In Pasha v. Kohler Co., No. 24-CV-0836-BHL, 2025 WL 2840242 (E.D. Wis. Oct. 7, 2025), the U.S. District Court for the Eastern District of Wisconsin upheld Kohler Co.’s decision to terminate a former employee’s long-term disability (“LTD”) benefits under an ERISA-governed plan. The court rejected the plaintiff’s claims that Kohler breached its fiduciary duties and acted arbitrarily and capriciously in denying her continued benefits.
Background
Plaintiff Pasha began working remotely for Kohler in August 2021 as an Associate Customer Service Representative, fielding plumbing-related calls, troubleshooting customer issues, and processing orders. As a Kohler employee, she was covered under the company’s short- and long-term disability plan.
In April 2022, Pasha applied for short-term disability benefits due to multiple health conditions—including chronic fatigue syndrome, postural orthostatic tachycardia syndrome (POTS), and chronic dizziness—that she claimed prevented her from performing her job duties. Kohler approved the claim and extended benefits several times through September 2022. After her short-term benefits ended, Pasha applied for long-term disability benefits, which Kohler initially approved through June 2023.
When her benefits period expired, Pasha submitted updated medical records. Kohler’s Occupational Health Nursing Supervisor reviewed the documentation and concluded that the evidence did not support total disability because Pasha could perform her job within a sedentary or light work classification. Kohler denied further benefits but allowed her to appeal.
On appeal, Kohler engaged Prevea, an independent medical review company, whose physician reviewer, Dr. Jasmine John, also found insufficient evidence to support total disability. Dr. John concluded that Pasha’s records did not demonstrate an inability to perform her job’s essential sedentary functions. After reviewing an additional functional capacity evaluation submitted by Pasha, Dr. John reaffirmed her conclusions. Kohler then issued a final decision denying continued LTD benefits, prompting this lawsuit.
Fiduciary Duty Claim: Attorney-Client Privilege Upheld
Pasha argued that Kohler breached its fiduciary duty by refusing to produce six emails between the company and its outside counsel, claiming she was entitled to them under the “fiduciary exception” to the attorney-client privilege.
Judge Ludwig rejected this argument. The court explained that once an employer’s interests diverge from the claimant’s—such as after a denial when litigation is reasonably anticipated—the fiduciary exception no longer applies. At that point, legal advice obtained by the plan administrator is for its own protection, not for the benefit of the plan participant. Because the disputed emails were created near the time of Kohler’s final denial, after Pasha had obtained counsel, they were protected by the attorney-client privilege and properly withheld.
Arbitrary and Capricious Review: No Procedural or Substantive Error
Applying ERISA’s “arbitrary and capricious” standard of review, the court found Kohler’s decision was supported by reasoned evidence and consistent application of plan terms.
Pasha contended that Kohler applied a “shifting standard” of disability and failed to provide a “full and fair review.” She argued that the company inconsistently defined her job’s material duties and failed to timely provide documents during the appeal process.
The court disagreed. It found that Kohler and its medical reviewers consistently described Pasha’s job as sedentary, involving phone and computer work performed remotely. Dr. John’s analysis reasonably relied on this understanding and engaged with the medical evidence, distinguishing the case from others where administrators ignored key job requirements or medical records.
The court also upheld Kohler’s reliance on Dr. John’s rejection of the functional capacity evaluation. Dr. John had reasonably concluded that the test involved tasks unrelated to Pasha’s actual job duties, distinguishing this case from the Seventh Circuit’s decision in Holmstrom v. Metro. Life Ins. Co., 615 F.3d 758, 766 (7th Cir. 2010), where an administrator improperly ignored relevant testing.
Finally, the court rejected Pasha’s argument that Kohler deprived her of a fair review by delaying disclosures. Kohler provided Dr. John’s reports well before the final decision, and the job description Pasha received days before the denial was consistent with earlier descriptions she herself had provided. The court found no prejudice or procedural defect.
The court concluded that Kohler’s decision was not arbitrary and capricious and that it had provided Pasha with a full and fair review of her claim. Accordingly, Judge Ludwig denied Pasha’s motion for summary judgment and entered judgment for Kohler Co. under Rule 56(f).
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If your long-term disability benefits have been denied or terminated, the attorneys at Roberts Disability Law, P.C. can help. Our firm focuses exclusively on representing individuals in ERISA and disability insurance disputes, and we have extensive experience challenging insurers and employers who wrongly deny benefits. Call us at (510) 230-2090, or contact us online to schedule a consultation and learn how we can help you protect your rights.
*Please note that this blog is a summary of a reported legal decision and does not constitute legal advice. This blog has not been updated to note any subsequent change in status, including whether a decision is reconsidered or vacated. The case above was handled by other law firms, but if you have questions about how the developing law impacts your ERISA benefit claim, the attorneys at Roberts Disability Law, P.C. may be able to advise you so please contact us.
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