Long-Term Disability Insurer Criticized for Use of eDOT Definition of Light Work

Employees in Chicago and the rest of Illinois with claims for long-term disability insurance are frequently aware that the initial definition of disability in a long-term disability insurance policy is based on your “own occupation” or “regular occupation,” meaning you are entitled to benefits if you are unable to perform the occupation you were performing before the disability began. But there is a difference between your “occupation,” as the insurance policy defines it, and your job duties. An occupation is broader than a specific job. Long-term disability insurers and claimants define that occupation by referencing vocational resources, such as the Dictionary of Occupational Titles, published by the United States Department of Labor. In recent years, long-term disability insurers have increasingly been relying on a publication called the Enhanced Dictionary of Occupational Titles—or eDOT for short—published by a private entity called Economic Research Institute. But do courts accept what insurers say the eDOT states? A recent case demonstrated how a court grappled with the insurer’s representations of the eDOT.

In Covill v. Unum Life Insurance Co. of America, No. 23-cv-19-LTS-MAR, 2024 WL 3443916 (N.D. Iowa July 16, 2024), Covill worked as a dental hygienist and went on disability leave due to severe abdominal pain following several surgeries, including a hysterectomy, bilateral salpingectomy, and laparoscopy. Unum Life Insurance Company of America (“Unum”) denied Covill’s claim, contending there was no basis for any restrictions or limitations. In the claim review, both Covill and Unum agreed Covill’s occupation of Dental Hygienist was a Light physical exertion occupation, but each party used a different vocational resource to define what is required of Light physical exertion. Covill used the Department of Labor’s Dictionary of Occupational Titles, while Unum used the eDOT by Economic Research Institute. According to the Dictionary of Occupational Titles, Light physical exertion work would have required standing and walking to a significant degree, or sitting most of the time while pushing and/or pulling with arm or leg controls. According to Unum, the eDOT states Light work involves sitting most of the time, though Unum did not include this description in its file for review by the Court. After Covill appealed unsuccessfully, she sued Unum under ERISA § 502(a) to recover the disability insurance benefits.

After reviewing the parties’ briefs, the Magistrate Judge in the United States District Court for the Northern District of Iowa recommended remanding the matter back to Unum for further factual development. The Court explained it could not resolve the discrepancy between the Dictionary of Occupational Titles definition of Light work, and the eDOT definition of Light work because Unum did not include the eDOT definition in the record. Unum’s vocational consultant merely stated in her report that the eDOT definition of Light work involves sitting most of the time. The Court thus recommended remanding the matter back to Unum so Unum could include in the record data from the Economic Research Institute supporting that Light work can be performed with frequent sitting.

If you have a denied claim long-term disability benefits, contact an experienced ERISA long-term disability attorney today.