Bosley v. Metropolitan Life Insurance Company

Filing 52

NOTICE RE QUESTIONS FOR HEARING ON PLAINTIFF'S RENEWED MOTION FOR SUMMARY JUDGMENT. Signed by Judge Alsup on 11/30/2016. (whalc2S, COURT STAFF) (Filed on 11/30/2016)

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IN THE UNITED STATES DISTRICT COURT

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FOR THE NORTHERN DISTRICT OF CALIFORNIA
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ROBERT BOSLEY,
No. C 16-00139 WHA

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For the Northern District of California

United States District Court

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Plaintiff,
v.

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METROPOLITAN LIFE INSURANCE
COMPANY,

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NOTICE RE QUESTIONS FOR
HEARING ON PLAINTIFF’S
RENEWED MOTION FOR
SUMMARY JUDGMENT

Defendant.
/

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At the hearing on December 1, counsel for both sides should be prepared to discuss

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whether plaintiff’s claims should be adjudicated by bench trial and, if so, whether and to what

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extent the Court should consider evidence outside the administrative record. Additionally,

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counsel for both sides should be prepared to answer questions about the facts of the case with

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specific citations to the administrative record. For example:

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•

How did defendant categorize occupations as, e.g., “sedentary,” “heavy,” or

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“very heavy,” and how did these categories affect defendant’s analysis of

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disability benefits claims?

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•

Medical Director” (AR 298)?

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How did defendant decide which claims require “a higher level review with [the]

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Did Dr. Peters’s finding that plaintiff’s history was “consistent with the [chronic
fatigue syndrome] that was diagnosed in 2007” with a history of “exacerbations”
(AR 291) rely on the 2008 and 2011 claims and their supporting documentation?

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•

What was Dr. Peters’s rationale for opining that plaintiff could work 40 hours

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per week with some limitations (AR 291) despite plaintiff’s subjective reports —

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and Dr. Zollinger’s corroborating notes — that plaintiff could not work?

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Did Dr. Zollinger have any clinical data verifying the “patient report” that the

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limitations recommended by Dr. Peters had been attempted and resulted in long

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periods of excessive fatigue precluding work (AR 271)?

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Why did Dr. Wysham require plaintiff to undergo “ongoing motivational

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interviewing” and “show that he is working with mental health in order to

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continue to receive work excuse letters” from her (AR 206)?
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Why and to what extent was plaintiff’s motivation to return to work or seek

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For the Northern District of California

United States District Court

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additional medical treatment relevant to defendant’s evaluation of his claim for

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disability benefits?

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The appeals nurse who recommended referring plaintiff’s appeal to infectious

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disease / internal medicine and psychiatry specialists also suggested “including

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any prior claim medical [record] if related to the current conditions” (AR 566).

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Plaintiff’s appeal was referred to the aforementioned specialists, but they did not

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consider the history of his 2008 and 2011 disability claims (AR 151–52,

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161–62). Why not?

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Dated: November 30, 2016.

WILLIAM ALSUP
UNITED STATES DISTRICT JUDGE

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