HomeNewsWhy You Need Vocational Evidence in Long-Term Disability Insurance Claims

Why You Need Vocational Evidence in Long-Term Disability Insurance Claims

Employees in Chicago and around the rest of Illinois consulting with me regarding their claims for long-term disability insurance benefits usually are unfamiliar with what vocational evidence is. Your medical restrictions and limitations define things you can and cannot do. But vocational evidence determines whether those restrictions and limitations are compatible with your occupation, or alternate occupations, depending on the definition of disability being used in your plan. Insurers often simply assess whether you can perform work at a given physical demand level, such as sedentary, light or medium physical demand level. But that does not take into account all the physical aspects of an occupation and whether you can perform them, such as keyboarding or mousing for occupations that are performed on a computer. The best approach in long-term disability claims is to get very specific restrictions and limitations, and obtain a vocational expert’s report opining on whether you can perform a given or alternate occupations with these restrictions and limitations. A recent case demonstrated how employing such a strategy resulted in success for the claimant.

In Chacko v. AT&T Umbrella Benefit Plan No. 3, No. 2:19-cv-01837-DAB-DB, 2023 WL 5806455 (E.D. Cal. Sept. 7, 2023), Chacko worked for AT&T as a software engineer. In late 2017, Chacko began experiencing severe pain in her eyes, neck, shoulders, and both arms, as well as blurred vision. Chacko’s doctors restricted her screen time, keyboarding, and mousing to 10 minutes in an hour. When Chacko applied for short-term disability benefits, Sedgwick (the plan’s claim administrator) relied on these restrictions in approving the claim. Sedgwick further approved Chacko’s claim for long-term disability benefits, again relying on these restrictions. But a few months later, Sedgwick terminated the long-term disability claim, contending nothing precluded Chacko from performing sedentary work, wholly ignoring the restrictions to screen time, keyboarding, and mousing. After Chack unsuccessfully appealed, she sued under ERISA § 502(a).

The United States District Court for the Eastern District of California ruled in Chacko’s favor, holding Sedgwick’s decision was arbitrary and capricious. The Court found it particularly egregious that Sedgwick initially determined screen time, keyboarding, and mousing were integral parts of the occupation and that Chacko was restricted from performing these demands, but then later disregarded those same medical restrictions and limitations. The court explained it was insufficient to merely find Chacko could perform sedentary work without evaluating the specific computer usage of the occupation and whether Chacko could meet those requirements.

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

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