A recent case, Popovich v. MetLife Ins., 2017 WL 6546920, Dec. 21, 2017, hot off the press from the Central District of California, reflects the common, impervious attitude of insurance carriers. They typically believe they have few limits on their decision-making and that a court has to agree with them. Not before this court, however. And not with outdated vocational information.
Mr. Popovich was an assistant news editor covering the investments sector when he developed a very serious heart disease. Just working at his desk left him with chest pains. The job was very stressful and fast-paced. After several surgeries, procedures and rehabilitation, Mr. Popovich filed a claim. Of course, MetLife did not want to pay a claim just because someone had heart disease and chest pain. MetLife worked very hard to deny the claim and thought it had its evidence in all the right places.
For its vocational report, however, MetLife used the Dictionary of Occupational Titles (DOT), which was last updated in 1991. It said that Mr. Popovich's job only required the physical demands of sedentary work according to the DOT. Mr. Popovich contended that his job involved a high degree of stress, given the publication was an online newspaper—a format which did not exist in 1991. With the Internet changing the pace of information, stale news is worthless, especially in the investment world.
The court noted that the DOT listing pertained exclusively to print editing and that,
“Simply put, the ‘news editor' occupation described by the DOT is fundamentally different from Plaintiff's ‘news editor' occupation.”
The court found that MetLife had an obligation to consider what the claimant actually did at his job as a part of its vocational analysis.
It seems that tricks can be played on endlessly in ERISA. However, in this case the court would not stand for it. The court sided with the Plaintiff and ordered MetLife to pay all past-due benefits plus interest.