About the Case
The BenGlassLaw long-term disability client, a former attorney for The MITRE Corporation, underwent a double bypass heart surgery. Post-surgery, his doctors advised against returning to his stressful job to prevent further cardiac issues. The claimant was covered under his employer’s Group Long-Term Disability Insurance Plan, managed by Reliance Standard Life Insurance Co. After applying for Long-Term Disability (LTD) benefits due to his condition, Reliance initially approved benefits for only one day and subsequently denied further benefits. BenGlassLaw filed a lawsuit under the Employee Retirement Income Security Act (ERISA) for judicial review of this decision. BenGlassLaw handled this case from appeal of the denial letter to lawsuit and we have further information for obtaining your disability benefits against Reliance here.
People Who Have Had Heart Surgery Should Stay Away from Increased Stress
The claimant argued that his cardiac condition, exacerbated by the stress of his job, rendered him unable to work as an attorney. He highlighted the specific demands of his role, including on-call responsibilities and high-stress situations involving national security. His doctors supported his claim, stating that returning to such a work environment could risk his health and potentially lead to a fatal heart attack.
But Reliance Insurance Said: You Can Still Work
Reliance Standard countered by focusing on the physical capability of the claimant to perform his job functions, disregarding the potential stress-related risks. They highlighted treadmill test results demonstrating normal heart functions and argued that his doctors did not provide sufficient evidence of physical limitations preventing him from working beyond January 12, 2021. Reliance also contested the significance of job stress on the claimant’s heart condition, citing lack of direct evidence linking stress reduction with the prevention of cardiovascular events.
Reliance Hired Cardiologists Who Said: There is No Proof Stress Causes Heart Disease
Dr. Mark Eaton, a Board-Certified internal medicine doctor with a sub-specialty in cardiovascular disease, was hired by Reliance to evaluate whether stress could exacerbate the claimant’s cardiac condition. Dr. Eaton provided a medical opinion that there was no medical documentation or clinical studies indicating that reducing or relieving chronic job stress results in the secondary prevention of cardiovascular events, essentially supporting Reliance’s position in denying the claim for LTD benefits.
Dr. Samuel S. Hahn of Yale Medicine, also provided an report for Reliance where he concluded that the claimant was not disabled according to the policy’s terms. He specifically disagreed with the attending physicians’ concerns regarding the relationship between stress and the risk of future heart attacks, stating that there is no substantial scientific evidence supporting the notion that reducing job stress results in the prevention of cardiovascular events. Dr. Hahn’s position was that while the claimant might not wish to return to his work as an attorney for MITRE Corporation, there was no medical evidence to support that he currently could not physically perform his duties.
Court Decision
The District Court sided with the claimant and against Reliance and doctors Hahn and Eaton, finding that Reliance Standard abused its discretion in several aspects. First, by failing to consider the risk of future harm the claimant faced if he returned to his high-stress job. Secondly, by not adequately considering the stress levels associated with various attorney positions that he could potentially perform. The court criticized Reliance for ignoring the unanimous opinions of the claimant’s treating physicians regarding the danger posed by job stress to his heart condition. Consequently, the court granted the claimant’s motion for summary judgment, denying Reliance’s motion and ordering the payment of back benefits and interest at 6% to the claimant from January 12, 2021. The court also noted Reliance’s inconsistent interpretations and handling of the claimant’s disability claim, especially their initial agreement to provide benefits for only one day without a rational explanation.
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