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A Denver attorney should have received long-term disability (LTD) benefits for respiratory and sinus problems she experienced from “sick building syndrome,” the 10th U.S. Circuit Court of Appeals decided.
Pamela Ray worked from 1982 until 1995 as a partner at the law firm of Gibson, Dunn & Crutcher, where she specialized in major real estate, oil, gas and mining transactions. She was insured by the firm’s LTD plan, which provided benefits for disability when an insured was unable to perform “each of the material duties of his or her regular occupation.”
Ray worked for the firm at its high-rise office building in Denver. In the fall of 1992, she moved to a new office on the same floor where she had worked for 10 years.
A few months later, she began to experience a severe cough, dizziness, fatigue, sinus pressure and pain and chest congestion. Over the course of the next year, through February 1994, Ray saw several physicians and underwent numerous medical tests to determine the cause of her ailments, which continued unabated except on weekends when she was away from the office. Although her symptoms improved when she worked from home for a brief period of time, Ray’s clients were unhappy with their access to her when she was not in the firm’s office, and she also was unable to work with and train associate attorneys from home.
After trying other offices, working fewer hours in the office, and even moving her office to another nearby building—all without improving her condition—Ray’s doctors generally concluded that she suffered from “sick building syndrome” and diagnosed her as disabled from performing her usual job duties in an office environment as an attorney.
Ray filed for long-term disability benefits from Unum Life Insurance Co. of America, the firm’s LTD carrier. Unum initially denied the claim, but later granted benefits under a reservation of rights. Later still, however, Unum finally denied the claim, concluding that Ray could still function as an attorney, whether at another law firm or even from home.
In March 1997, Ray filed a lawsuit in federal district court, claiming Unum’s denial of benefits was arbitrary and capricious and in violation of the Employee Retirement Income Security Act (ERISA).
Although the trial court agreed and awarded her benefits, the 10th Circuit initially reversed the trial court’s ruling because it did not apply the proper standard of review to Ray’s claims. After a new trial court review, in which the court considered additional medical evidence, the trial court again ruled in Ray’s favor, awarding her benefits through age 65 (she was then in her late 40s).
Unum again appealed, arguing primarily that the trial court improperly found that working in a large office building at a large firm (such as Gibson, Dunn & Crutcher) was a material part of her job.
The appeals court agreed with the trial court finding, however, that Ray’s practice specialty (complex real estate and oil and gas transactions) could not be performed from home.
More importantly, the court concluded that the nature of Ray’s practice was such that it could be performed only at a large law firm, which is typically located in a large office building. The 10th Circuit found that Unum improperly disregarded evidence provided by other large-firm attorneys, who all explained that it would be impractical, if not impossible, for Ray to carry on her practice outside of a large firm/large office building environment.
Finally, the appeals court upheld the trial court’s decision to award Ray future benefits, provided her disability continued. The 10th Circuit determined that the ERISA provisions that authorized Ray’s lawsuit specifically gave the court authority to clarify Ray’s right to future benefits under her LTD plan.
Ray v. Unum Life Insurance Co. of America, 10th Cir., Nos. 05-1284, 05-1420 (March 28, 2007).
Professional Pointer: Although Ray apparently made no employment claims against her employer, implicit in the court’s lengthy written opinion was the notion that her employer worked with her to attempt to accommodate what appears to have been a disability covered by the Americans with Disabilities Act (ADA). Ray’s firm allowed her to work from home and even permitted her to try out other office space—all without success relative to her respiratory problems. The Equal Employment Opportunity Commission (EEOC) considers such accommodations to be appropriate under the ADA, provided they are reasonable and do not cause an undue hardship on the employer.
James B. Thelen is a principal with the law firm Miller, Canfield, Paddock and Stone PLC, in Lansing, Mich.
Sick Buildings, HR Magazine, October 2000
SHRM Benefits Toolkit
SHRM Online Workplace Law Focus Area
Editor’s Note: This article should not be construed as legal advice.
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