Reidy v. The Unum Life Insurance Company of America et al
Filing
42
MEMORANDUM OPINION. Signed by Judge Paula Xinis on 8/7/2018. (kns, Deputy Clerk)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND
*
KARIN REIDY,
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Plaintiff,
*
v.
Civil Action No. PX–16–2926
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THE UNUM LIFE INSURANCE
COMPANY OF AMERICA, et al.
*
Defendant(s).
******
MEMORANDUM OPINION
Plaintiff Karin Reidy (Reidy) brought this suit against Unum Life Insurance Company of
America and The Squire Patton Boggs Group Long Term Disability Plan (collectively
“Defendants”), seeking a declaration of entitlement to disability benefits, payment of backbenefits plus interest, and costs pursuant to the Employee Retirement Income Security Act, 29
U.S.C. § 1001, et seq. (“ERISA”). Pending before the Court are cross-motions for summary
judgment. ECF Nos. 35 & 38. The issues are fully briefed and the Court now rules pursuant to
Local Rule 105.6 because no hearing is necessary. For the reasons set forth below, Defendants’
motion for summary judgment is GRANTED and Reidy’s cross-motion is DENIED.
I.
BACKGROUND
Reidy is a former employee of the law firm then known as Patton Boggs, where she
served as the Director of Professional Development and Retention for the firm’s Washington,
D.C. office until her termination in May 2014. While at Patton Boggs, Reidy was a plan
participant under a group benefits plan established by Patton Boggs, the Squire Patton Boggs
Group Long Term Disability Plan (“the Plan”). ECF No. 1 at ¶ 6; see also ECF No. 8.
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Defendant Unum Life Insurance Company of America (“Unum”) is the claims administrator and
insurer of the Plan. ECF No. 1 at ¶ 7; see also ECF No. 6.
Reidy has received treatment for recurrent episodes of major depression since 1987. See
UA-CL-LTD-000042–45. Around March 2014, Reidy’s depression worsened, and she took a
leave of absence on the recommendation of her employers, “because [Reidy] was looking and
behaving in a manner that raised concerns.”1 UA-CL-LTD-000688. Reidy was approved for
Short Term Disability (“STD”) leave on April 7, 2014, for a period of three months, from April
7, 2014 through July 10, 2014. UA-CL-LTD000459. According to one of Reidy’s psychiatrists,
Dr. Michael Silver (“Dr. Silver”), Reidy’s symptoms improved somewhat following time away
from work, but at the encouragement of Patton Boggs’ Human Resources department, Reidy
decided to continue full-time treatment through the end of her STD leave. UA-CL-LTD000459.
At or around May 30, 2014, Patton Boggs merged with another law firm. Reidy’s position was
eliminated, and she was subsequently terminated. UA-CL-LTD000459; UA-CL-LTD-000490.
Reidy applied for Long Term Disability (“LTD”) and Life Insurance Premium Waiver
(“LPW”) benefits on January 19, 2015. See UA-CL-LTD-000042–45. In her application, Reidy
identified her medical condition as “major depression.” She further described her symptoms as
including “negative ruminations, confusion, inability to function due to disorganized thoughts,
constant fear, zero confidence in self, uncontrollable crying, uncontrollable negative thoughts,
inability to concentrate,” and “more.” UA-CL-LTD-00042–43. Reidy listed her current medical
1
At summary judgment, Reidy asserts that she took leave “on the advice of emergency room personnel.” See ECF
No. 38 at 1. However, nothing in the record supports this assertion. Rather, the record decidedly reflects that Reidy
took leave based her employer’s recommendation, and with the subsequent agreement of one of her physicians. See
UA-CL-LTD-000651–52; UA-CL-LTD-000656, UA-CL-LTD-000668–69; UA-CL-LWOP-000352–53. Reidy’s
Disability Claims form also indicates no hospital visits or admissions within the past twelve months. UA-CL-LTD000044.
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treatment providers as two psychiatrists, Dr. Silver and Dr. Kamal Jojodia (“Dr. Jojodia”). UACL-LTD-00044.
Two psychiatrists, employed by Unum, reviewed Reidy’s claim: Dr. Nicholas Kletti
(“Dr. Kletti”), Dr. Stuart Shipko (“Dr. Shipko”), with Dr. Kletti performing initial review.
Reidy’s file was also examined by two registered nurses, Rachelle Mack and Allyce Hawkes.
UA-CL-LTD-000408–11, UA-LWOP-000214–18; UA-CL-LTD-00507–10, UA-CL-LWOP000323–26. Defendants’ review consisted of telephone interviews of Reidy on February 16,
2015, and July 29, 2015, medical records provided by Dr. Silver (psychiatrist), Dr. Jajodia
(psychiatrist), and Reidy’s psychotherapist, Brian Corrado, and monitoring Reidy’s online
activity, such as posting on job-search websites and message boards. See, e.g. UA-CL-LTD000538–546, UA-CL-LTD-000647–52; UA-CL-LTD-000656–57, UA-CL-LTD-000675; UACL-LTD-006667; UA-CL-LWOP-000342–53. Unum interviewed Reidy’s treating physicians,
when possible. Mr. Corrado did not answer Defendants’ repeated efforts to obtain additional
details on Reidy’s condition, despite Reidy’s authorizing release of medical records. UA-CLLTD-0000656–57, UA-CL-LTD-006667. Dr. Jajodia deferred any opinion on Reidy’s disability
to her primary care doctor, Dr. Jack Summer, who last treated Reidy in September 2014, before
the relevant claims period. UA-CL-LTD-000545. Accordingly, Defendants’ review primarily
relied on Dr. Silver’s statements and records, and their conversations with Reidy. See, e.g. UACL-LTD-000545.
