MCCOOL v. LIFE INSURANCE COMPANY OF NORTH AMERICA (2021)

United States Court of Appeals, Ninth Circuit.2021-04-02No. No. 18-56529

Summary · law.co

Holding. The appellate court affirmed the district court's judgment in favor of LINA, finding no clear error in the district court's factual determination that McCool failed to prove by a preponderance of the evidence that he could not sit for four hours in an eight-hour workday.

McCool appealed a district court decision denying his claim for disability benefits under his employer's ERISA plan. McCool argued he was disabled and unable to work, but the insurance company LINA disputed this. The central issue was whether McCool could sit for four hours during an eight-hour workday, which is the threshold courts use to determine if someone qualifies as disabled under ERISA when a policy lacks its own definition of disability. The district court found that three doctors testified McCool could sit "frequently," defined as 2.5 to 5.5 hours per workday, which meant he had not proven he could not meet the four-hour sitting requirement. Accordingly, the court ruled against McCool's disability claim.

Summary generated by law.co from the public-domain opinion. The opinion text itself is public domain.

Key issues

Whether McCool met his burden of proving disability under the ERISA plan
Whether McCool could sit for four hours per workday
Application of the Armani standard when an ERISA disability policy lacks a definition of disability

Procedural posture

McCool appealed the district court's judgment following a bench trial in which the court ruled in favor of LINA on McCool's claim for wrongful denial of disability benefits.

Authorities cited

No cited authorities resolved to law.co cases yet.

Opinion · public domain

MEMORANDUM **

Appellant Gabe McCool (McCool) appeals the district courts judgment in favor of Appellee Life Insurance Company of North Americas (LINA) following a bench trial. We have jurisdiction under 28 U.S.C. § 1291, and review the district courts factual findings following a bench trial for clear error. See Stormans, Inc. v. Wiesman, 794 F.3d 1064, 1075 (9th Cir. 2015). The district courts interpretation of the Employee Retirement Security Act (ERISA) and conclusions of law are reviewed de novo. See id.

McCool asserts that LINA wrongfully denied his requested disability benefits under his employers ERISA benefit plan. In the normal course, a court would review the policy to determine the definition of “sedentary” or suggestion of what definition to follow. However, this policy does not contain a definition. Thus, the district court properly applied the standard from Armani v. Northwestern Mut. Life Ins. Co., 840 F.3d 1159 (9th Cir. 2016), which (1) imposes the burden upon the claimant to prove by a preponderance of the evidence “that he was disabled under the terms of the plan”; and (2) adopts the “consistent” interpretation of “ERISA law” that an individual is unable to perform “any occupation” under a disability policy if that individual “cannot sit for more than four hours in an eight-hour workday.” Id. at 1163 (citation omitted).

The district court did not clearly err in finding that McCool failed to meet his burden of proving by a preponderance of the evidence that he could not sit for four hours a day. Three doctors opined that McCool could sit “frequently.” “Frequently is defined as between 2.5 to 5.5 hours in an 8-hour workday.” The district court found that McCool failed to establish that he cannot sit for four hours a day “despite repeated findings that he can sit frequently.” This finding was not clearly erroneous in light of the record evidence, and was consistent with our analysis in Armani.

AFFIRMED.