Pillsbury & Coleman Wins Disability Benefits for Stanford Physician Against The Lincoln National Life Insurance Company

It is an all too common occurrence that disability insurance carriers will rely on an insured’s part-time work status as a basis to deny disability benefits altogether.  This was the case for a Stanford family medicine doctor of almost 30 years, who was forced to reduce her employment to 50% due to multiple debilitating bone, joint, and spinal conditions.  Stanford’s disability insurance carrier, The Lincoln National Life Insurance Company, initially approved the physician’s partial disability benefits, but wrongfully terminated her claim just two years later.

Lincoln claimed that because the physician was able to sit for 4 hours per day and stand and walk for a combined 4 hours per day, she could perform full-time sedentary work if she was provided an opportunity to change positions at will.  In the Ninth Circuit, however, the law is clear that “an employee who cannot sit for more than four hours in an eight-hour workday cannot perform ‘sedentary’ work that requires ‘sitting most of the time.’” Armani v. Nw. Mut. Life Ins. Co., 840 F.3d 1159, 1163 (9th Cir. 2016).  Through an administrative appeal, Pillsbury & Coleman was able to reverse Lincoln’s decision and win the Stanford physician her disability benefits.  At bottom, no insured should be penalized for her valiant efforts to continue working in spite of a disability.