Appellate Court Finds Kansas City Life Insurance’s Denial of Missouri Nurse’s Disability Benefits Wrong
An appellate court found Kansas City Life Insurance’s (KCLI) denial of Missouri nurse’s disability benefits wrong, affirming the lower court’s decision. Ronald Bernard, a nurse anesthetist, filed a lawsuit against KCLI for short-term and long-term disability benefits after his claims were denied.
Ronald Bernard was hired as a nurse anesthetist at Mid-Missouri Anesthesiologists, Inc. in 1991. Nearly ten years later, in 2000, Bernard became addicted to fentanyl eventually seeking in-patient treatment in 2001. Mid-Missouri placed Bernard on probation for several years following his treatment, and his employment contract allowed for regular drug testing as well as termination should a result return positive.
While Bernard was able to remain clean for several years, he relapsed in 2015 but continued to work without incident. In 2017, however, two nurses reported Bernard for using syringes and suspected drug use. When Mid-Missouri took Bernard to a drug-testing facility he confessed and was fired; his sample subsequently came back positive for fentanyl.
Benard started seeking treatment after his employment ended with Mid-Missouri and applied for short-term and long-term disability benefits with KCLI, his former employer’s insurance carrier. Despite statements from his treating physicians supporting his inability to work as a certified nurse anesthesiologist due to addiction and relapse, KCLI denied the claims. KCLI’s reasoning was that Bernard would have been able to do his job if he had not failed the drug screening.
The Courts’ Decisions
The lower court held that no reasonable person would find that Bernard, who was so addicted that he injected himself with drugs during the workday with co-workers nearby, is capable of performing the duties of his job. KCLI appealed the loss, arguing that although Bernard’s employer fired him due to safety concerns of the patients he had safely administered anesthesia while under the influence. The Eighth Circuit Court of Appeals concluded that although Bernard made no medical errors despite his addiction and relapse, and did not seek treatment until after his employment was terminated, KLCI’s conclusion that he was not disabled before coverage ended was wrong.
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