ERISA disability claims can turn on how a plan defines your occupation. For lawyers and other professionals, an insurer may need to evaluate the duties of your specialty. In Macpeak v. Unum, that distinction led a Pennsylvania federal court to order Unum to reinstate a securities attorney’s long-term disability benefits.
On September 28, 2026, the U.S. District Court for the Eastern District of Pennsylvania granted summary judgment to a securities attorney at Morgan Lewis & Bockius LLP. The court ordered Unum Life Insurance Company of America to reinstate her long-term disability (LTD) benefits retroactively. Unum paid her benefits from September 2017 until November 2023 and then stopped. The court held that Unum abused its discretion because it treated Ms. Macpeak as a generic “attorney,” even though her ERISA plan defined an attorney’s “regular occupation” as her specialty in the practice of law.
The decision matters to lawyers, physicians, and other professionals who rely on “own occupation” or “regular occupation” disability coverage. It also matters to the attorneys evaluating LTD claims.
Macpeak v. Unum: Why the Court Restored LTD Benefits
Ms. Macpeak has a variety of conditions. She cut her schedule and still works part time at Morgan Lewis. Under the plan, a person counts as disabled if Unum determines that sickness or injury “limited” the person “from performing the material and substantial duties” of his or her “regular occupation.” For most employees, the plan measures the regular occupation “as it is normally performed in the national economy.” For attorneys, however, the plan defines the regular occupation as the attorney’s “specialty in the practice of law” at the time the disability begins.
The parties agreed that the deferential arbitrary-and-capricious standard of review applied. Ms. Macpeak won anyway because Unum misclassified her regular occupation as a general attorney as opposed to her specialty.
How Your Specialty Affects ERISA Disability Claims
A specialty-based definition of “regular occupation” determines what the insurer must measure. For example, a securities lawyer who researches regulations and drafts fund documents does different work than a trial lawyer, a patent prosecutor, or a law professor. If the insurer compares a claimant only to a generic “attorney,” it can conclude that she could do some legal job. However, that conclusion ignores the job she actually held and insured.
The Third Circuit has long held that “regular occupation” means the usual work the insured actually performed immediately before the disability began. In Lasser v. Reliance Standard Life Insurance Co., 344 F.3d 381 (3d Cir. 2003), the court held that an orthopedic surgeon’s regular occupation was that of an orthopedic surgeon in a four-person New Jersey practice group. It also held that on-call and emergency surgery duties counted as material to his practice. The Macpeak court relied on Lasser to hold that an administrator may not “ignore an insured’s specialized duties and treat the claimant as a generalist.”
The court also relied on Doe v. Standard Insurance Co., 852 F.3d 118, 125 (1st Cir. 2017). There, the First Circuit rejected an insurer’s reliance on the Dictionary of Occupational Titles (DOT) description of a generic lawyer. The Doe court noted that the insurer “charged an enhanced premium for the promise of enhanced specialty coverage” and then undercut that coverage.
Not every circuit agrees. Professionals should therefore read their policy language closely and consider where their case would be filed. Similarly, the stakes for physicians are high. A cardiothoracic surgeon who can no longer operate may still be able to review charts or teach. If the policy protects the specialty, those remaining abilities should not defeat the claim.
How Unum Used Generic Reviews to Terminate Benefits
The record in Macpeak shows why accurate vocational and medical reviews matter in ERISA disability claims:
- 2019 vocational review. Unum’s consultant classified Ms. Macpeak’s occupation as “Attorney,” eDOT code 110.117-022, “as performed in the national economy.” The consultant listed duties such as trial work, defending lawsuits, applying for patents, settling labor disputes, and teaching college law courses. None of those duties matched her securities practice.
- Physician file reviews. Unum asked three physicians whether Ms. Macpeak could perform the general physical and cognitive demands of an attorney. All three said she could. However, none of them evaluated her actual duties.
- Termination letter. Unum described her regular occupation as “Sedentary” and listed only generic attorney demands.
Unum argued that its 2019 review mentioned her securities work. The court found that the consultant noted her specialty “in the introduction” but “then completely ignored it in her analysis.” The court concluded that “the record is devoid of any indication that Defendant ever measured Plaintiff’s limitations against her actual duties.”
What to Do When Unum Denies or Stops Your LTD Benefits
If your benefits stop, compare the insurer’s reasons with your plan and the work you actually performed. An ERISA attorney can help evaluate the denial, develop an administrative appeal, and assess whether litigation is appropriate.
- Review the denial letter and deadlines. Check your plan’s appeal procedures and keep copies of your submissions.
- Request the claim file. Find out which job description and medical reviews the insurer relied on.
- Document your specialty. Supply an employer job description and a detailed account of your actual duties.
- Connect medical evidence to your work. Ask your treating physicians to explain how your symptoms affect the specific demands of your specialty.
For more information about the process, see the U.S. Department of Labor’s guide to filing and appealing disability benefit claims. ERISA generally requires claimants to complete the plan’s claim process before suing, although exceptions may apply. Review your own plan and denial notice promptly.
Can a Court Reinstate Terminated Disability Benefits?
After it finds an abuse of discretion, a court must choose a remedy. In the Third Circuit, the court looks to the status quo before the insurer’s wrongful decision. A wrongful initial denial often leads to a remand to the plan administrator. A wrongful termination of benefits the insurer already approved often leads to reinstatement (Miller v. Am. Airlines, Inc., 632 F.3d 837, 856–57 (3d Cir. 2011)). The Macpeak court applied that rule. Unum had “already approved and paid” the benefits, so the court ordered retroactive reinstatement.
For claimants whose benefits stop, this distinction has consequences. A remand sends the claim back to the insurer, which can build a new record and issue a new decision. By contrast, reinstatement restores the benefits the insurer cut off and requires payment of the past-due amounts. Reinstatement does not change the plan’s terms going forward.
ERISA Litigation and Attorney Referrals
This case concerns disability benefits, but The Garner Firm’s ERISA litigation practice also handles life insurance, pension and 401(k) benefit disputes, and breach-of-fiduciary-duty claims. We represent clients in individual cases and class actions. Attorneys seeking to refer an ERISA matter can contact our team to discuss the claim.
Talk With an ERISA Attorney About Your Disability Claim
The Garner Firm, Ltd. represents professionals, executives, physicians, and employees in complex ERISA, disability, and life insurance disputes. Founder and Managing Member Adam H. Garner concentrates his practice on ERISA litigation and long-term disability appeals and has handled ERISA lawsuits in state and federal courts nationwide. Partner Melanie J. Garner has more than 20 years of experience in state and federal courts, and much of her practice involves ERISA disability claims and litigation. The firm represents clients on individual and class-wide bases.
If Unum or another insurer has denied or terminated your long-term disability benefits, or measured your claim against a generic job instead of your specialty, contact The Garner Firm. Call (215) 645-5955 or complete the contact form on our website to schedule a free consultation. Our office is at 1617 John F. Kennedy Blvd., Suite 1111, Philadelphia, PA 19103.
This post provides general information and does not constitute legal advice. Reading it does not create an attorney-client relationship.