Oregon District Court Finds Unum Wrongfully Denied Long-Term Disability Benefits

In Koehnke v. Unum Life Insurance Company of America, No. 6:23-CV-00819-AA, 2025 WL 2682390 (D. Or. Sept. 19, 2025), the District of Oregon held that Unum improperly denied long-term disability (LTD) benefits to a participant whose chronic back and hip pain prevented her from performing the duties of her regular occupation. Applying a de novo standard of review under ERISA, the court concluded that the plaintiff proved by a preponderance of the evidence that she was disabled under the plan’s “regular occupation” definition of disability.

Plaintiff Koehnke had a long history of spinal problems, fibromyalgia, and chronic pain. After a jet ski accident in 2006, she underwent spinal surgery but continued to experience worsening symptoms. Over the years, MRIs revealed progressive degenerative disc disease, nerve root impingement, and facet arthropathy. Despite intensive treatment—including physical therapy, multiple pain medications, injections, and other interventions—her pain steadily worsened.

Koehnke worked as a Document Control Manager for Morrow Equipment from 2014 until 2021. Her treating physician, Dr. Ulrike Guempel, repeatedly documented her inability to sit for more than 20–30 minutes or stand for more than 15 minutes without severe pain. After her condition deteriorated further in 2021, Koehnke ceased working and applied for LTD benefits under Unum’s policy.

Unum denied her claim, relying on file reviews by its own physicians who concluded that she could perform her job with “positional changes.” Unum also emphasized certain “normal exam” notations and pointed to her occasional travel as inconsistent with disability. Koehnke appealed, providing a functional capacity evaluation (FCE) showing she was unable to sustain even sedentary work, updated medical records, and supporting statements from family members. Unum nevertheless upheld its denial.

The court conducted a bench trial on the record under Federal Rule of Civil Procedure 52 and reviewed Unum’s denial de novo. The court made several key findings:

• Credibility of Treating Physician: The court gave significant weight to Dr. Guempel, who treated Koehnke for seven years. Her restrictions were consistent with the medical record, imaging results, and the FCE. Although ERISA does not impose a “treating physician rule,” the court found her long-term observations highly probative.
• Subjective Symptom Testimony: The court emphasized that pain is inherently subjective and cannot be disregarded simply as “self-reported.” Ninth Circuit precedent requires that such testimony be weighed alongside objective evidence. Here, Koehnke’s reports of pain were corroborated by MRIs, surgical history, and consistent treatment.
• Improper Reliance on File Reviews: The court found that Unum’s reviewing physicians selectively cited irrelevant or generic exam notes (e.g., notations about “no distress” or intact cranial nerves) while ignoring the extensive diagnostic evidence supporting disability. Their dismissal of the FCE and failure to account for the progressive nature of her condition rendered their opinions unpersuasive.
• Travel Not Disqualifying: The court rejected Unum’s reliance on Koehnke’s occasional travel, noting that a few trips—taken with difficulty and additional medication—did not undermine her chronic pain testimony or demonstrate work capacity.
• Scope of Review: The court limited its decision to whether Koehnke was disabled under the plan’s “regular occupation” standard, declining to address the broader “any occupation” standard because that issue had not been developed in the administrative record.

The court granted Koehnke’s motion for judgment, holding that she was disabled within the meaning of the policy and entitled to LTD benefits. It ordered the parties to meet and confer on the amount of benefits owed, interest, and any attorney’s fees. Unum’s motion for judgment was denied except as to the “any occupation” issue, which the court held was not properly before it.