The 5th Circuit Court of appeals recently reversed a ruling for a worker suffering from Reynaud’s Disease, which is a condition preventing the claimant from working in a cold environment. Unfortunately, the claimant worked at a chicken processing plant as a Hazard Analysis coordinator. Her job duties required that she inspect each part of the processing plant, including the refrigerated sections where the temperature was maintained at approximately 40 degrees. The LTD insurance policy provided benefits if she was disabled from “performing the duties of her Regular Occupation.” Reliance Standard, the Long Term Disability Insurer, denied the claim based upon an in-house vocational reviewer who concluded her regular occupation would be classified as a “Sanitarium” as defined by the DOT and that the material duties “include neither employment at a poultry processing plant nor exposure to the cold.” Utilizing an abuse of discretion standard the Appellate court overturned the lower court’s decision for the claimant.
This is just one more in a very long line of cases demonstrating the difficulty claimant’s face in pursuing ERISA claims for Long Term Disability Insurance benefits. And, in my opinion, the inherent unfairness in the current state of the law.