{"id":7455,"date":"2020-04-06T16:15:00","date_gmt":"2020-04-06T21:15:00","guid":{"rendered":"https:\/\/www.nickortizlaw.com\/?p=7455"},"modified":"2024-02-06T13:25:20","modified_gmt":"2024-02-06T18:25:20","slug":"arning-v-aetna-court-rules-there-was-no-abuse-of-discretion","status":"publish","type":"post","link":"https:\/\/www.nickortizlaw.com\/arning-v-aetna-court-rules-there-was-no-abuse-of-discretion\/","title":{"rendered":"Arning v. Aetna – Court Rules There Was No Abuse of Discretion"},"content":{"rendered":"\n
Charles Buford Arning (\u201cArning\u201d) was employed full-time by ECMD, Inc. as the President<\/a> of the Arndt & Herman Building Products Division. Aetna Life Insurance Company (\u201cAetna\u201d)<\/a> administered a Long-Term Disability<\/a> Executives Plan provided to ECMD employees. <\/p>\n\n\n\n The Plan\u2019s language provides:<\/p>\n\n\n\n “You will be considered disabled while covered under this . . . Plan on the first day that you are disabled as a direct result of a significant change in your physical or mental conditions and you meet all of the following requirements:(1) be covered by the Plan; (2) be under a physician\u2019s regular care<\/a>; and (3) be disabled by illness or injury as described by Aetna\u2019s Test of Disability.”<\/p>\n<\/blockquote>\n\n\n\n The language of the Test of Disability provides:<\/p>\n\n\n\n \u201cYou meet the test of disability on any day that: You cannot perform the material duties of your own occupation solely because of an illness, injury, or disabling pregnancy-related condition; . . .\u201d<\/p>\n\n\n\n Own occupation means \u201cthe occupation you are routinely performing when disability begins, and \u201cis viewed as it is normally performed in the national economy rather than for specific employers.\u201d<\/p>\n<\/blockquote>\n\n\n\n On September 15, 2016, Arning was reprimanded for failing to appear regularly during business hours and for not explaining where he was when he was not in the office. Several days later, Arning received a memo explaining that there were issues with his division\u2019s and his own performance. Arning was terminated on January 4, 2017, for his lack of performance.<\/p>\n\n\n\n Prior to Arning leaving ECMD, Inc., he had a number of medical procedures between 1973 and 2013, including \u201cinguinal hernia repair, left total hip replacement<\/a>, right total knee replacement, right rotator cuff repair<\/a>, right pectoralis tendon repair<\/a>, and resection of left first rib secondary to a benign tumor, laminectomy of the lumbosacral spine to address left leg pain in 2008, and a laminectomy to address left leg and right hip pain in 2013.\u201d <\/p>\n\n\n\n However, none of those operations or procedures were related to work. Later, Arning was also diagnosed with \u201clumbar degenerative disc disease<\/a> (primary), inguinal neuralgia (secondary), and peripheral neuropathy<\/a> (other).\u201d As a result, his medical provider, Dr. Hans Hansen, allowed him to perform light work, such as \u201c[e]xerting up to 20 pounds of force occasionally and\/or up to 10 pounds of force frequently.\u201d<\/p>\n\n\n\n\n
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