Joyce R. Carter v. Fruit of the Loom, d/b/a Vidalia Apparel, et al.
(August 2004)

Lauren A. Welch won a victory (August 2004) in favor of Provident Life and Accident Insurance Company in the case entitled Joyce R. Carter v. Fruit of the Loom, d/b/a Vidalia Apparel, et al. in the U.S. District Court, Western District of Louisiana.

The long-term disability (LTD) policy issued by Provident provided that after an insured had been disabled from his own occupation for twenty-four months, disability benefits would only continue if the insured was unable to perform any occupation for which he was suited based on education, training, or experience. After paying the plaintiff under the “own occupation” provision, Provident terminated payment of benefits when the medical data submitted on behalf of the plaintiff indicated that she could perform light or sedentary work under the “any occupation” provision. While the plaintiff challenged Provident’s reliance on medical data only, and claimed that Provident abused its discretionary authority when it failed to obtain an opinion from a vocational expert, the District Court specifically held that “it was not necessary to obtain expert testimony as to claimant’s residual functional capacity.” The District Court concluded that “Provident extended every benefit of the doubt to claimant; however, the evidence does not support that Carter is disabled.” Plaintiff’s claims were dismissed, with prejudice.