A recent decision by the U.S. Fifth Circuit Court of Appeals highlights just how tough it can be for people in Louisiana to hold on to their employer-sponsored long-term disability benefits.

The case, Stout v. Smith International, Inc., No. 24-30571, 2025 WL 1029503 (5th Cir. Apr. 7, 2025) centers on Charles Stout, a Louisiana resident whose benefits for a heart condition were cut off by MetLife, the benefits administrator. After years of receiving payments, Mr. Stout found himself suddenly under review. MetLife decided he no longer met the plan’s definition of disability, and two courts ultimately upheld that decision.

To justify ending Mr. Stout’s benefits, MetLife relied on the opinions of two independent, board-certified cardiologists. Both doctors reviewed his medical records and concluded that his condition would not keep him from working full-time. What made the company’s case even stronger was that Mr. Stout’s own cardiologist, Dr. Barker, eventually agreed that he could return to work.

MetLife didn’t stop at medical records. The company looked closely at Mr. Stout’s daily life and activities. It discovered that he had started and led a youth basketball program, serving as its president and coach. Surveillance footage also showed him loading and unloading construction materials, including carrying heavy boards on his shoulders.

When Mr. Stout took the matter to court, the legal standard did not work in his favor. According to binding precedent, the district judge’s job was not to decide whether Mr. Stout was truly disabled, but only to determine if MetLife’s decision was reasonable and based on solid evidence. This “abuse of discretion” standard means the court gives a lot of leeway to the insurance company’s judgment.

On appeal, the Fifth Circuit also found that MetLife’s decision was well supported. The opinions from two independent specialists, the agreement from Mr. Stout’s own doctor, and the evidence of his physical activities all pointed in the same direction. The court also noted that Mr. Stout did not present any strong evidence to contradict MetLife’s findings or to show that his medical condition truly prevented him from working full-time at the time his benefits were cut off.

For anyone in Louisiana who relies on long-term disability benefits, the outcome of this case is a sobering reminder of what’s at stake. Insurance companies will carefully examine both your medical records and your day-to-day activities. Having your own doctor’s clear and documented support can make all the difference when your benefits are on the line, and if your doctor does not agree you are disabled, staying on benefits can be an extreme long shot.

(This case was not handled by The Pellegrin Firm and this summary is based on publicly-available court decisions).