Latest / FLG Disability Insights / Why Lost Income Wasn’t Enough for Provident Partial Disability Benefits
Transcript
- Can a thirty-two percent pay cut prove partial disability? It sounds powerful. But in one recent Provident case, lost income cleared only one part of the policy’s test. Welcome to FLG Disability Insights. I’m Nick Feden of Feden Law Group. Whitlock had diagnoses of anxiety and depression. Her psychiatrist recommended reduced hours, and her salary at HUB fell by about thirty-two and a half percent. That exceeded the policy’s twenty-percent earnings-loss threshold. Still, the policy required more. She had to show that she continued performing some material occupational acts, while being unable to perform all the necessary acts—or unable to perform them for as long as normally required. The court accepted that Whitlock had a genuine medical diagnosis. But it found that the record did not establish the required occupational incapacity. Her psychiatrist described situational stressors and improvement after she left HUB. The record also said she spent thirty-two to forty hours a week growing her own company. The court favored the reviewing psychiatrist’s assessment and concluded that Whitlock had not carried her burden. The result was judgment for Provident on all claims. There was no benefits award and no remand. This was an unpublished, case-specific district court order—not a nationwide rule against mental-health claims or continued work. The practical lesson is that a partial-disability claim needs a bridge between diagnosis and occupation. Identify the job’s material duties. Explain how long those duties normally take. Then connect supported medical restrictions to the duties and the ability to sustain them. A recommendation for reduced hours is more useful when the record explains why the condition limits sustained performance. Those details help explain the connection between the diagnosis and the insured work. Continued work also needs careful, truthful context. If the claimant works somewhere else, the record should explain the actual duties, hours, and supported differences from the insured occupation. A lower paycheck may be meaningful, but it does not automatically prove every policy requirement. The court also held that ERISA governed this particular policy arrangement, despite individual ownership and portability, based on facts including Lockton’s discount, premium handling, and commissions. That conclusion was fact-specific too. Visit FedenLawGroup dot com and try FLG Case Analyst Beta. Get a full report from our attorney-trained, cutting-edge AI model, then connect with our firm about your next step. This podcast provides general information, not legal advice, and listening does not create an attorney-client relationship. I’m Nick Feden. Thanks for listening to FLG Disability Insights.