Delaware Gastroenterologist with Shoulder Pain Owed Long-term Disability Benefits from Reliance Standard Life Insurance Company
Federal court rules that a Delaware gastroenterologist with shoulder pain is owed long-term disability (“LTD”) benefits from Reliance Standard Life Insurance Company (“RSL”).
Dr. Patrick was a board-certified gastroenterologist. After a residency in internal medicine, Dr. Patrick’s career was focused solely on gastroenterology. As part of her job, she was required to perform a variety of endoscopic procedures, all of which were physically and mentally demanding.
In 2007, Dr. Patrick injured her right shoulder and had surgery. The surgery was only partially successful. She was not able to perform the procedures that were required of her at her job. In 2008, she filed for disability benefits with RSL on the basis that she cannot do her regular occupation as a gastroenterologist. RSL approved her claim and paid monthly disability benefits.
The Termination and Appeal
In 2018, after 10 years of paying benefits, RSL terminated Dr. Patrick’s benefits. Dr. Patrick appealed the terminated but RSL also denied the appeal. In denying the appeal, RSL stated that her regular occupation was that of an Internal Medicine doctor, she had no restrictions, and was capable of working full-time as an internal medicine doctor.
Dr. Patrick filed a lawsuit in federal court. She argued that she was disabled from performing the duties of a gastroenterologist, just like she had been for the 10 years RSL paid benefits. The court agreed.
In reviewing the case, the court noted that when Dr. Patrick submitted her initial claim in 2008, she did so as a gastroenterologist. The court also noted that from 2008 to 2018, it treated Dr. Patrick as a disabled gastroenterologist who could not perform endoscopic procedures, not an internal medicine doctor.
Overall, the court determined that the record did not support RSL’s change in position to classify her regular occupation as an internal medicine doctor. Rather, the evidence overwhelmingly supported Dr. Patrick’s position that she was disabled and unable to work in her regular occupation as a gastroenterologist.
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