>A disability plan participant filing for long-term disability (LTD) saw a potential conflict between the language of the pension plan document – which used the term “regular occupation” – and the summary plan description (SPD) – opting for the term “regular job.” Looking to capitalize on an opportunity, the participant said the SPD should rule, and in that case, she was unable to perform her narrowly defined “regular job” – the specific job in the specific office with the specific co-workers with whom the participant worked, not just the kind of work the participant did.
More specifically, since the participant could not work with the people in the office, she was thus unable to perform her “regular job” and ostensibly was disabled.
>Affirming a lower district court’s opinion, the US Court of Appeals for the Sixth Circuit found the SPD and the plan document were not in direct conflict, and that the SPD did not control over the plan document because the term “regular job” in the SPD was “merely ambiguous,” and did not conflict with the plan document’s term “regular occupation.”
“At most, the alleged inconsistency in terms is that the word ‘job’ as used by the SPD is ambiguous,” the court’s found.
Going one step further, the court’s opinion in Valeckv. Watson Wyatt & Co. said that even if the two terms did conflict, ultimately, the court must defer to the plan administrator’s “rational interpretation.” In this case, the plan administrator judged the participant was not disabled because even if the participant was unable to work with the two co-workers, being an employee benefit professional, as the participant was, is not limited to one specific office. The participant in this case could do the same job under different circumstance, the plan administrator deemed.
The case is Valeckv. Watson Wyatt & Co. , 6th Circuit, Number 03-1854, unpublished.