
ERISA Disability and Life Insurance Litigation
Oral arguments from various courts of appeal across the federal circuits involving long term disability or life insurance claims governed by ERISA.
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ERISA Disability and Life Insurance Litigation
Can On-Call Hours Count Toward Full-Time Employment Status for Disability Claims?
The claimant was a physician, who transitioned from part-time to full-time disability due to her deteriorating health condition. But her application for long-term disability benefits, which is governed under the complex umbrella of ERISA was denied by her Insurance company - UNUM.
At the heart of this dispute lies a contentious debate over the definitions of "full-time employment" versus "active employment." UNUM forwards a compelling argument, positing that the essence of full-time employment transcends the simplicity of a numerical hour threshold. According to them, it should mirror the employer's expectations and the specific demands of the occupation. They critiqued the district court's approach, accusing it of merging the distinct notions of full-time employment status with the active employment criterion, thereby diluting the stringent requirement of being a full-time employee to qualify for eligibility.
This is the oral argument in the 9th circuit court of appeals.
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under both.
Speaker 2:Okay, but so I guess what I'm struggling with just right here, if I want to be a cross examiner here is Judge Collins has just recited how the 30 hours there's a reasonable way to get there. When you were asked what's full-time employment, as you said it depends and you didn't have a number.
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Speaker 2:Each side has 15 minutes so we're ready and counsel for the appellant may begin by stating your appearance and advising me of any amount you want to reserve for rebuttal.
Speaker 1:Thank you, your Honor, and good morning. May it please the court. My name is Dan McGuire and I'm here to represent Unum Life. I'd like to reserve three minutes for rebuttal.
Speaker 2:All right, that's aspirational, but hopefully it'll happen. So go ahead.
Speaker 1:This issue in this case is whether Dr Connor was eligible for the Unum coverage. At issue, there are two eligibility requirements. The first is that she'd be a full-time employee, a term that's not defined in the policy, and the second is that she'd be in active employment, which is defined in the policy as working at least 30 hours a week. The district court found coverage attached because Dr Conner was working at least 30 hours a week. Before this panel are three charges of error. First, the district court erred by eliminating the full-time employee requirement for eligibility, instead conflating full-time eligibility with the active employment definition as a contract interpretation issue that is subject to de novo review by the panel. Second, the district court erred so on that issue.
Speaker 4:your argument is that working 30 hours a week does not constitute full employment, and what does, in your view, then?
Speaker 1:If the employer requires further hours or if the occupation requires further hours, then although the amount of hours your Honor might be relevant, it's not determinative.
Speaker 4:And what is determinative in your view?
Speaker 1:The employer's view and the occupational requirements.
Speaker 2:That sounds pretty vague.
Speaker 1:That doesn't help me, your Honor. The point is that not all occupations are the same, so if in the example, People normally think in normal usage.
Speaker 4:people think of full time in terms of number of hours, and so you have a clause that says all full time employees in active employment in the United States are eligible. And then active employment means and then it goes on and has the 30 hour benchmark. It is the natural reading of those two phrases to think that's what it means to be in full employment.
Speaker 1:I respectfully disagree, your Honor, and here's why. So, in interpreting the policy, we must do two things. One, we must give the words in the policy a meaning. There's a reason they're in there. We have to consider that If the term is not defined, then we look to the dictionary definition. I've cited two dictionary definitions, one from Blacks, the other from Merriam-Webster.
Speaker 2:Under both, Okay, but so I guess what I'm struggling with just right here if I want to be a cross-examiner here is Judge Collins has just recited how the 30 hours there's a reasonable way to get there. When you were asked what's full-time employment, as you said it depends, and you didn't have a number and it's your contract and if there's any ambiguity you don't win on that. Give me a number. 30's got a basis. 30 hours has a basis. You can find words that lead to that. You can't give me a number. How do we get to your number when it's your contract?
Speaker 1:Because, your Honor, there is no number. That's the point of our argument is that active employment is defined by a number, but full-time employment cannot be.
