Standard Insurance Wins Appellate Remand for Claimant’s Own Occupation Disability Determination
Author: Attorney Gregory Dell
Cheney v. Standard Insurance Company and Long Term Disability Insurance (Standard) is a case in which the U.S. Court of Appeals for the Seventh Circuit sent back to the Illinois District Court for resolution of several issues. One issue concerned whether or not the plaintiff was disabled from working within her own occupation.
Overview of Relevant Facts
In 1991, the plaintiff, Carole Cheney, began working as an attorney for Kirkland & Ellis, LLP (Kirkland). In 1997 she was made a partner. For all her years at Kirkland, she suffered from spinal problems, including degenerative spinal disease. Kirkland granted her request for ergonomic accommodations in 1994. In 2003, due to her health issues, she was allowed to do most of her work at home.
In July 2012, just prior to undergoing a spinal fusion, she applied for long-term disability benefits. Her application was denied and she filed an ERISA law suit in the U.S. District Court for the Eastern District of Illinois. The District Court ordered Standard to pay benefits to Cheney and found she was disabled from working in her own occupation. Standard appealed. The court of appeals found that when the district court determined she was disabled from her own occupation, it erred and “asked the wrong question.” The case was remanded for district court to make findings consistent with the Court of Appeals order.
Standard’s Own Occupation Definition
Under Standard’s policy, a person is considered disabled from their own occupation if they “are unable to perform with reasonable continuity the Material Duties” of their own occupation. “Own Occupation” is defined as employment “of the same general character as the occupation you are regularly performing for your Employer when Disability begins.” The policy continues, “If your Own Occupation necessitates a professional or occupational license, the scope of your Own Occupation is ‘as broad as the scope of your license.’”
In determining that Cheney was disabled from her own occupation, the district court found that she was unable to work as a litigation partner in a big law firm. The district court has specifically stated that whether or not she could work as a lawyer was “not the question.” In fact, the court of appeals found that to be the exact question that needed to be resolved under the terms of the policy, saying “Because the practice of law requires a license, the issue is whether Cheney can find any work—in the same specialty or another, or generally—as a lawyer.” The case was remanded for resolution of this issue.
Inability to Perform Just One Essential Job Task Does Not Qualify Plaintiff for Benefits
The district court seemed to find Cheney was disabled from her own occupation because she was unable to sit at a computer or sit in court. The court of appeals disagreed, noting, “The inability to perform a single material job task does not demonstrate disability within the meaning of this policy.” The court remanded since the district court’s treatment of this issue was “cursory and not supported by evidence from Cheney’s doctors.”
This case was not handled by our office, but it may provide guidance to those who have similar “own occupation” clauses in their disability policies and need help in the interpretation. Feel free to call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.