A federal court in Pennsylvania recently gave the plaintiff somewhat of a victory by reversing a decision of Liberty Mutual Life Assurance Co. of Boston. According to the court ruling, Liberty acted arbitrarily and capriciously in denying the claimant’s application for long term disability benefits. Liberty used the wrong definition for the plaintiff’s “own job.”

Unfortunately, this is somewhat of a common tactic used by disability insurers to deny claimant’s benefits. It is a manipulative technique that claimants do not always notice. Without an attorney to help, claimants may not realize the wrong definition is being used. They go forward with their administrative appeals and even litigation while overlooking this important part of their claim.

Importance of Using Proper Job Description

The disability policy in question provided benefits to claimants who are unable to perform the “material and substantial duties” required of their own occupation. This is the same definition used in most disability policies. Then, when evaluating a claim, the insurer looks to the Dictionary of Occupational Titles (DOT) to makes its decision based on the job description found there. The DOT lists the duties of the specific job as it occurs in the national economy.

The problem in this case is that the claimant worked as a plant controller, which is a job classified by the DOT as requiring “light duty.” Instead of evaluating whether or not he could do the job of a plant controller, Liberty classified his occupation as simply a controller, which is classified by the DOT as a sedentary job. The court sent the case back to Liberty to evaluate the claim for disability benefits using the correct job description.

This was a partial victory for the claimant in that he has another chance to win his case. But, Liberty also has another chance to deny his claim. The court did not require Liberty to grant the claimant benefits. At least this time, Liberty will have to honor the specific job description.

At Attorneys Dell & Schaefer, we work with vocational consultants to be sure the proper job description is used by the insurer when evaluating the claim. If you have a claim with a disability carrier that has been denied, you need to file an appeal, or are even just considering filing a claim, contact any one of our attorneys. We offer a free consultation and welcome the opportunity to help you.