Speaker 5:Counsel, if you can't give us a number, how do we know that she's not a full-time employee?
Speaker 1:There are a number of reasons why your Honor, one is her own statements. That's our strongest evidence. That's factual, that's a factual basis.
Speaker 5:I thought you were talking about the law. You told us this was De Novo review, so I'm trying to figure out De Novo. How do we know that she's not a full-time employee as a matter of law? We followed the dictionary definitions which I've cited, including Blacks and Merriam-Webster. And what did?
Speaker 1:Blacks say how many hours. Blacks says full-time employment means one hired to work at least the number of hours in a work week as defined by the employer or statute, usually 35 to 40 hours.
Speaker 5:Does the employer have a number here that you can give us?
Speaker 1:For each occupation it's different.
Speaker 5:Counsel, you keep telling me that you can go to the facts if you want to go to the facts here, but you told us this was de novo review, so you got to be able to give me a number to tell me why this is not full-time employment.
Speaker 1:Your honor. The point of my argument is I can't give you a number, because that term cannot be defined with reference solely to a number. If you have a physician, a judge, a lawyer who works 60 hours a week, then 60 hours is full-time for them. If you have a clergy member, a yoga instructor or a physical therapist who works 20, then 60 hours is full-time for them. If you have a clergy member, a yoga instructor or a physical therapist who works 20, then it's 20.
Speaker 4:So then, an associate at a law firm who has a light week and works only 45 hours a week is suddenly part-time. I don't think people use the words in that way. That's not normal usage.
Speaker 1:No, your Honor, I understand your point, but my point is that associate who's working 45 hours in a slow week is not going to be working in a slow week for forever and the dictionary defines it as defined by the employer. So the employer, in the case of your associate, your Honor, does not cut the associate's pay because they're working that number of hours.
Speaker 5:It would all be great if the employer had defined something here, but if you can't tell us what the employer has defined, you're just making it up.
Speaker 1:Your Honor, we're not making it up. Respectfully, we're relying on the dictionary definitions, which make it clear to us, and hoping to convince you of this, that fewer than the number of standard of hours, standard number of hours is part-time, but the standard number of hours for that occupation and for that employer is what the occupation and the employer require so counsel.
Speaker 5:Let's suppose I don't want to drag my colleagues off task here, but let's suppose I'm not persuaded immediately by what you've said. I'd appreciate if you'd go to the facts and at some point in your argument I would appreciate you addressing whether Dr O'Connor is collaterally estopped by virtue of the filings that she made in the other insurance policy. That seemed troublesome to me, but I didn't see any argument that there was collateral estoppel. Do you have a side suit against Dr O'Connor for claiming that she was disabled in the other policy that you hold? No, your Honor.
Speaker 2:It seems that her first policy was, I don't know Revere, and then this policy is do you say it, Unum or Unum? How do you say it?
Speaker 1:Unum your Honor.
Speaker 2:Unum. But now Unum bought up Revere, and so the side story looks like Unum's kind of irritated that they're having to pay under two different policies.
Speaker 1:I'm sorry, your Honor, I didn't know that here was a question.
Speaker 2:So yes, Unum that kind of looks like if you can't give us a number, and then well, what's really going on here? And you can't give us a number? But it seems like that there's an irritation on Unum's part, that they've already paid under Revere and now they bought up Revere and now there are two policies. That's basically undisputed and we've got to interpret it.
Speaker 1:I understand your Honor and as far as your irritation point, I don't know if these people get irritated by claims, but I do know.
Speaker 2:I think they do. I think they do and they think on some level. But that still doesn't mean and everyone knows that as a backstory, but we still have to look if she's entitled to coverage under this one, then she gets it, regardless of whether she got it under another one.
Speaker 1:That's true, but they're still paying the other ones, so it's not like they terminated the claim under the other one.
