Judge Candace Jackson-Akiwumi, nominated by President Biden to the US Court of Appeals for the Seventh Circuit, wrote a unanimous opinion joined by Biden nominee John Lee that ruled that an insurance company and a lower court had improperly denied long-term disability benefits to an Army veteran suffering from chronic pain and other disorders. The decision in Scanlon v Life Ins. Co. of North America was issued in August, 2023
What happened in this case?
Scott Scanlon is a US Army veteran who has worked as a systems analyst for the McKesson Corp. He has a “history of chronic pain and sleep disorders” and took temporary leave in 2017 and sought workplace accommodations. McKesson denied the full accommodations he requested, so he applied for long-term disability benefits under a McKesson policy with Life Insurance Co. of North America (LINA).
LINA denied benefits to Scanlon, despite significant evidence that his orthopedic and other disorders caused him significant pain and made him unable to “sit longer than 15 minutes at a time and no more than approximately 3 hours a day in total.” This made it impossible for him to perform his job, which requires him to sit and do job tasks for around 8 hours per day. LINA relied instead on two medical examiners who reviewed Scanlon’s disability claim and concluded it should be denied.
Under the federal Employment Retirement Income Security Act (ERISA), Scanlon filed suit in federal district court, which similarly denied his claims. He then appealed to the Seventh Circuit.
How did Judges Jackson-Akiwumi, Lee, and the Seventh Circuit Rule and Why is it Important?
Judge Jackson-Akiwumi’s unanimous decision focused on the ruling by the district court, which was required under ERISA to conduct a complete and new review of Scanlon’s claims under the LINA disability insurance policy. She found that the lower court “clearly erred” when it “failed to consider Scanlon’s inability to sit at his desk for eight hours a day as required” by his job and perform his job functions, and could not simply rely on the conclusions of the two medical examiners hired by the insurance company. She also noted that Scanlon’s treating providers and the Veterans Administration “consistently reported” that he “suffered from severe chronic pain” and other disorders that “impact his daily life” and ability to work.
Based on the lower court’s “clear errors” in light of the evidence, Judge Jacks0n-Akiwumi’s opinion vacated the lower court ruling and sent the case back for reconsideration. Under ERISA, she made clear, the lower court must carefully and “independently decide” Scanlon’s eligibility for benefits.
Judge Jackson-Akiwumi’s decision is obviously important to ensure that Scott Scanlon gets his full day in court to demonstrate that he is entitled to disability benefits under the insurance company policy. It also sends a significant message to lower courts evaluating other disability insurance claims under ERISA about the need to undertake careful and independent reviews of insurance denials, particularly in the Seventh Circuit states of Illinois, Indiana, and Wisconsin. In addition, the ruling serves as another reminder of the importance of promptly confirming fair-minded Biden nominees like Judges Jackson-Akiwumi and Lee to our federal courts.