In this dispute over ERISA-governed short- and long-term disability insurance benefits, Bernard v. Kansas City Life Ins. Co., No. 20-1593, 2021 WL 1244403 (8th Cir. Apr. 5, 2021), the Eighth Circuit agreed with the district court’s grant of summary judgment to Plaintiff-Appellee Ronald Bernard. The district court found that Defendant-Appellant Kansas City Life Insurance Company abused its discretion when it determined Bernard, a nurse anesthetist who is addicted to fentanyl, is not disabled from his own occupation because of his addiction.
Bernard started working for Mid-Missouri Anesthesiologists, Inc. in 1991 and then became addicted to fentanyl ten years later. Mid-Missouri put him on probation for several years and required regular drug tests. His contract subjected him to termination if a test returned a positive result. He remained clean for many years but then relapsed in 2015. He continued to work without incident for two years until two nurses reported him for using syringes and suspected drug use. Mid-Missouri took him to a drug-testing facility, and he admitted to using fentanyl at work. Mid-Missouri fired him and his sample later tested positive for fentanyl.
Bernard did not begin seeking treatment for his addiction until after the end of his employment. He applied for short- and long-term disability benefits with Kansas City Life and included supportive statements from his doctor and addiction specialist. They both supported his inability to perform his duties as a certified nurse anesthetist due to his addiction and relapse. Kansas City Life denied his claim on the basis that he could perform his regular occupation and would have been able to perform his job if he had not tested positive to the drug screening. In other words, his drug use did not preclude him from performing his duties, it was his employer’s decision to fire him.
The district court concluded, “No reasonable person could find that a nurse anesthetist so addicted to Fentanyl that he injects himself with drugs during the work day while his medical co-workers are nearby is capable of performing the duties of his job.” Bernard v. Kansas City Life Ins. Co., No. 19-4043, 2020 WL 974873, at *7 (W.D. Mo. Feb. 28, 2020). Kansas City Life appealed. On appeal, Bernard contested the standard of review, arguing that de novo review should apply because the plan administrator was not granted discretionary authority. The Eighth Circuit did not decide this issue because under either standard of review, Bernard is entitled to benefits. Kansas City Life admits that Bernard was fired because of his “employer’s serious concern for the safety of the patients,” but this cannot be reconciled with its position that he was not disabled because he had safely administered anesthesia while under the influence of fentanyl. Just because he made no errors and did not seek treatment until after he was terminated does not mean he was not disabled before his insurance coverage ended. Decision affirmed.
*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.
LEAVE YOUR MESSAGE
We know how to get your insurance claim paid. Call today at:
(510) 230-2090