Speaker 4:But this whole issue of whether or not her claims with respect to this policy were factually inconsistent with the claims she made in prior years under the Revere policy. This was all hashed out in front of the district court and an attack on her credibility, and then the district court made a judgment as to how to weigh that and our review is just for clear. Error on that point Is that right To that limited question?
Speaker 1:the answer is yes, but in a de novo review, when the court has the opportunity to review the record as a whole, it must also consider why would we get to de novo review in assessing that question of Dr Conner's credibility? Your Honor. As part of the de novo review, the court should look at all the facts in the record and determine which is more credible when does the de novo review come from?
Speaker 4:I thought you conceded in your opening brief that the standard of review was clear.
Speaker 1:error the clear error on the second issue. Your Honor, the first issue as to whether or not the full-time employee requirement was disregarded is subject to de novo.
Speaker 2:I just heard you say two seconds ago that de novo review on credibility and that part of the court's. We don't do that.
Speaker 1:I'm asking the court not to make a specific finding on credibility, your Honor, I'm asking instead for the court to look at the record as a whole following its novel review and determine that the plaintiff, dr Conner, did not sustain her burden of proving entitlement to coverage.
Speaker 4:Assume we disagree and we think the 30-hour standard is what applies to full-time, Then it's a factual question Whether she was working 30 hours in the period right before that's relevant. That was hotly disputed in front of the district court and she made a judgment as to how she resolved that.
Speaker 1:And we don't get to review that de novo. Your Honor, with respect to the second issue which I raised, which is the district court's finding on that issue, whether or not she was in active employment, that's subject to a different standard of review, the clearly erroneous standard of review. So in that respect I would agree with your Honor. But where we part company, I think, is on the first issue which is the full-time employment definition?
Speaker 2:So you concede that if we don't agree with you on the full-time employment, you lose, because there isn't clear error? Am I hearing that?
Speaker 1:No, your honor, I'm saying that if we lose on the de novo review, then the court goes to the second claim of error, which is that the district court's finding on the DeNovo review, then the court goes to the second claim of error, which is that the district court's finding on the active employment issue was clear error. Why don't you tell us what was clear error? Briefly, your Honor, I'd like to save some time for rebuttal, but I do want to answer your question. So her own statements, I think, are the strongest evidence. She consistently told Paul Revere that she was working part-time because her health prevented her from working more. Her doctor said she couldn't work more, that's how she collected.
Speaker 4:But she gave an explanation for that and I understand you don't think much of that explanation.
Speaker 3:This podcast is brought to you by Ben Glass Law, a national leader in long-term disability insurance claims. We help doctors, lawyers, entrepreneurs, ceos and other C-suite executives get paid for their long-term disability benefits. Visit us at benglasslawcom or give us a call at 703-591-9829.
Speaker 4:Case but the district court waived that and accepted the explanation, and I don't see what says that was unreasonable. This was one that you could have resolved either way, but the district court resolved it against you.
Speaker 1:Respectfully your Honor. The declaration that Dr Conner signed after she filed her total disability claim in June of 2019 said she was working at least 30 hours from the time she started there in July of 2017. That directly contradicts her statements to Paul Revere during that same period of time, for which there's been no explanation.
Speaker 2:You can't say there was. You can't, that's hyperbole. You can't say there was no explanation, because she was confronted in the district court with that inconsistency and she gave an explanation.
Speaker 1:And she gave an explanation, I recognize that you don't agree with the explanation, but to say there was no explanation seems to me to be hyperbole. Your Honor, I didn't mean to be hyperbolic about the issue, but what I meant to emphasize was that the statements in the declaration which the district court used as the basis for its decision were not supported by either plaintiff's prior comments at a time she had no reason to state that she was working more hours than she did or the other evidence in the file, including the fact that the employer hired her for part-time, paid her for part-time, contracted her for part-time. She never renegotiated her contract. That universe of facts supports our position in this case, your Honor, okay.
