2003 Tax Ct. Memo LEXIS 182">*182 Judgment entered for respondent with respect to deficiencies and for petitioner with respect to additions to tax under
MEMORANDUM OPINION
JACOBS, Judge: Respondent determined deficiencies in petitioner's Federal income tax and additions to tax under
Addition to Tax
Year Deficiency
1997 $ 102,731 $ 25,683
1998 $ 26,347 $ 6,587
After concessions by the parties, 2003 Tax Ct. Memo LEXIS 182">*183 2 the issue remaining for decision is whether disability benefits received by petitioner in 1997 and 1998 from UNUM Life Insurance Co. of America (UNUM) are excludable from his gross income pursuant to
Background
The parties submitted this case fully stipulated, without trial, pursuant to
When the petition in this case was filed, petitioner resided in Carson City, Nevada. From 1991-94, petitioner was employed as the chief executive officer of Calera Recognition Systems (Calera). 3
2003 Tax Ct. Memo LEXIS 182">*184 In August 1991, Calera contracted for a group long-term disability insurance policy through UNUM (the UNUM policy) for the benefit of its employees. Under the UNUM policy, UNUM agreed to pay a monthly benefit provided it received proof that the insured employee was disabled. As relevant in this case, under the UNUM policy, the terms "disability" and "disabled" meant that, because of injury or sickness: (1) The insured could not perform any of the material duties of his regular occupation; or (2) while able to perform at least one but not all of the material duties of his regular occupation on a part-time or full-time basis, the insured was earning not more than 80 percent of his indexed predisability earnings.
Under the UNUM policy, if an insured employee provided proof of continued disability and regular attendance of a physician, UNUM agreed to pay the monthly benefit for the period of disability following a 90-day elimination period. The monthly benefit could neither exceed the insured employee's amount of insurance nor be paid for a period longer than the maximum benefit period. The amount of insurance was 66-
The maximum benefit period was determined by the insured employee's2003 Tax Ct. Memo LEXIS 182">*185 age at disability, as follows:
Age at Disability Maximum Benefit Period
Less than 60 To age 65
60 60 mos.
61 48 mos.
62 42 mos.
63 36 mos.
64 30 mos.
65 24 mos.
66 21 mos.
67 18 mos.
68 15 mos.
69 and over 12 mos.
If a disability was caused by mental illness, alcoholism, or drug abuse, the benefit period generally could not exceed 24 months. 4
2003 Tax Ct. Memo LEXIS 182">*186 Calera paid the premium under the UNUM policy. Petitioner was not required to pay any portion of the premium or to make contributions in order to be covered under the UNUM policy. Petitioner was not required to include (and did not include) any portion of the premium payment in his gross income.
In December 1994, petitioner suffered a severe neurological impairment that prevented him from engaging in any gainful employment. On January 12, 1995, petitioner filed a claim with UNUM for monthly disability benefits.
Initially UNUM refused to pay petitioner's disability claim for lack of medical documentation establishing that petitioner suffered a loss of function. Petitioner filed an administrative appeal. UNUM eventually reversed its initial decision and approved petitioner's disability claim.
On June 19, 1997, UNUM paid petitioner a lump sum of $ 237,885.69 for benefits owed from March 21, 1995 to June 18, 1997. In addition to the lump-sum payment, on July 20, 1997, petitioner began receiving monthly disability payments of $ 9,333.33. Petitioner received benefits totaling $ 286,931.22 in 1997 and $ 115,597.08 in 1998.
On his 1997 and 1998 Federal tax returns, petitioner reported2003 Tax Ct. Memo LEXIS 182">*187 the $ 286,931 (rounded) received from UNUM in 1997 and the $ 115,597 (rounded) received in 1998 as non-taxable sick pay. Petitioner filed both his 1997 and 1998 tax returns in December 1999.
Although UNUM paid petitioner the disability payments in 1997 and 1998, petitioner disputed the amount of the monthly benefit he was entitled to receive. While UNUM paid petitioner $ 9,333.33 per month in 1997 and 1998, petitioner demanded monthly benefits of $ 10,000. Petitioner filed suit against UNUM in State court on September 17, 1998. Petitioner and UNUM settled their dispute, and the suit was dismissed on November 15, 2000. The State court settlement had no effect on the amount petitioner had received from UNUM in 1997 or 1998.
