Reasonableness in evaluating the standard of disability

A recent Fourth Circuit Court of Appeals decision, unpublished, Smith v. Reliance Standard Life Insurance Company, No. 18-2225, __F.App’x__, 2019 WL 2539289 (4th Cir. June 20, 2019), noted the importance of considering, in a dispute over long-term disability benefits, whether return to work would increase stress and thereby worsen chronic medical conditions.

The court affirmed the grant of summary judgment to Plaintiff.  Plaintiff had a triple bypass surgery, diabetes, nerve damage, narrowed and hardened arteries, multiple strokes, and multiple stents.  The SSA and all his doctors concluded that he could not work.  The insurer, Reliance, relied on stray and typographical errors in his medical records.  It also over-emphasized minor improvements in Plaintiff’s health picture. The court noted “Doctors, like everyone else, make statements relative to a baseline, and Smith perhaps was better or ‘doing well’ for someone with many serious underlying health problems.” Focusing on one small upswing was found to be unreasonable unless the recovery was sufficiently substantial.

The court concluded Plaintiff could not return to work because the stress of working would risk undoing the progress that he made.  The court stated:  “Reliance came close to asserting that Smith needed to prove that he could not perform sedentary work due to a physical limitation on, for example, sitting, typing, or speaking. This is quite a high standard. Such a rule would erase disability eligibility for all but the bedridden. Some serious diseases are debilitating because of their effect on the mind or because they worsen with stress. This is a place for medical judgment, not per se rules: ‘The rule is one of reason.’” (quoting Harrison v. Wells Fargo Bank, N.A., 773 F.3d 15, 22 (4th Cir. 2014)).