Plaintiff, Michael Aisenberg, was a former cyber security attorney for a defense contractor in Washington D.C. Mr. Aisenberg was covered under his employer’s long-term disability (“LTD”) plan with Reliance Standard.
After undergoing a double bypass heart surgery, his doctors recommended he stop working. Mr. Aisenberg ceased working in 2020 after he was experiencing shortness of breath and a CT scan revealed severe stenosis of two arteries and growing stenosis of three arteries. Mr. Aisenberg underwent surgery again in July 2020. This surgery had complications and eventually led to open heart surgery.
Mr. Aisenberg’s cardiologist advised him to not return to work as an attorney because the stressful nature of the job could lead to further heart problems.
Mr. Aisenberg submitted his LTD claim to Reliance. With the claim, two of Mr. Aisenberg’s doctors wrote letters of support saying returning to work would endanger his health and cause further medical complications.
Reliance denied the LTD claim alleging there were no physical exam findings to support his claim.
Mr. Aisenberg appealed the denial of LTD benefits. During the appeal review, Reliance’s reviewing doctor opined there was no medical evidence to support he cannot physically perform his job. Reliance denied the appeal and a lawsuit was filed pursuant to ERISA.
The Court’s Ruling
Magistrate Judge Anderson found that Reliance abused its discretion in denying Mr. Aisenberg LTD benefits because Reliance failed to consider the potential harm if Mr. Aisenberg returned to work at his stressful job.
Judge Ellies remanded the case back to Reliance to determine whether other less stressful attorney positions existed in the national economy that would avoid harm to the Mr. Aisenberg. Judge Ellies also asked Reliance to address the risk of harm if Mr. Aisenberg went back to his high stress job.
Reliance had a vocational review done and a new doctor review Mr. Aisenberg’s claim per the Judge’s order. Reliance’s new doctor opined that there is no medical documentation nor clinical studies to indicate that reducing or relieving chronic job stress results in secondary prevention of cardiovascular events. Reliance again denied Mr. Aisenberg’s claim.
The Court reviewed the case again and found that Reliance abused its discretion a second time in denying Mr. Aisenberg’s claim. The Court said Reliance was consistently inconsistent in its conclusions and its doctors failed to address the evidence that supported the claim.
If you become disabled from a specialty occupation, it is important to have the support of your doctors and demonstrate why your medica condition prevents you from working in your own specialty.
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