Sappi Company's Difficult Definition of Disability is Not Illegal According to Minnesota Federal Court
In Anderson v. Sappi Fine Paper of North America, plaintiff worked for Sappi for 30 years as a carton line operator during which time she suffered continuously from chronic pain due to her club feet. Her job required her to stand for several hours a day. After she fractured her foot while on vacation, she quit work and filed a claim for disability asserting that due to her long-term feet and knee problems, she could no longer stand long enough each day to do her job. She was examined by several different specialists who did not say she could no longer work, but instead recommended Sappi provide her accommodations so she could work.
The plaintiff raised three separate issues in the Minnesota court: 1) Sappi erred in denying her claim; 2) Sappi had a conflict of interest since it was both the payor of benefits and gatekeeper as the one who decided who received benefits; and 3) Under Sappi’s definition of disability, no none could ever meet it.
Federal District Court Upheld Sappi’s Denial of Disability Benefits
Anderson claimed she was disabled from performing her job with Sappi and used the fact that the Social Security Administration had granted her disability benefits as support for her claim. The court noted that since the SSA used a different definition of disability, that fact was not relevant. It noted that even SSA’s award of benefits included the caveat that she could do sedentary work.
In upholding Sappi’s decision, the court stated: “Sappi was not tasked with weighing conflicting medical opinions. Absent from the record is any opinion from any physician that examined Anderson who determined that she was unable to work without an accommodation.” Since the medical evidence did not support her claim that she could not do her job, the court upheld Sappi’s denial of disability benefits.
Court Finds No Conflict of Interest
Anderson claimed Sappi had a conflict of interest since it was both the gatekeeper who decided who was granted benefits and the payor of those benefits. She alleged that this conflict caused them to arbitrarily deny her claim. The court noted that “the conflict of interest is readily apparent.” Even so, it deemed that is not enough. A claimant must show a “history of biased claims administration.” Claimant here was able to locate only one decision from “nearly a decade ago” to support her claim. That was simply not enough evidence to establish a history of bias.
Disability Definition That is “Exceedingly Difficult to Meet” Cannot be Rewritten by the Court
Sappi’s definition of disability according to its policy language is when someone is: “unable to engage in any occupation or perform any work for any kind of compensation of financial value.” The court expressed sympathy with the plaintiff who had persevered and worked in chronic pain for 30 years and who had “well-documented multiple medical conditions.”
But, despite her medical problems, the court upheld the contract language, holding that, “Although exceedingly difficult to meet, the law does not compel Sappi to have a more favorable definition of disabled; the law does not even require Sappi to have a plan at all.”
This case was not handled by our office, but it may provide claimants guidance when they want to pursue disability benefits but their medical records do not support their claim, and to those who have an issue regarding a conflict of interest with their employer who is also their insurer. If you need assistance with a similar matter, please contact any of our lawyers for a free consultation.
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It’s next to impossible to get $ out of them without a lawyer. They use plenty of intimidation and unfair tactics. They don’t want to pay. And yet, their CEO made 13 m... read more >
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Every month I get paid on a different date
I will start by saying that my experience is not as horrible as others, like the folks who have valid claims but get nothing from Lincoln. I feel for you and hope to god y... read more >
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They will do anything to not approve your claim
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Who are Dell Disability Lawyers?
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Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
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Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
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When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.