meaningless except for extreme cases of complete mental or physical incapacity33. As
soon as Delta saw anything stating that Ms. Wolf could work, it interpreted the statement
to mean that Ms. Wolf was not disabled under the terms of the Plan34. This is a very
narrow interpretation of the terms “work” and “disabled” and is unreasonable because the
term could be interpreted more expansively; without further definition in the Plan, the
terms are ambiguous.
Delta’s interpretation of the Plan is similar to the case of Helms v. Monsanto Co.,
Inc., 728 F.2d 1416 (11th Cir. 1984). Helms applied for disability benefits under a group
plan which defined disability as being unable to engage in any occupation or employment
for remuneration or profit. His benefits were denied because an independent medical
examiner determined that, although he believed Helms was disabled, he could not say
that anybody was disabled under the definition provided. This is exactly what has
occurred in Ms. Wolf’s case. In Helms, the court overturned the decision denying
benefits under an arbitrary and capricious standard.
“Common knowledge of the occupations in the lives of men and women teach us that there is scarcely any kind of disability that prevents them from following some vocation or other, except in cases of complete mental incapacity. Although the achievements of disabled persons have been remarkable, we will not adopt a strict, literal construction of such a provision which would deny benefits to the disabled if he should engage in some minimal occupation, such as selling peanuts or pencils, which would yield only a pittance. The insured is not to be deemed ‘able’ merely because it is shown that he could perform some task.
... To bar recovery, under the provisions of the [plan], the earnings possible must approach the dignity of a livelihood. Mr. Helms is required to show physical inability to follow any occupation from which he could earn a reasonably substantial income rising to the dignity of an income or
33 “An interpretation which gives a reasonable, lawful and effective meaning to all the terms is preferred to an interpretation which leaves a part unreasonable, unlawful, or of no effect.” Meredith v. Allsteel, Inc., 11 F.3d 1354, 1358 (7th Cir. 1993).
See, Exhibits D and I, discussed and explained