Hartford Abuses Discretion with Faulty Occupational Analysis - W.D. KY

[Rob Hoskins]

In Benningfield v. Hartford Life and Accident Insurance Company, et. al., plaintiff seeks long term disability benefits from an ERISA governed plan insured by Hartford. Plaintiff was a diesel mechanic for all of his adult life, but Hartford concluded that plaintiff could work in a white collar job because of his experience as a Union representative. The court holds that Hartford’s conclusion was an abuse of discretion.

Under the “any occupation” standard, a plan administrator is “under a duty to make a reasonable inquiry into the types of skills [a claimant] possesses and whether those skills may be used at another job that can pay [him] the same salary range as [his pre-disability earnings].” McDonald, 347 F.3d at 162. “Just as a plan administrator must consider some inquiry into the nature and transferability of a claimant’s job skills, a plan administrator must make some inquiry into whether the jobs selected are ones that the claimant can reasonably perform in light of specific disabilities.” Brooking v. Hartford Life and Accident Ins. Co., 167 Fed. Appx. 544 549 (6th Cir. 2006). See also Fant v. Hartford Life and Accident Ins. Co., 2010 WL 3324974, *9 (E.D. Mich. Aug. 20, 2010). Presumably, this is what Hartford attempted to do when it engaged Roger K. McNeeley, a rehabilitation counselor, to conduct the Employability Assessment Reports.

The first EAR showed no viable occupations. The second EAR revealed only one. Benningfield argues that the one job Hartford found is not a viable occupation given his high school education, 30 years of manual labor, and lack of supervisory and business skills to qualify him for this position. The Court agrees.

To begin with, the second Employability Assessment Report failed to take into consideration Plaintiff’s partial loss of vision in his left eye. Hartford explained that, although Benningfield’s ophthalmologist, Dr. Jones, stated that Benningfield could not return to his previous job, Dr. Jones never said that Benningfield would be unable to perform duties of a sedentary occupation. Even assuming Benningfield is capable of performing sedentary work with his partial loss of vision, this impairment should have been considered.

Next, changing Benningfield’s abilities of compiling, computing, copying and comparing under the “Data” section of the Ability Profile in the second EAR, without any support that he was so capable is highly suspect. The second EAR stated it changed these abilities because LG&E’s job description checklist for a Senior Equipment Mechanic included “preparing detailed record or reports such as inventory records, receiving reports, operating logs, lab analyses, quantities, etc.,” which was listed as being performed 20-60% of work time. (AR H0736, H1255). This was a generalized mental requirement listed in a series of other general job functions as part of Benningfield’s application for LTD. Benningfield’s description of his own job did not include any compiling, computing and comparing of data though, only repairing mobile equipment with the use of sledge hammers, impact guns, large wrenches and pipe wrenches. (AR H1127.) The Court finds that Hartford’s denial of Benningfield’s long-term disability benefits based on an EAR that does not contain all relevant medical information, and includes abilities that neither Benningfield or his employer indicated he specifically possessed, suggests that Hartford did not perform a reasoned review of the claim. See Kouns, 780 F. Supp. 2d at 588 (“Although according to the occupation job titles dictionary all of the potential jobs selected by Hartford for Kouns require low-level visual skills, the Court is troubled by the fact that Hartford based its final decision on an employability analysis that was never updated to include accurate medical information.”) Benningfield has a high school education and spent the last 30 years working as a diesel mechanic. He has no other training or experience. The EAR described a Senior Equipment Operator as a non-supervisory position, requiring use of “a sledge hammer, impact guns, large wrenches, pipe wrenches and [repairing] mobile equipment and conveyor belt systems.” (AR H0735.) Nevertheless, the Employability Analysis Report concluded that Benningfield could obtain a professional and managerial position that requires managing business affairs, maintaining relations with unions, employers and press representatives, interpreting and enforcing detailed contract specifications, and negotiating with the management of companies. According to the EARs, the occupation of a Business Representative is categorized by the U.S. Department of Labor’s Dictionary of Occupational Titles as an occupation in the “Professional and Kindred” industry. (AR H0742.) According to the dictionary, the Professional and Kindred industry occupations are defined
as:

[O]ccupations requiring extensive study or experience in professions, technical services, sciences, art, and related types of work. The preparation for these occupations . . . is typically acquired through university, college, and technical institute training; experience providing institute training; experience providing equivalent backgrounds; or some combination of these. The functions of these occupations are predominantly mental rather than manual.

(U.S. Dept. of Labor, Dictionary of Occupational Titles (4th Ed., Rev. 1991), available at http://www.oalj.dol.gov/ PUBLIC/DOT/ REFERENCES/DOTINDU.HTM.)

Hartford believes this occupation is viable because of Benningfield’s experience as a union steward. Hartford is critical of Benningfield for arguing that his experience as union steward should not be considered because it required no special qualifications, carried little responsibility, was based on seniority and no one else wanted to do it, because these facts are not in the record. That argument is well-taken, however, it points out another very important fact—that the record is devoid of any information related to what Benningfield’s experience as a union steward actually was. There is no evidence that Mr. McNeely or Hartford ever knew what the experience entailed. Despite not knowing, Hartford concluded that Benningfield could go from diesel mechanic using sledge hammers and pipe wrenches to a business professional managing business affairs, interpreting and enforcing detailed contract specifications, and negotiating union matters with management. That is quite a leap, particularly when there is no evidence to show what Benningfield did as a union steward.

The question was never whether Benningfield was capable of sedentary work, but whether his training, education and experience would make him a candidate for an occupation that met certain earning requirements. After reviewing the relevant factors, weighing the inherent conflict of interest, and considering the one occupation identified, the Court finds that Hartford’s decision did not result from a deliberate and principled reasoning process and was not supported by substantial evidence. Hartford acted arbitrarily and capriciously in terminating Benningfield’s disability benefits and his benefits are reinstated.

A copy of the decision is attached.