ERISA-Eighth Circuit Reads Doctors’ Letters To Support Conclusion of Permanent Disability

All too often, the results in cases involving claims for health or disability benefits depends on a doctor’s report or letter before the plan administrator or the court, and on how the administrator or court interprets it. Such was the case in Rote v. Titan Tire Corporation, Nos. 09-2510, 09-2890 (8th Cir. 2010).

In that case, the plaintiff, Cindy Rote, had been seeking long-term disability benefits from the disability plan (the “Plan”) of Titan Tire Corporation (“Titan”) for over eight years. Rote had needed surgeries to replace the joints in both of her thumbs. After the surgery, Titan asked Dr. Anthony Sciorrotta to evaluate Rote’s ability to return to work. Dr. Sciorrotta suggested that Rote be restricted to jobs that did not require frequent pinching with more than five pounds of force and did not involve kneeling or squatting. Titan informed Rote that there were no jobs compatible with those restrictions available at the plant, and presumably did not allow her to resume work.

Rote eventually filed an application for long-term disability benefits under the Plan. Titan, as the Plan’s administrator, denied Rote’s application for disability benefits. Rote then filed suit against Titan under ERISA, challenging the denial of her claim for the benefits. The case eventually found its way to the Eighth Circuit Court of Appeals. The question as to the entitlement to the benefits came down to whether Rote’s disability was “permanent”. In the course of the proceedings, Rote’s attorney wrote to both Dr. Sciorrotta and a Dr. Neff. Her attorney’s letter noted that a question had arisen as to whether the work restrictions imposed on Rote were only temporary, or were intended to be permanent, and then asked whether the doctors recommended that Rote continue to follow these work restrictions indefinitely. Both doctors responded affirmatively with respect to the restrictions on pinching and gripping. Dr. Sciorrotta explained that, with respect to whether he would recommend that Ms. Rote continue to follow these restrictions indefinitely, he would say that regarding her hands, she should continue with those restrictions since they were outlined by Dr. Neff and were felt to be of a permanent nature. Rote later submitted a letters from the doctors clarifying that they thought that Rote’s restrictions should be permanent.

In denying Rote’s claim for disability benefits, Titan had seized on the word “indefinitely”, used in the doctors’ letters, to conclude that Rote’s condition was not permanent. The Court disagreed with Titan. It said that the intended meaning of “indefinitely” as used in the letters-that the restrictions are permanent-was clear from the context of the letters by Rote’s attorney and the doctors. Rote’s attorney first informed the doctors that there was a question about whether the restrictions were only temporary or were intended to be permanent, before asking whether the restrictions should be continued indefinitely. The doctors’ affirmative responses, when read in context, show that the restrictions are permanent, not temporary. Moreover, the doctors resolved any doubt about their intent in their subsequent letters. The Court found that Rote’s disability was permanent, and affirmed the decision of the District Court, which had awarded long-term disability benefits to Rote.

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