Employee Wage and Benefits

Fact Situation #1

Without reading the entirety of the plan, it is hard to discern the circumstances under which an employer can award or deny benefits. It is highly suspect, though, where here the employee had been approved for benefits under the plan that her circumstances changed such that the decision would be reversed. Although, if there is some provision in the plan stating that disability benefits would be reviewed annually, or some other timeframe, by review of the records without requiring an in-person examination, then, it may be argued that the employer had not violated ERISA but exercised the employer rights under the plan.

It might be important to get a grasp on the timeline in terms of date of injury, award of disability under the employer’s plan, award of Social Security disability benefits and date deemed ineligible for employer plan befits. In addition, these scenarios are operating under the assumption that she was granted long term disability rather than short term disability under the employer plan.

Further, the employer plan may have undergone some review and then revision changing the conditions for benefits from capability to perform own job duties to capability to perform any job duties. And, yet another scenario may be that the SSD benefits exceed the maximum benefits possible under the employer plan thus considering the employee ineligible.

So, in this case, the court has to consider contract language in the employer plan regarding eligibility requirements, per se. Then, paying special attention to the medical examination process initially, and whether or not there is an in-person examination required for any potential review of the benefits. When those benefit reviews occur. While Social Security Disability benefits are irrelevant to the employer plan in terms of determining disability status, the amount an individual receives for the same; and then adjusting the employer plan benefits based thereon.

If the language in the employer plan grants the employer the right to periodically review benefits paid, and that review does not require an in-person examination, but deeming an examination f the records acceptable, then, the employer in this case has probably not violated ERISA. If it is determined that SSD benefits exceeded the employer plan paid benefits, then the offset might deem the employee ineligible and terminate benefits. If there is no plan provision for the review and the offset does not wipe out the employer plan and/or only files are reviewed in determining eligible for employer plan benefits, the employee may have a claim.

It may be that the crux of this case revolves around the initial employer plan determination granting benefits, the SSD benefits awarded, and then the employer plan benefits terminated. However, employers do not have to necessarily follow the same recommendations or come to the same decisions as those supporting awards of SSD, since different experts may arrive at different conclusions. Taft v. The Equitable, 9 F.3d 1469, 17 EBC 1888 (9th Cir. 1993); Chandler v. Underwriters Laboratories, 850 F. Supp 728 (N.D. Ill. 1994).

Finally, there are some other caveats depending upon certain specifics which were not disclosed in this matter. For instance, the degree of disability is essential when analyzing the veracity of the termination where there is a huge gap between a major level of disability and minimal level of disability. Anderson v. Operative Plasterers’ II, 991 F.2d 356 (7th Cir. 1993). In another case where an abuse of discretion was claimed by the plaintiff, the court opined that just because an employee was deemed disabled by Social Security that did not necessarily carryover to a determination of disability pursuant to an employer’s long term disability plan, even though the employer suggested the employee apply for the same. Elliott v. Sara Lee Corp., 190 F.3d 601, 607-08, 28 EBC 1957 (4th Cir. 1999). This is true even if the plan had previously followed such determinations in the past. See Anderson, et.seq. One court included in its decision that there was no connection between an employer’s long term disability plan and Social Security disability benefits as long as the employer had proof of the grounds for its determination. De Coninck v. Provident Life & Accident Ins. Co., 747 F. Supp. 627, 632 (D. Kan. 1990).

Fact Situation #2

At first blush, the instinct is to categorize this individual as an exempt (from minimum wage and overtime requirements) employee because of his apparent independence from the company and time dedicated to administrative tasks. However, the FLSA contains very specific requirements which must be met in order for an individual treated as an exempt employee (U. S. Department of Labor, 2008).

A potential exempt employee must fall into at least one of the following categories: Executive, Administrative, Professional, Computer Employee, Outside Sales, Highly Compensated Employee, Blue Collar or First Responders (U. S. Department of Labor, 2008). Without even first attempting to appropriately categorize the field service engineer in the case at hand, after a cursory review of each of the categories, one requirement is evident in each one and that is the amount he was compensated (U. S. Department of Labor, 2008). That information is not available so by default and without making any assumptions he must be a non-exempt employee entitled to any time worked over a 40-hour week at time and one-half (U. S. Department of Labor, 2008).

However, for the sake of argument and in an attempt to look at both sides of the fence, for these purposes, the salary will be assumed at $2,500 per month. With that additional piece of information, a better determination can be made. To that end, the field service engineer clearly does not belong in either of the first three categories or the last four categories of exemptions listed above.

The requirements for the Computer Employee Exemption are (1) salary level of at least $455 per week; (2) must be employed in some computer-based capacity, including software engineer; (3) perform system analysis and performance assessment and adjustments, (4) implementation of computer systems based on design specifications; (5) implementation of machine operating systems; (4) or some combination of skills (3) through (5) (U. S. Department of Labor, 2008).

The field service engineer satisfies the requirements of the above-referenced exemption in that he oversees implementation of the employer’s robotic equipment, maintains the equipment, conducts business on behalf of the employer, continues his education in the field of robotics and completes the relevant paperwork. Of course, the continuing education and paperwork are irrelevant; however, it is worth noting since the amount of salary is not included, consideration should be afforded to the assumption that the field service engineer earns less than the $455 Computer Employee Exemption threshold. In that case, the employee fails one of the exemption requirements which in and of itself classifies him as a non-exempt employee and is entitled to overtime (U. S. Department of Labor, 2008). In fact, if the salary is less than $455 per week, the field service engineer fails all available exemption categories (U. S. Department of Labor, 2008).

Thus, if the salary is less than the $455 exemption requirement, the plaintiff should be awarded for any overtime which is calculated at one and one-half times his normal hourly wages for any time worked over 40 hours. That time would include unusual travel time, that is travel time outside the normal time to travel to and from work, time spent in continuing education at the request of his employer, any calls made or received relevant to the business of the employer, administrative tasks performed on behalf of the business, and off-site work. (United States Department of Labor, 2014)

Of course, all the above determinations come into play since the employment relationship was first established rather then one of independent contractor (U. S. Department of Labor, 2008). Further, it is impossible to classify him in any respect without the amount of his salary. 

References

Anderson v. Operative Plasterers’ II, 991 F.2d 356 (7th Cir. 1993)

Chandler v. Underwriters Laboratories, 850 F. Supp 728 (N.D. Ill. 1994)

De Coninck v. Provident Life & Accident Ins. Co., 747 F. Supp. 627, 632 (D. Kan. 1990)

Elliott v. Sara Lee Corp., 190 F.3d 601, 607-08, 28 EBC 1957 (4th Cir. 1999)

Taft v. The Equitable, 9 F.3d 1469, 17 EBC 1888 (9th Cir. 1993)

U. S. Department of Labor. (2008, July). Fact sheet #17A. Retrieved from http://www.dol.gov/whd/regs/compliance/fairpay/fs17a_overview.pdf