Speaker 2:Unless my colleagues have additional questions, I'll allow you to reserve the balance of the time. You have a minute and a half, but I'll give you two minutes for rebuttal. We don't appear to have additional questions, all right, so we'll go to. I believe it's, is it Scott Calvert?
Speaker 6:Yes, your Honor, all right, please state your appearance.
Speaker 6:May it please the court. Scott Calvert, on behalf of Appley. Dr Carolyn O'Connor. Dr O'Connor submits that the district court's interpretation of the policy was the correct one, that Unum is arguing, that Unum, in this case, is trying to impose a different standard on Dr Conner, one that is not included in the policy. Excuse me, the plan. The plan says nothing about requiring 40 hours a week to be full-time. The most obvious reading of the plan is that in order to be considered an active employee full-time active employee you need to work at least 30 hours a week.
Speaker 2:So then, how do we reconcile Dr Conner's representations to Paul Revere that she worked 20 to 25 hours a week with her present claim that she worked more than 30 hours a week?
Speaker 6:So the most recent representation to Paul Revere regarding the slightly lower numbers per week was in July 2018, which is six months before her claim of disability.
Speaker 4:But he points out that part of what she claimed extended back to 2017. And what was the explanation for that inconsistency?
Speaker 6:So there are two things, your Honor One. That dispute is not necessarily relevant to this case. That would be a dispute with Paul Revere, If Paul Revere has a concern about that. Dr Conner was making misrepresentations.
Speaker 4:We have to make a clear error review of whether or not you could correctly resolve this way, and if there's a flagrant inconsistency in what she said, that would bear on that. So why is there not?
Speaker 6:I don't believe there is a flagrant inconsistency, your Honor, she worked in. So, as I was saying, the last representation to UNAM was made in July 2018. She was disabled in December 2018. As part of her disability this is part of her declaration and other statements that she made to UNAM. Is that part of the reason she had to go on full-time disability as opposed to just residual was that over the last six months from July 2018 to December last claim form was filed with Paul Revere and during that time, she was working more than 30 hours a week. She was working 30, 40, all the way up to 50, considering and more once her on-call hours are factored in.
Speaker 6:There is no inconsistency. She has not made inconsistent statements to either insurance company. The Paul Revere representations were July 2018 and prior. The claims to Unum were. The statements were the last six months, which is July 2018 to December 2018. And again to the collateral estoppel issue raised during Mr McGuire's questioning, again, if Paul Revere has an issue with those representations, that's a Paul Revere issue, but this is a Unum issue. Unum has not raised that issue.
Speaker 4:And, in fact, on the 30th. Let me direct your attention to that particular comment he referenced. She said that she was working a minimum of 30 hours per week, but usually more, since July 2017. Did she say that and if so, what is the explanation for that?
Speaker 6:Because that does seem inconsistent. Again, even if that is inconsistent, your Honor, that's a Paul Revere issue, that is not a UNAM issue.
Speaker 4:No, it may be an issue for Paul, but it's an issue for us because if it's flagrantly contradictory and the district court blew by this, maybe that's clear error.
Speaker 6:There's two things, your Honor. One, that the representations on the claim form for earlier there's a Dr Holst was considered that the patient facing hours, so that's when she was talking about seeing patients. But the additional hours that were included in her contract were more than just patient facing hours. Those were also administrative task hours. Those were the on-call hours. Those were different hours and it was the ramping up over time that was problematic and that's what caused her to have to go on full-time disability because her hours were increasing and increasing. And so it's the most. It's the last six months and once the on-call hours over time, accumulative time, that's when she was working. This is not clear error, because the judge looked at all of these things and consider all of these things and determined that Dr Conner had demonstrated that she was working more than 30 hours a week.
Speaker 2:Are the on-call hours considered hours worked? Even if Dr Conner was not actually called and if the on-call hours are not counted as hours worked, did Dr Conner was not actually called and if the on-call hours are not counted as hours worked, did Dr Conner still work more than 30 hours a week?
