An Ohio trial court ruled that a truck driver with PTSD was disabled and entitled to disability benefits from United of Omaha Life Insurance Company (“United”).
Background
In early 2018, Larry Whetstone got into a collision with a bus while driving an 18-wheel truck for work. Although he did not experience any external physical symptoms, he was very shaken following the accident, enough that he immediately went to urgent care.
A few days after the accident, he began experiencing several symptoms of anxiety. The anxiety was worst when he had to drive, even a small vehicle for personal use. He sought care first with his primary care physician and later with a therapist for weekly sessions and a psychiatrist for monthly sessions. He was diagnosed with recurrent major depressive disorder, generalized anxiety disorder, and post-traumatic stress disorder (“PTSD”).
His Long-term Disability Claim
When his symptoms did not improve, Mr. Whetstone filed for short term disability (“STD”) from United. All three physicians agreed that he could not return to work to drive a commercial vehicle. United approved his STD benefits until the maximum period.
He then filed for long-term disability (“LTD”) benefits. United denied his claim after United’s doctor determined there was no “compelling” evidence of functional impairment. Moreover, United’s doctor believed Mr. Whetstone’s inability to drive was because he chose not to, not because there was any “objective” evidence such as cognitive testing that showed he cannot.
Mr. Whetstone filed an appeal with United, but it was denied after a second United doctor reached similar conclusions.
The Trial Court’s Decision
After his appeal was denied, Mr. Whetstone filed a lawsuit. In reviewing the case, the Ohio judge determined that the evidence of disability presented by Mr. Whetstone was strong while United’s was weak.
Specifically, the judge rejected United rationale that it was not unreasonable for denying the claim for lack of “objective” evidence when the LTD policy did not require Mr. Whetstone to produce such evidence.
The judge also noted how all three of Mr. Whetstone’s medical providers continuously stated that he could not return to driving a commercial vehicle due to his mental conditions. The judge continued, saying that unless there was something about the treating doctor’s observations that were unreliable, their “subjective” observations were acceptable for mental health conditions.
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