Angela Blount v. United of Omaha Life Ins Co
OPINION filed : Because this court s issuance of a full opinion would serve no jurisprudential purpose and would be duplicative, we AFFIRM on the basis of the well-reasoned opinion of the district court, decision not for publication. Julia Smith Gibbons, John M. Rogers (AUTHORING) and Bernice Bouie Donald, Circuit Judges.--[Edited 06/30/2017 by JRH]
NOT RECOMMENDED FOR FULL-TEXT PUBLICATION
File Name: 17a0386n.06
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT
UNITED OF OMAHA LIFE INSURANCE
Jun 30, 2017
DEBORAH S. HUNT, Clerk
ON APPEAL FROM THE
UNITED STATES DISTRICT
COURT FOR THE MIDDLE
DISTRICT OF TENNESSEE
GIBBONS, ROGERS, and DONALD, Circuit Judges.
ROGERS, Circuit Judge. In this ERISA case, plaintiff Angela Blount challenges the
denial of long-term disability benefits by defendant United of Omaha Life Insurance Company,
which relied on plan language limiting such benefits where a disability is caused by drug or
substance abuse. Blount contends that the plan language does not apply in the case of opioids
taken pursuant to her doctor’s prescription. The district court, however, properly determined that
United of Omaha did not abuse its discretion in interpreting the plan language.
United of Omaha—the relevant plan administrator—began paying Blount long-term
disability benefits on the basis of her treating rheumatologist’s diagnosis of pain, fatigue, and
cognitive problems associated with lupus and fibromyalgia.
However, subsequent treating
physicians and independent medical experts expressed doubt with the initial diagnosis and
opinion, instead attributing Blount’s disabling fatigue and cognitive problems to her “massive”
Angela Blount v. United of Omaha Life Insurance Company
prescription opioid regimen for lupus and fibromyalgia. On the basis of these later medical
opinions, United of Omaha determined that Blount was disabled due only to the effects of her
opioid regimen—not lupus and fibromyalgia—and invoked a provision in her plan that limited
benefits to 24 months when the disability was due to “substance abuse,” i.e., “any condition or
disease, regardless of its cause, listed in the most recent edition of the International Classification
of Diseases as a mental disorder.”
Within 24 months, Blount had exhausted all her
administrative remedies within United of Omaha’s claims and appeals procedures and her
benefits were terminated.
Blount then brought suit in the Middle District of Tennessee under the civil enforcement
provision of the Employee Retirement Income Security Act (ERISA). See 29 U.S.C. § 1132.
Both Blount and United of Omaha moved for judgment on the administrative record. The district
court granted United of Omaha’s motion but denied Blount’s, reasoning that there was
substantial evidence in the record to support United of Omaha’s determination that Blount was
disabled due to her opioid regimen, and that it was neither arbitrary nor capricious for United of
Omaha to invoke the 24-month substance abuse limitation in Blount’s plan once it determined
that Blount’s disability was due to her opioid regimen. Blount v. United of Omaha Life Ins. Co.,
No. 3:15-CV-00876, 2016 WL 4191725 (M.D. Tenn. Aug. 8, 2016). Blount now appeals.
After carefully reviewing the record, the applicable law, and the parties’ briefs, we
conclude that the district court’s opinion correctly sets out the facts and governing law. Because
this court’s issuance of a full opinion would serve no jurisprudential purpose and would be
duplicative, we affirm on the basis of the well-reasoned opinion of the district court.
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