When Speaking Limits Matter in an ERISA Disability Claim
A job may require little lifting and still demand more speaking than a person can manage. For someone with shortness of breath or difficulty speaking, the label ‘sedentary’ leaves a critical question unanswered: Can the person sustain the specific activities the work requires?
That issue sits at the center of Krambeck v. Unum Life Insurance Co. of America, No. 8:24-cv-2102-TPB-NHA, ECF No. 53 (M.D. Fla. Sept. 30, 2026). The court denied both sides’ requests for summary judgment on long-term disability benefits. It did not award benefits or send the claim back to Unum. The benefits dispute remained unresolved, with a bench trial planned unless the parties jointly agreed to another procedure. Read the court’s decision.
How much speaking can the claimant sustain?
Unum initially approved benefits for a Costco employee whose symptoms included shortness of breath and difficulty speaking following claimed COVID infections. After a nine-month period applying an own-job definition of disability, the policy shifted to an any-gainful-occupation definition.
The medical assessments differed sharply. The treating physician described a limit of 30 minutes of speaking per day, later reduced to a few minutes. Unum’s medical reviewers concluded that the claimant could perform sedentary work with occasional speaking—up to approximately two and a half hours in an eight-hour day.
Those assessments describe very different work capacities. A physician’s telephone conversation with an insurer’s reviewer, the summary of that conversation, and later responses also raised credibility questions. The court did not resolve those questions in its summary judgment ruling.
For claimants, the practical lesson is to make functional limitations concrete. A record explaining how long someone can speak, what happens afterward, and how much recovery is needed can address questions that a diagnosis alone leaves open. The demands of a proposed occupation deserve the same precision. Our discussion of occupational specialty in another Unum disability dispute explores the related importance of identifying the work actually at issue.
The policy’s governing law mattered
The court also examined which standard would govern its review. The policy specified Washington law, and a 2020 amendment replaced the entire policy. The court concluded that Washington’s 2009 prohibition on discretionary clauses applied, rejecting Unum’s argument based on the policy’s original 2001 effective date.
That conclusion supported de novo review, under which the court independently evaluates entitlement to benefits. Applying controlling Eleventh Circuit decisions, the court found that genuine factual disputes prevented summary judgment without the parties’ express agreement to a trial on the written record.
This was a decision about a particular policy and its history. Claimants should not assume that every ERISA policy, amendment, or state law produces the same result.
A procedural opening, with benefits still undecided
Krambeck illustrates why the details of both medical evidence and policy language matter. A claimant’s ability to sit at a desk does not answer every question about the ability to work, and the applicable review standard can affect how a court resolves disputed evidence.
If a long-term disability denial overlooks specific limits on speaking or other work functions, Feden Law Group can review the denial and discuss potential next steps. Schedule an initial consultation with an attorney.
This article provides general information, not legal advice. Reading it or scheduling a consultation does not by itself create an attorney-client relationship.