Health Considerations (Policy §II): Insufficient support for mental health conditions during disability, neglecting recovery |
Ex. 7T (Lack of resources or referrals for mental health) |
Policy §II |
Repeated Delays |
16. Notification of Changes to Leave (Policy §III): Lack of clear, timely updates on leave status, disrupting planning (Exhibit email from Keith) |
Ex. 7U (Inconsistent communication) |
Policy §III |
During Time off. |
17. No Additional Waiting Period (Policy §II): Imposed waiting periods for successive disabilities |
Ex. 6A, 7S |
Policy §II |
During time off |
18. Workplace System Access (Policy §III): Premature revocation of access to certain systems, creating barriers to tracking leave status. |
Ex. 7C |
Policy §III |
All time |
19. PTO Usage for STD Supplement (Policy §III): PTO use was mandatory but should be an option to the benefit |
Ex. 7B (explaining PTO was a required), 7U (the policies on PTO). |
Policy §III |
Misaligned STD and FMLA usage |
20. FMLA Coordination (Policy §III): Failure to track FMLA concurrently with STD |
The TPA's record is not what Cox records state.. |
Policy §III |