Opinion ID: 2966248
Heading Depth: 4
Heading Rank: 3

Heading: Work at a Real Estate Agency

Text: As a final reason for rejecting Dr. Blackwood's medical opinion as sufficient proof, the Liberty analyst handling Cook's claim cites [t]he fact that [Cook] has been working part time as a realator [sic] during the time her MD has stated she is completely disabled. In May 1997, an employee of Sanders informed Liberty that Cook was working at a real estate agency while she was receiving disability benefits from Liberty. Cook acknowledged that she had started working a few hours a week doing real estate open houses and a few showings. A Liberty claims analyst informed her that her disability benefits would be offset by the income she was receiving from her part-time job. (11) She was further told that she could work on a part-time basis while continuing to receive benefits, so long as her earnings did not go above a certain limit. As a follow-up to this conversation, he faxed her a section of the plan document explaining the offset process. He then contacted the agency for which Cook was working and requested Cook's earnings history. The agency informed Liberty that Cook had begun working in April 1997, and between April and July 1997, she had netted $175 in income. Her job duties included occasional open houses, showings, [and] customer phone calls, but Cook was not putting in desk time. This is the extent of the information in the administrative record relating to Cook's part-time job. In February 1998, Liberty requested that Cook provide information regarding her total earnings from this job, and in August 1998, it sent the same request to the real estate agency. It does not appear from the documents in the record that either responded. In relying on Cook's limited work at the real estate agency as a basis for rejecting Dr. Blackwood's assessment of Cook's total disability, Liberty ignores the fact that Cook had discussed her part-time work with Liberty analysts. None of them mentioned to her that her work left her in danger of losing her disability benefits. In fact, the plan states: If the Covered Person is earning less than 20% of his Pre-Disability Earnings, the Disability Benefit will be paid. Therefore, the plan specifically contemplates the possibility that a person receiving full disability benefits could also be working part-time -- but she could earn no more than 20% of her former salary at Sanders. Moreover, even with deferential review, Liberty possessed too little information regarding Cook's part-time work history to support a decision to terminate her benefits on that ground. At the time it made its initial decision, Liberty knew only that Cook had earned $175 over three months in 1997 and had worked a few Sundays tending open houses. It is true that Liberty requested, and Cook failed to provide, her W-2 form for 1997 from the real estate agency. She should have provided that information. Yet Liberty did not rely on Cook's lack of response to its request for her W-2 form as a basis for its termination decision. Instead, it saw in Cook's realtor work another reason for questioning the veracity of Dr. Blackwood's opinion that she was out of work indefinitely. However, Liberty's evidence that Cook was working elsewhere was so thin and outdated that it could not have reasonably relied on it as a basis for rejecting Dr. Blackwood's assessment of Cook's severe working limitations. Indeed, Liberty did not point out to Cook, either in its initial termination letter, or in its letter affirming its denial, that her part-time work at the agency factored into its decision. The failure to do so suggests Liberty's own recognition of the weakness of this evidence as a basis for terminating Cook's benefits.