Compliance October 1, 2003

US High Court to Define "Treating Physician Rule" in LTD Cases

January 10, 2003 (PLANSPONSOR.com) - US Supreme Court justices have agreed to decide whether a worker's doctor can overrule the administrator of a workplace disability plan on whether benefits should be extended.

Reported by

Fred Schneyer

According to a Dow Jones news report, the issue is an important one for employers because different federal appeals courts around the country are interpreting the “treating physician rule” in different ways when considering a long-term benefits case. Dow Jones said justices have collected legal briefs on the issue from various parties for months.

In the case taken up for review, Kenneth Nord, an employee for Black & Decker Corp. , filed for long-term disability for a back injury in 1997. The request was denied after the plan determined through an independent examination that Nord’s injury didn’t prevent him from doing his job, Dow Jones said.

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That conflicted with the view of Nord’s physician and Nord sued. A federal judge sided with the company, while a US 9 ^th Circuit Court of Appeals panel reversed the lower court decision. The 9th Circuit ruling said the treating physician’s view takes precedence when there are conflicting opinions about an employee’s condition.

The case is Black & Decker Disability Plan v. Nord, 02-469.