Speaker 6:I'll take the second part of the question first. Yes, even if on-call hours are not included. Based on her declaration and her representations that she submitted to the court to the district court and to UNUM during the claim review process she averaged around 32 hours a week. A couple of times it was lower than 30, it was 29, 28 and a half, and other times it was more than 30, 32 and a half, but over time she averaged more than 30. The on-call hours should count because she had to work, she had to be by the phone, she had to answer calls. It's not like she never worked during the on-call hours and additionally, in addition to taking so on Saturdays, your on-call hours require you to go into the clinics. Her Saturday on-call hours required her to be on site. Her weekday on-call hours she had to be available by telephone and during those times she was maybe not necessarily taking calls for the full 5, six, eight hours, but she was available to work. She was required by her employer to be available to work. She did take calls during that time and I believe she would use that time to fill out paperwork and that sort of thing. So to get back to your first question, there's no indication as to why on-call hours would not be part of her part of the hourly requirement. She had to work those hours. Those hours were part of her requirement, if you. As cited in the briefing, the the employment contract required and mentioned that she needed to work on-call hours. So there's no reason for on-call hours to be separate from her regular hours and the plan does not delineate between working hours in the office and administrative and that sort of thing and on-call hours.
Speaker 6:Unum drafted this plan with the help of her employer. If they wanted to exclude on-call hours from the hours requirement, they had every opportunity to do so. The fact that they didn't do so does not allow them now to come back and rewrite the plan and rewrite on-call hours out of the hours worked. It does not allow Unum to get back to the. I think the main argument that Unum is making is that it has the right to rewrite the plan to require 40 hours a week or 20 hours a week in Mr McGuire's if the person is a yoga instructor. In the final briefing Unum makes a big point that they're the largest disability insurance company and so they can't be expected to write every single policy. But Unum has more than one policy. It's not a one-size-fit-all policy that goes to a doctor or a lawyer or accountant or a yoga instructor or a teacher, to use some of the examples that Mr Maguire used. Unum worked on this policy with the employer. There are a million. There are a million. There are many different.
Speaker 2:Hyperbole. That's what your, what counsel? For the appellant got cited for Hyperbole.
Speaker 6:Yes, which is why I checked myself. There are hundreds of different options that can be available.
Speaker 2:Less is more in appellate arguing. Okay, that's a, I'm going to do an emce this afternoon, and less is more hyperbole is bad.
Speaker 6:Thank you, your Honor. I will still stand by my statement that there are hundreds of different options that could go through in any plan document. There are exclusions. There are pre-existing exclusions. There are limitations for the kind of disability Unum controlled the plan. Unum wrote this plan. If Unum wanted to define full-time as being 40 hours a week, it could have done so. It made the affirmative decision not to do so, but then when Dr Conner made her claim, it argued that she has to work 40 hours a week to qualify for benefits, because Black's Law Dictionary says or Unum, or Merriam-Webster's definition of part-time says this, and we'll talk about.
Speaker 2:What weight should we give to Dr Conner's employment agreement, which reflects a status of part-time employee working 12 to 15 hours a week?
Speaker 6:Your Honor, I would say that it is important to note that even the one statement that UNAM is relying on regarding Dr Conner's hours being less than 30 said she worked 19 hours a week. Even the employer said she worked more than that. I think that is patient facing time. She was in the office around that period of time and actually quite more. But I think that goes along with the thing that was mentioned earlier is that each employer requires different things. That said, the employment agreement did say 12 to 15, but that's the letter, not the agreement. The employment contract listed a dozen, a bevy of duties that she was required to meet and it took more than 12 and 15 hours. Even her employer stated one time she was working 19 hours.
Speaker 2:Now two other times. It's been 30 hours. Did the district court hear that evidence?
Speaker 6:Yes, your Honor, the evidence that she worked more than 19?
Speaker 2:No that the part-time employee working 12 to 15 hours? Did the district court hear that as part of the entire hearing, determining whether she was part-time, full-time, whatever?
