A federal appeals court backed Unum's move to cut off a worker's long-term disability benefits, agreeing he could still do sedentary work.
The US Court of Appeals for the Eighth Circuit affirmed the ruling on August 28, 2026, ending a sheet metal fabricator's fight with Unum Life Insurance Company of America over benefits governed by federal law.
The worker hurt his left shoulder in October 2019. An MRI showed a "full thickness retracted rupture of the long head biceps tendon," and he had surgery a month later. Unum approved short-term disability, then long-term benefits starting in April 2020.
The case turned on a switch built into the plan. For the first 24 months, "disabled" meant being "limited from performing the material and substantial duties of your regular occupation." After that, the standard tightened: the worker had to be "unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience."
That change did the work. His treating surgeon reported from June 2020 that he could handle sedentary work - "mostly seated work" with light lifting - and stuck with that view through May 2022. By December 2020, the surgeon raised the lifting limit to 20 pounds, and in early 2021 told him he might have to switch careers. A Unum vocational consultant later named three jobs he could fill: production clerk, rental dispatcher and routing clerk.
Unum ended the benefits as of April 13, 2022, the day the "any gainful occupation" test took effect, saying he was "not precluded from performing the duties of alternative, gainful occupations." After the cutoff, the surgeon reversed himself and said the worker could not work at all. Unum's reviewers disagreed, and the insurer held its ground.
Because the plan did not give Unum discretion to decide eligibility, a district court reviewed the denial from scratch, acting as factfinder. It found the worker capable of sedentary work and ruled for Unum. The appeals court saw no clear error.
The panel would not credit the surgeon's late "attempt to walk back [the worker's] restrictions after-the-fact," noting nothing in the records explained why tighter limits would apply as of April 13, 2022. The court also rejected the claim that Unum used a shifting rationale, saying its reasoning never changed.
