Juanita Nichols v. Reliance Standard Life Insurance Company

This case presents an important and recurring question involving ERISA long-term disability insurance. In the decision below, the Fifth Circuit deepened an existing conflict over the proper way to define a worker’s “regular occupation,” which is the critical benchmark for deciding whether a worker is disabled. The Fifth Circuit, siding with the Sixth and Eighth Circuits, defined the term at the “high[est] level of generality”—classifying a worker’s generic occupation without accounting for “each of a claimant’s job duties.” Other circuits, by contrast, define “regular occupation” as “a position of the same general character as the insured’s previous job, requiring similar skills and training, and involving comparable duties.” Instead of defining “regular occupation” in a broad or generic way, these circuits consider the claimant’s “actual job duties”—“the usual work that the insured is actually performing immediately before the onset of disability,” taking into account the “nature of the institution where she was employed.” The practical difference is stark: think “doctor” versus “orthopedic surgeon in a small medical practice”; “teacher” versus “special-education food instructor;” or “attorney” versus “high-stress trial litigator.” The Fifth Circuit openly admitted that its definition is “different from the definition endorsed” by multiple circuits, and the Eighth Circuit has likewise recognized that the “circuits are split” on this common question. The question presented is: Whether “regular occupation” refers to a general category of employment in a broad and generic sense, or instead refers to a claimant’s “actual job duties”—“the usual work that the insured is actually performing immediately before the onset of disability.” (I)