A federal trial court in Washington found that Reliance Standard Insurance Company (“Reliance Standard”) wrongly terminated benefits to an electronics production supervisor with carpal tunnel syndrome, among other conditions.
Background
Ms. Christa Waldrip suffers from carpal tunnel syndrome which causes neck and shoulder pain. She also had an outbreak of shingles, which caused more neck pain, suffers from multiple sclerosis, experiences lower back pain and left leg pain, and weakness in her hands. Ms. Waldrip underwent three surgeries, two for her carpal tunnel and one spinal surgery on her neck.
Reliance Standard agreed she was disabled from her own occupation and approved long-term disability (“LTD”) benefits. Two years later, Reliance Standard terminated benefits as the definition of disability changed from being unable to work in her own occupation to any occupation. At that point, Reliance Standard determined she was capable of working full-time in any sedentary occupation.
LTD Appeal and Lawsuit
Ms. Waldrip timely appealed Reliance Standard’s termination. Included in the appeal were extensive medical records, letters of support from her treating physicians, and declarations. Reliance Standard insisted on an Independent Medical Examination (“IME”) by a doctor selected by Reliance Standard. Unsurprisingly, the IME doctor concluded Ms. Waldrip could work full-time. Ultimately, Reliance Standard denied her appeal.
Ms. Waldrip then filed a lawsuit and after reviewing all the evidence, the court sided with Ms. Waldrip. It concluded that she carried out her burden of proving she could not perform full-time sedentary work.
The court gave great weight to her subjective complaints that she could not sit and focus for more than a few minutes at a time due to the pain. Moreover, the court observed that the IME doctor did not conduct any tests to determine whether she could sit for prolonged periods nor did his report clearly state she could sit for the time required by a full-time sedentary job. It also noted that neither Reliance Standard nor the IME doctor explicitly questioned whether Ms. Waldrip was faking the pain. In fact, quite the opposite as both agreed she has chronic pain.
Ultimately, the court ordered Reliance Standard to pay Ms. Waldrip the LTD benefits owed.
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