Speaker 6:Yes, your Honor, that letter is part of the administrative record and was central in Unum's argument that she was a part-time employee. But the plan, the important part of the plan, is that it does not delineate between. It does not define part-time or full-time. It doesn't say your employer has to classify you as full-time, it just talks about the 30 hours per week.
Speaker 2:But you're not reading my tea leaves. From this standpoint, I'm asking you if the information that, while that does seem inconsistent with being a full-time employee, was that thrown in the mix of factors that were considered before an ultimate decision was made? So is that part of whether there's clear error, whether there was a factual finding? Obviously, if that was left out, that might be significant, but I'm asking you, was that part of the full mix?
Speaker 6:It was part of the mix, your Honor. It was part of the administrative record that was submitted to the court and that the court reviewed. It was also made central to Unum's argument. So the court did review that document and incorporate that in its decision that Dr Conner was working more than 30 hours a week and was required to work more than 30 hours a week, especially once the on-call is factored in. Required to work more than 30 hours a week, especially once the on-call is factored in. So yes, that was considered at the district court level and baked into the cake, as it were.
Speaker 5:Was Dr Conner when she was on-call. Does that mean that she would have to take phone calls, or does that mean that she would have to go into the office or into the hospital or make a house call? What did that mean?
Speaker 6:So it was different for weekday versus weekend. On the weekends the on-call required that Dr Conner go to the office so that if a patient came into the office a physician was there to treat that patient. For the weekday on-call hours she had to be by the phone to answer questions in an emergency or something.
Speaker 5:Okay, and did she record the time? So if she got a call during that time, I understand she's on call so she has to be by the phone. That limits some of her activities. If she gets a call, did she record that any place? Was this recorded and compensated in some other way?
Speaker 6:I don't believe so, because she was not separate. She was not compensated separately for her on-call hours. Her on-call hours were part of her job requirements. So if she had to, go in on a Saturday.
Speaker 5:She wasn't billing someplace. That said look, I spent another two hours getting into the office on Saturday to actually see somebody on this Saturday, although I was on call the following Saturday and didn't see anybody at all.
Speaker 6:That's correct, your Honor. For the weekend she was physically in the office so she would be there from whatever hours were required 8 to 2, 8 to 3, 8 to 5, something like that. But she was not paid extra for her on-call work so there was no need to log that requirement because that was part of her job duties. That was part of her job to get her. That was part of the hour she had to work, so there was not a separate log that she was compensated and paid for. That was just part of all of the hours she was required to work as a physician at this job, do we?
Speaker 5:know whether Dr Conner's on-call responsibilities differed from any other doctor, who clearly was in the office for 40 hours a week.
Speaker 6:No, there's no evidence that her on-call duties and requirements or responsibilities were different from any other doctor. On the weekend she had to go in and on the weekday she had to take calls just the same from any other doctor. On the weekend she had to go in and on the weekday she had to take calls just the same as any other doctors. She worked part-time because she could only work part-time due to her disability. She wanted to continue working on a limited basis to the extent that she could, and so she worked until she couldn't work any longer, and they knew that when they hired her, that she would not be working full-time as some of the other physicians were. As Mr McGuire said earlier, each job has different hour requirements and for a part-time doctor that ended up being 40 hours a week, whereas the full-time doctors obviously must have worked more.
Speaker 2:It seems like her attractiveness, her unattractiveness, is she has these migraines and when you hire someone like that that they're not probably going to be as reliable as someone that's totally healthy. But her attractiveness is they got to pay her quite a bit less, even though the district court found she was working quite a bit more.
Speaker 6:Yes, your Honor, that was part of her employment agreement and that was obviously something that she was comfortable with as well, because she wanted to continue working as a doctor and this clinic provided her the opportunity to do so. Can I ask?
Speaker 4:a quick question about the attorney's fees. I just want to make sure I understand the record. Am I right that the only evidence on the issue of rates consisted of prior orders from other cases and a general statement that the rates were reasonable for the subject in the area? I didn't see, for example, any surveys of what rates were by lawyers for particular subjects in particular geographic areas.
