An Alabama salesman won his disability claim against Continental Casualty Company (“CNA”) when an appellate court reversed the lower court’s denial of his benefits, holding that he was disabled despite showing up to work and collecting a paycheck.
Roger Whatley worked for Baker Brothers, a wholesale heating and air conditioning distributor, in various capacities, most recently as a sales representative. In late 1995, Baker Brothers closed its Dothan, Alabama store and Whately was notified ahead of time that he would be employed as of December 31st. On October 2, however, Baker Brothers terminated Whately, effectively immediately, due to poor performance and inability to get along with coworkers.
Before being terminated, Whately had been suffering from a number of conditions for which he was receiving medical care including chronic kidney stones, kidney disease, pulmonary disease, hypertension, and sleep apnea. During his last year of work, Whatley had three major operations and in the last two months of employment he passed four kidney stones.
In April 1996, Whately filed a disability claim with CNA, the company that administered the disability plan on behalf of Baker Brothers. CNA denied the claim, alleging that Whatley became disabled after he was terminated from Baker Brothers and, thus, he was not covered under the disability plan. In 1997, Whately filed suit for his disability benefits under ERISA. The District Court of Alabama held that Whatley was not entitled to benefits because he wasn’t totally disabled, and was able to work up through his termination date. Part of the district court’s decision was based on the fact that Whately worked overtime on his last day of employment, although it acknowledged he had to take several rest breaks and had trouble performing day-to-day. Whatley appealed the court’s decision.
Appellate Court’s Decision
Reviewing the district court’s decision de novo, the Alabama Appellate court turned to the plan language which required a claimant to be “continuously unable to perform the substantial and material duties of his regular occupation.” In order for Whately to be entitled to disability benefits, the court reasoned, he had to satisfy the definition of disability while still employed with Baker Brothers.
The appellate court disagreed with the district court’s conclusion that Whately could not have been disabled before his termination simply because he came to work and was collecting a paycheck. Considering the totality of the claim, including the medical records and physicians’ opinions, the appellate court found that Whately was unable to perform his occupation even before his date of termination in light of his rapidly declining health around that time.
The appellate court vacated the lower court’s judgment in favor of CNA and sent Whatley’s case back to the lower court for further proceedings.
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