ERISA Long-Term Disability Denial Upheld: Eighth Circuit Affirms Unum Termination Where Treating Doctor’s Own Records Supported Sedentary Work

In Halloran v. Unum Life Insurance Company of America, No. 25-2550, — F.4th —, 2026 WL 2545315 (8th Cir. Aug. 28, 2026), a panel of Chief Judge Colloton and Circuit Judges Gruender and Kobes, with Judge Kobes writing, affirmed the termination of a claimant’s ERISA long-term disability benefits. The court held that Plaintiff had not proven he was unable to perform any gainful occupation once his group disability policy’s definition of disability changed at the 24-month mark. For anyone whose ERISA-governed group disability insurance claim has been denied at the two-year point, the decision is a clear illustration of how much weight a court gives to a treating physician’s own contemporaneous records, and how difficult those records are to overcome once they are in the file.

What is the “any occupation” standard in an ERISA disability policy?

Most ERISA long-term disability policies define disability in two stages. For the first 24 months, a claimant typically must show only that he cannot perform the material and substantial duties of his own regular occupation. After 24 months, the standard shifts. Plaintiff’s Unum policy then required him to show he was “unable to perform the duties of any gainful occupation for which [he was] reasonably fitted by education, training or experience.” That is a much harder standard, because a claimant must rule out not just his prior job but a range of other work he could reasonably do. Plaintiff, a sheet metal fabricator, injured his left shoulder in 2019, underwent surgery, and received benefits under the own-occupation standard until the definition changed on April 13, 2022.

Why did the court find that Plaintiff could perform sedentary work?

The record centered on Plaintiff’s treating physician, Dr. Michael Freehill, who performed the shoulder surgery and treated Plaintiff from 2019 through May 2022. From June 2020 forward, Dr. Freehill consistently reported that Plaintiff could perform sedentary work, first with a 10-pound restriction and later with a 20-pound restriction, and he repeated those limitations across multiple assessments even after Plaintiff reinjured the shoulder and continued to report pain. An Unum vocational rehabilitation consultant identified three gainful occupations, production clerk, rental dispatcher, and routing clerk, that Plaintiff was qualified for and could perform, noting no medical disagreement that he could do sedentary work. The court found ample record support for the conclusion that Plaintiff retained sedentary-work capacity when the any-occupation standard took effect.

Can a treating doctor reverse course after the benefits are terminated?

This was the heart of the case. After Unum terminated benefits, Plaintiff obtained a functional capacity evaluation concluding he could not work, and Dr. Freehill then opined that Plaintiff could not work either. But when Unum’s reviewing physician followed up, Dr. Freehill confirmed that his restrictions “remained as issued from 6/1/21 through 5/2/22,” which allowed sedentary work, and he backtracked on the no-work opinion. The district court, sitting as factfinder, declined to credit Dr. Freehill’s after-the-fact attempt to walk back the restrictions, because nothing in the medical records explained why a more restrictive limitation would suddenly have been required as of April 13, 2022. The Eighth Circuit held this was not clear error. Where there are two permissible views of the evidence, the factfinder’s choice between them controls, and pointing to some evidence of disability is not enough to overturn the finding.

Does an insurer’s failure to follow ERISA claims procedures change the outcome?

Not here. Plaintiff argued that Unum failed to provide adequate notice or a fair review under its own claims policy, its Regulatory Settlement Agreement, and 29 U.S.C. § 1133. The court explained that the district court had considered Unum’s conduct and disagreed that the record showed a violation. More importantly, even if Unum had failed to follow reasonable claims procedures, the remedy would have been de novo review of the claim in federal court, which is exactly the review Plaintiff received. Because the policy did not grant Unum discretionary authority, the district court reviewed the denial de novo as factfinder rather than under the deferential arbitrary-and-capricious standard. The court also rejected Plaintiff’s reliance on King v. Hartford Life & Accident Insurance Co., distinguishing that abuse-of-discretion case because Unum’s rationale had stayed consistent throughout and because de novo review does not limit a court to the administrator’s stated explanation.

What does this ERISA decision mean for disability claimants?

The court affirmed the termination of benefits. The practical lesson for claimants with group disability insurance is that the record built during the claim, especially by a treating physician, carries enormous weight, and a favorable opinion offered only after benefits are cut off may not be enough to reverse a denial. It also shows that the shift to the any-occupation standard at 24 months is a genuine turning point in many ERISA claims, and one worth preparing for well before it arrives.