Speaker 6:Am I reading the record correctly, your Honor, I believe you've missed two declarations that were submitted in support of the hourly rates. So there was the evidence that you did note the previous orders that counsel has gotten from other cases and we also cited two cases where other ERISA attorneys earned up to $900 an hour three years prior with similar experience. But there was a third piece of evidence. There were two declarations submitted on behalf of Dr Conner, one from an attorney, glenn Cantor, and another attorney, robert McKinnon, who are experienced ERISA attorneys, talking about how much they charge for doing the same work. And it is. They charge the same amounts, if not more now, and they had raised their rates earlier in time.
Speaker 4:But I thought that they just talked about what they charged for providing advice. They said that generally we can't use contingencies for this sort of work, but what we're doing like planning, then we'll do advice and that's the rate. But then they didn't say sometimes, when there's difficulty estimating, you'll see that they'll say for this community, this is what litigators, this is what the market bears for litigators. I didn't see that kind of evidence here.
Speaker 6:Those attorneys practice in throughout California, as does our office. This office was this case is in the Northern District and those attorneys also practice in the Northern District and that's what they charge for ERISA cases. There were also submissions of other court cases saying this is the rate approved in the Northern District for ERISA cases. We demonstrated through the declarations and our own court orders that we've obtained, and then court orders from other cases, that the rates are consistent with the market and that's the requirement. Unam just asked for a blanket reduction but doesn't offer any support for why we should get the lower attorney's fees rates. They just say give them less money per hour, but do not cite any justification for that. They didn't do any survey, they didn't provide any declarations, they didn't provide any court cases saying that the hours that we charged, the hourly rate that we charged, was excessive.
Speaker 2:There don't appear to be any additional questions, so we'll go to rebuttal.
Speaker 6:Thank you.
Speaker 2:Mr McGuire, oh, you're muted.
Speaker 1:I apologize. Thank you, your Honor. Before I summarize, I just wanted to touch briefly on two points raised by the panel in Mr Calvert's argument. On two points raised by the panel in Mr Calvert's argument First, as it relates to whether the district court considered the employment contract in making its final ruling. And the answer to that question can be found on page six of the lower court's decision, which is SER 151, where the court says that the employment contract was hearsay when offered to prove the truth of the statements therein. So in our view, because hearsay is admissible in an ERISA case, that was an error. Second, before I summarize, there was a point about her clinical work versus her on-call hours. So she told Paul Revere that she worked eight to one or two clinical three days a week. So that gives her about 15 to 18 hours. Her employer said that they give them two hours administration for every eight hours of clinical. So the clinical work doesn't get her there. She needs the on-call hours to get to 30. And Mr Calvert says that the plan does not distinguish that. But it does, because the definition of active employment says you must be working, that not available to work be working. In summary, your Honor, thank you for your attention.
Speaker 1:Today. It's our position that the district court erred by removing the full-time employment requirement from the policy, that under the de novo review, the court should review the record and find Dr Conner did not sustain her burden of proving she was a full-time employee and, as a result, the court should reverse with instructions to enter judgment in favor of Una. Alternatively, the court should reverse with instructions to enter judgment in favor of Unum. Alternatively, the court should find that the district court's finding that Dr Conner was in active employment was clearly erroneous. Based on the evidence as a whole, it's clear that a mistake was committed. And finally, if the court finds in Unum's favor on either of those things, plaintiff would not be the prevailing party and the fee claim should be vacated. The rest of the fee claim argument we will submit on the briefs.
Speaker 2:All right, thank you both for your arguments in this matter. It will be submitted.
Speaker 3:The proceeding has been a production of Ben Glass Law, a Fairfax, Virginia-based personal injury and long-term disability law firm. For a free evaluation of your claim, visit us at benglasslawcom or call us at 703-591-9829.