Discussion
Gross income includes all income from whatever source derived.
Four conditions must be met for
In the instant case, petitioner received $ 286,931.22 in 1997 and $ 115,597.08 in 1998 from UNUM under the UNUM policy, an accident or health insurance plan. Petitioner received the benefits for a disability caused by a severe neurological impairment, a personal injury or illness, that he suffered beginning in December 1994. The benefits were attributable to contributions made by Calera, petitioner's employer, and the contributions2003 Tax Ct. Memo LEXIS 182">*189 were not included in petitioner's gross income. Thus, in the situation involved herein, all four conditions of
The legislative history of
Assume that under the plan of an employer payments equal to 25
percent of annual compensation are made to employees for loss of
a leg. The $ 10,000 employee would therefore receive a payment of
$ 2,500 and the $ 4,000 employee would receive a payment of
$ 1,000. These amounts2003 Tax Ct. Memo LEXIS 182">*190 would be excludible from gross income if,
under the plan, they are payable regardless of the period that
the employee is absent from work.
In
payments under accident and health plans that do not resemble
income, while including those that do.
mechanism for accomplishing this purpose. It excludes from gross
income only those amounts of accident and health insurance
payments that are computed with reference to the nature of the
taxpayer's injury. Only these payments are compensation for "the
permanent loss or loss of use of a member or function of the
body, or permanent disfigurement," and as such do not resemble
income. On the other hand,
amounts that vary according2003 Tax Ct. Memo LEXIS 182">*191 to the amount of time an employee is
absent from work. These amounts resemble income in that they
tend to compensate a person for lost wages.
To accomplish the congressional purpose of excluding only
those payments that compensate for permanent losses of bodily
function, the nature-of-the-injury requirement is best read to
require that benefits vary according to the type and severity of
a person's injury. Only then are the payments and the injury
sufficiently related to reflect the compensatory purpose
required by
Thus, "amounts received as accident or health insurance benefits may be excluded from gross income under
To exclude from income amounts described in
The parties agree that the payments petitioner received from UNUM in 1997 and 1998 constitute payments for his permanent loss or use of a member or function of his body within the meaning of
In the case before us, UNUM agreed to pay the monthly benefit for the period of disability following a 90-day elimination period. The UNUM policy provided that petitioner's monthly disability benefit would be based on 66-
Payments from a disability plan do not qualify for the
Petitioner contends that the benefits were computed by reference to the nature of the injury because the UNUM policy distinguished between physical injury or illness and mental illness. We disagree.
The monthly benefit for a total disability caused by mental illness did not differ from the monthly benefit for a total disability caused by physical injury. The benefit period (and thus the total benefit) for a disability caused by mental illness could be shorter than the benefit period for a disability caused by a physical illness or injury, only if the employee was under age 65 when he/she became disabled and did not return to work within 24 months. We do not believe that such payments are based2003 Tax Ct. Memo LEXIS 182">*194 upon the type and severity of the injury as required by
Furthermore, here, petitioner's total disability benefit was not calculated simply by virtue of his sustaining an injury. Rather, it was contingent upon his absence from his job. Payments that are designed to replace the income an employee has lost due to disability, rather than to compensate for the injury itself, cannot be said to be computed without regard to the length of time the employee was absent from work.
Payments under the UNUM policy are designed to replace the income an employee lost due to disability and are computed with regard to the employee's absence from work. The UNUM policy plainly did not compute the amount of payments "with reference to the nature of the injury," nor did it award benefits "without regard to the period the employee [was] absent from work." We conclude, therefore, that the benefits are not excluded from income under
We have considered various arguments made by petitioner not discussed above and have not found them persuasive
To reflect the foregoing and the parties' concessions,
Decision will be2003 Tax Ct. Memo LEXIS 182">*196 entered for respondent with respect to the deficiencies and for petitioner with respect to the additions to tax under
1. All section references are to the Internal Revenue Code in effect for the years at issue, and all Rule references are to the Tax Court Rules of Practice and Procedure.↩
2. Respondent concedes that petitioner is not liable for the addition to tax under
3. Calera ceased conducting business sometime in 2000.↩
4. If an insured employee continued to be disabled and became confined in a hospital or institution after the 24-month period and for at least 14 consecutive days, the monthly benefit was payable during the confinement.↩