In Mackey v. Liberty Life Assurance Company of Boston, an Arkansas federal court ruled that Liberty abused its discretion when it denied benefits to Mackey on the grounds that there were three vocational alternatives for her without actually considering her abilities to perform the job duties of the alternate occupations. The court did not accept Liberty’s conclusion and remanded with instructions that, “A benefit plan administrator must also consider its member as an individual, factoring the material characteristics of the person, such as (in this case) age and computer skill.”
Plaintiff Brenda Mackey was a registered nurse employed for approximately 20 years by Baxter Regional Medical Center. Due to chronic knee pain, she underwent an arthroplasty which left her with femoral nerve palsy. She became dependent on hydrocodone for pain relief and received disability benefits since it was undisputed that she was unable to work in her own occupation as an operating room nurse. After two years, the definition of disability changed, requiring her to be disabled from working in “any occupation that the Covered Person is or becomes reasonably fitted by training, education, experience, age, physical and mental capacity.”
Liberty employed a Vocational Case Manager who reviewed Mackey’s medical records and determined she should be able to work at three different sedentary occupations, two of which were jobs for registered nurses. The third one required use of computer skills. The court analyzed all three jobs and determined Liberty had abused its discretion in deciding Mackey could perform the job duties without proper analysis. It remanded to Liberty with specific instructions.
Court’s Remand Order
The court found three specific errors with Liberty’s denial of benefits.
1) Two of the three alternate occupations still required Mackey to work as a registered nurse. All treating physicians, plus those employed by Liberty to review Mackey’s medical records, agreed she needed to take hydrocodone, a controlled substance, for her chronic knee pain. An employee of the Arkansas Nursing Board informed Liberty that nurses are prohibited from taking a controlled substance during the hours they are working, a caveat Liberty ignored. On remand, the court noted that Liberty must “obtain proof of a different interpretation from the Nursing Board, or defer to the Board employee’s interpretation of the regulation.” This interpretation precludes Mackey from working in these jobs.
2) Liberty failed to consider Mackey’s age as required by the terms of the benefit plan. She was 63 at the time of her appeal, which is “a central factor” in determining whether she can perform the duties of an occupation “that she had never performed in her career before.” On remand, Liberty must consider her age.
3) Liberty failed to consider Mackey’s computer skills which were required by one of the alternate jobs it determined she could perform. Liberty acknowledged that Mackey did not own a computer, but seemed to think that was not relevant when it found she sent emails through her phone. On remand, Liberty must give proper weight to Mackey’s lack of computer skills.
For all these reasons, the court reversed Liberty’s decision denying benefits and ordered it to reconsider based on the court’s ruling.
This case was not handled by our office, but it may provide claimants guidance in responding to insurers who suggest alternate careers without fully considering a claimants’ capability of performing the job duties of “any other occupation.” If you need assistance with a similar matter, or any other disability issue, please contact any of our lawyers for a free consultation.