In Bigham v. Life Assurance Company of Boston, a Seattle federal court held that Liberty erred in terminating the plaintiff’s long term disability benefits when it was clear that she could not perform the required tasks of her own occupation as a Security Technical Program Manager for Amazon, LLC. In that role, she was required to “focus her thoughts and interact with others for long periods of time on a daily basis.” Three treating physicians verified she was unable to perform these and other duties required of her own occupation.
For various reasons, the court concluded that Bigham was “entitled to long-term disability benefits under the terms of the LTD Plan” due to her inability to perform the tasks of her own occupation. It remanded to Liberty to determine if she was entitled to extended benefits by being disabled from performing any occupation.
Standard of Review
A federal court generally reviews the actions of a plan administrator to determine if the administrator abused its discretion in making the decisions it did. Under that standard, the court “is forbidden to make factual finding or weigh evidence.” The court must give deference to the Plan Administrator’s decision even if the decision is not the one the court would have made.
In this case, the parties agreed that the court could engage in de novo review, which means the court considered all the evidence presented as though it was a court trial. Under this standard, the court reviews the entire record and is permitted “to make factual findings, evaluate credibility, and weigh evidence.” The court stated that the difference in the standard of review made a difference in its decision in this case.
Liberty Erred in Requiring Objective Proof of a Medical Condition for Which No Objective Proof Exists
Bigham’s own occupation required her to, among other things, use critical thinking skills, “complete complicated mathematical equations and assist in the protection of information.” All three of her treating physicians concluded her pain from fibromyalgia and the high doses of pain medication precluded her from performing her job tasks. The pain caused her to suffer from “disruption of cognitive function.” She required “regular doses of morphine throughout the day” which interfered with her memory.
One reason Liberty gave for terminating Bigham’s long term disability benefits was that her symptoms were subjective and there was no objective medical evidence to support her disability claim. The court rejected this argument, finding that “subjective symptoms” can support a disability claim. Furthermore, in a case such as this where there is no objective test that can be performed, it is wrong to deny benefits, particularly when there is no “credible reason to disbelieve the reports of Ms. Bigham or her medical providers regarding her symptoms and their disabling consequences.”
Court Finds Video Surveillance Consistent with Bigham’s Disability Claim
Liberty conducted video surveillance of Bigham over a seven-day period of time. It showed her walking with a friend, driving a short distance, bending over and picking up her small dog, smiling and talking with her friend. Liberty claimed this showed she was not disabled. The court disagreed, finding that nothing in the surveillance video showed the plaintiff in a workplace setting or performing any of the complex job tasks she was required to perform in her own occupation with Amazon.
Ultimately, the court held that the plaintiff was entitled to all the long term disability benefits afforded her from being disabled from her own occupation. It remanded to Liberty to determine if she was entitled to extended benefits due to her inability to perform any occupation.
This case was not handled by our office, but it may provide claimants guidance in their pursuit of a disability claim when there is no objective evidence of a medical condition. If you need assistance with any aspect of your disability claim, please contact any of our lawyers for a free consultation.