Opinion ID: 2974356
Heading Depth: 2
Heading Rank: 2

Heading: What Constitutes Gainful Employment

Text: Before analyzing whether Tracy is unable to be “gainfully employed anywhere,” we must determine what it means to be “gainfully employed” under the Plan. This circuit has not yet defined what constitutes “gainful employment,” but the Eleventh Circuit addressed a similar question in Helms v. Monsanto, 728 F.2d 1416 (11th Cir. 1984). In Helms, the disability plan at issue provided that in order to be eligible for benefits an employee must be “prevented from engaging in any occupation or employment for remuneration or profit.” Helms, 728 F.2d at 1419 (emphasis added). The court stated: Total disability under this type of provision is not considered to exist if the insured can follow any remunerative occupation, whether in his present vocation or another. The phrase should not be given an absolute and literal interpretation. It should not mean that the affected individual must be utterly helpless to be considered disabled. It must be a relative term which means that the individual is unable to engage in a remunerative occupation or to do work in some profitable employment or enterprise. Permanent disability is a question of fact that depends upon all the circumstances of a particular case. Id. at 1420. The court pointed out that it is difficult to define the phrase “any occupation or employment for remuneration for employment,” because a “person would almost never be deprived of the ability to earn a nominal sum unless he is rendered completely immobile and without any cognitive ability.” Id. at 1420. The Helms court then drew from Social Security disability provisions and pointed out that in that context requirements for disability are “framed in terms of gainful employment and not just nominal employment.” Id. at 1421 (emphasis added). 12 In this case, the Plan, like the Social Security Act, defines a qualifying disability as a disability that prevents “gainful employment.” Thus, the reasoning from Helms is especially useful. The Helms court went on to state that: Although the achievements of disabled persons have been remarkable, we will not adopt a strict, literal construction of such a provision which would deny benefits to the disabled if he should engage in some minimal occupation, such as selling peanuts or pencils, which would yield only a pittance. The insured is not to be deemed “able” merely because it is shown that he could perform some task. Id. at 1421. The court found that to bar recovery under the provision at issue (“any occupation”) in that case: [T]he earnings possible must approach the dignity of a livelihood. [The plaintiff] is required to show physical inability to follow any occupation from which he could earn a reasonably substantial income rising to the dignity of an income or livelihood, even though the income is not as much as he earned before the disability. Id. at 1421-22. This circuit has already agreed with the court in Helms “that the phrase ‘prevented from engaging in every business or occupation’ cannot be construed so narrowly that an individual must be utterly helpless to be considered disabled.’” VanderKlok v. Provident Life and Acc. Ins. Co., Inc., 956 F.2d 610, 614 -15 (6th Cir. 1992) (quoting Helms, 728 F. 2d at 1421). Yet, in VanderKlok, this court established only that “a claimant’s entitlement to payments based on a claim of total disability must be based on the claimant’s ability to pursue gainful employment in light of all the circumstances,” id. (quotation omitted) (emphasis added), and failed to further elaborate on what constituted gainful employment. We now further adopt the holding in Helms that “gainful employment” is that employment from which a claimant may “earn a reasonably substantial income rising to the dignity of an income or livelihood, even though the income is not as much as he earned before the disability.” Id. at 1421- 13 22; see also Torix v. Ball Corp., 862 F.2d 1428 (10th Cir. 1988) (also adopting the standard set forth in Helms).