A Federal Judge has upheld Procter & Gamble’s decision to deny a former employee’s claim for long term disability benefits. Formerly employed as a production tech at Procter & Gamble’s Paper Product facility in Russellville, Arkansas, the claimant was forced to leave his occupation on April 6, 2008 due to degenerative disc disease, spinal stenosis and lumbar radiculopathy. Shortly after leaving work, the claimant filed an application for Short Term Disability (STD) benefits by Procter & Gamble. His STD claim was approved and paid for the full 52 week period. Long Term Disability (LTD) benefits were then approved in April of 2009.
Effective August 1, 2009, Procter & Gamble found the claimant to no longer be fully disabled, but determined that he was only “partially disabled.” This was a significant decision made by Procter and Gamble as partial disability benefits on this policy will only be paid for a 52-week lifetime maximum. Although the claimant appealed the decision twice, Procter and Gamble denied his appeals and found him still only to be partially disabled. Unfortunately for the claimant, since he was only approved as “partially disabled,” his claim was only to be paid through July 30, 2010. Because all of the required administrative appeals were denied, the former production tech was forced to file a Federal ERISA Lawsuit in Arkansas Federal Court.
Federal ERISA Lawsuit Filed
After the final denial issued by Procter & Gamble, the claimant brought an ERISA lawsuit in the United States District Court for the Eastern District of Arkansas. Unfortunately for the former production tech, the Judge ruled in favor of The Procter & Gamble Long Term Disability Allowance Policy and upheld its decision to deny the claimant’s claim for benefits.
The Court found that the Trustees of the Policy (those who make the determination of disability for the Policy) did not abuse their discretion in finding that the claimant was only partially disabled. The Judge pointed to the substantial evidence relied upon by the Trustees which indicated that the claimant could perform sedentary work. This evidence included that of his own treating physicians, one of whom stated that he was “doing great from surgery and is without complaints.” Another treating physician also concluded in his own reports that there was no substantial objective medical evidence to suggest an inability to work in a sedentary capacity. With this evidence in its favor, the Judge concluded that the Trustees of The Procter & Gamble Long Term Disability Allowance Policy did not abuse their decision in denying LTD benefits to the claimant. The Court agreed that the former production tech was not totally disabled within the meanings of the Plan. Finally, the Court also awarded a judgment in favor of Procter & Gamble as the claimant failed to pay Procter & Gamble the overpayment owed due to his award of Social Security Disability Benefits.
Although this case was not handled by Dell & Schaefer, if you have been denied benefits under The Procter & Gamble Long Term Disability Allowance Policy or under any long term disability plan, please do not hesitate to contact us for a free consultation.