Employees in Chicago and around the rest of Illinois with claims for long-term disability benefits often ask if returning to work can hurt their long-term disability insurance claim. Sometimes it does not, and sometimes it does. For example, it is common for someone claiming disability to make an attempt to return to work, only to find out they are not able to perform the job as they had hoped, and return to disability claim status. These scenarios usually bolster a claim, rather than harm it. In other situations, somebody may return to work after an injury and much later make a claim for long-term disability benefits, raising the question as to how the individual was able to work post-injury. A recent case highlighted an example of how returning to work after an injury hurt the claim.
In Lewis v. Unum Life Insurance Co. of America, No. 3:22-cv-00067, 2023 WL 5401873 (S.D. Tex. Aug. 22, 2023), Lewis worked as a senior accountant for an energy company. He was involved in a low-speed motorcycle accident in 2018. At the emergency room, he reported having a headache and lower back pain, but denied any trauma. There was no diagnosis of a traumatic brain injury, concussion, or neurological disorder. Less than three weeks after the accident, Lewis returned to work full-time. In mid-2019, Lewis began treating with a neurologist for headaches he experienced twice a week, getting treatment approximately every six months. In late 2020, Lewis went out of work to obtain a total left hip replacement surgery. When the surgeon released Lewis to return to work, Lewis contended he remained disabled due to cognitive impairment from his motorcycle accident. Unum denied Lewis’ claim, asserting he was able to work for over two years after the accident, and any head injury would not be expected to be progressive in nature. After Lewis unsuccessfully appealed, he sued under ERISA § 502(a).
The United States District Court for the Southern District of Texas performed a de novo review of the record and the parties’ motions for judgment. The court ruled against Lewis, and awarded judgment to Unum. The court was especially persuaded that Lewis was able to work in his own occupation because he continued to do so for over two years after the motorcycle accident, discrediting that Lewis suffered from any traumatic brain injury in 2018. Thankfully, the court declined to award Unum attorney’s fees.
If you have a claim for long-term disability benefits, contact a skilled ERISA long-term disability lawyer today.