Defendants denied Reidy’s LTD claim on July 30, and then her LWP claims on July 31,
2015. UA-CL-LTD-000687–94; UA-CL-LWOP-000379–84. The stated reasons for the denial
was that Reidy had improved between March and May 2014 and could have returned to work
before her termination, and that, her symptoms had improved as of January 2015. See UA-CL-
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LTD-000687–94; UA-CL-LWOP-000379–84. Defendants further noted that Reidy denied that
her other medical conditions — migraine headaches and hypothyroidism — were in any way
disabling. See UA-CL-LTD-000687–94; UA-CL-LWOP-000379–84.
Reidy, through counsel, appealed Unum’s decision on January 22, 2016 and submitted
additional information to support her claim. See UA-CL-LTD-000757–866. The record was
supplemented with additional records from Dr. Silver, information regarding Reidy’s other
medical conditions, and a November 13, 2015 neurorehabilitation evaluation in which
psychologist Dr. Rick Parente (“Dr. Parente”) administered a series of tests, and concluded that
Reidy was “unable to return to her former job.” See UA-CL-LTD-04095. A substantial body of
general medical literature on Reidy’s conditions was also submitted. See UA-CL-LTD-000758–
803; see also ECF No. 38 at 13–15.
Dr. Peter Brown, a psychiatrist working full-time as an Unum claims reviewer, reviewed
Reidy’s appeal. Dr. Brown, noting inconsistencies between Dr. Parente’s report and Reidy’s
medical records as to Reidy’s drug and alcohol use and that Reidy’s testing scores did not
necessarily support the report’s conclusion, requested Dr. Parente’s raw test data. See, e.g. UACL-LTD-006874; UA-CL-LTD-006823. Defendants also repeatedly urged Reidy, through
counsel, to submit records from her primary psychotherapist, Mr. Corrado, noting that “[t]he lack
of these treatment records severely limits our ability to fully evaluate Ms. Reidy’s reports of
impairing symptoms.” See e.g. UA-CL-LTD-006823. Although Reidy’s counsel notified Unum
that they intended to submit Dr. Parente’s raw test data, it was not timely provided, and the
requests for Corrado’s records went unanswered. See ECF No. 40-2, UA-CL-LTD-006828.
On March 21, 2016, Defendants issued letters upholding the denial of Reidy’s claims,
finding that despite Reidy’s “chronic and complex psychiatric condition,” her symptoms
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improved over time and that as of January 29, 2015, she did not meet the plan’s definition of
long term disability. UA-CL-LTD-6836–46; LA-CL-LWOP-000414–422. The decision also
looked more closely at Reidy’s chronic migraines and thyroid condition, and found that her
physicians and Reidy herself perceived those conditions as “not impairing.” UA-CL-LTD006807–08. UA-CL-LTD-006839; UA-CL-LTD-000681–83.
After Unum issued its decision, Dr. Parente provided Unum the requested raw test data.
See UA-CL-LTD-006877. Dr. Brown reviewed the data, found it incomplete, and accordingly
noted that the data did not “change [his] previous conclusions.” UA-CL-LTD-006877. The data
was then reviewed by another Unum claims reviewer, Dr. William Black (neuropsychology),
who also found the data to be incomplete and of limited assistance. See UA-CL-LTD-006872.
Defendants took no further action, noting that the appeal decision was already filed, Dr. Parente
had not timely submitted any raw data, and that Reidy had not requested any further review.
UA-CL-LTD-006880.
On August 19, 2016, Reidy filed this action against Defendants under § 502(a)(1)(B) of
the Employment Retirement Income Security Act of 1974 (“ERISA”), requesting that this Court
declare her entitled to benefits under the Plan. ECF No. 1. She then filed a motion to compel
discovery, ECF No. 26, which was denied for “failure to assert particularized facts that render
extra-discovery necessary” regarding Unum’s conflict of interest in adjudication of her claim.
See ECF No. 32; Helton v. AT & T Inc., 709 F.3d 343, 352 (4th Cir. 2013); Fed. R. Civ. P.
26(b)(1). On February 9, 2018, Defendants moved for summary judgment, and Reidy thereafter
filed a cross-motion for summary judgment. See ECF Nos. 37 & 38.
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II.
STANDARD OF REVIEW
a. Summary Judgment
Summary judgment is appropriate when the Court, construing all evidence and drawing
all reasonable inferences in the light most favorable to the non-moving party, finds no genuine
dispute exists as to any material fact, thereby entitling the movant to judgment as a matter of law.
Fed. R. Civ. P. 56(a); see In re Family Dollar FLSA Litig., 637 F.3d 508, 512 (4th Cir. 2011).
Summary judgment must be granted “against a party who fails to make a showing sufficient to
establish the existence of an element essential to that party’s case, and on which that party will
bear the burden of proof at trial.” Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). When
both parties file motions for summary judgment, the court is to “rule on each party’s motion on
an individual and separate basis, determining, in each case, whether a judgment may be entered
in accordance with the Rule 56 standard.” Krajewski v. Metropolitan Life Ins. Co., No. RDB08-2406, 2009 WL 2982959, at *4 (D. Md. Sept. 14, 2009) (quoting Towne Mgmt. Corp. v.
Hartford & Indem. Co., 627 F. Supp. 170, 172 (D. Md. 1985)). If a party’s statement of a fact is
“blatantly contradicted by the record, so that no reasonable jury could believe it,” the Court
credits the record over the averred fact. See Scott v. Harris, 550 U.S. 372, 380 (2007).
b. ERISA Administrator Review
When, as here, a benefit plan gives the administrator discretionary authority to determine
eligibility for benefits or to construe the terms of the plan, the Court reviews the administrator’s
denial of benefits under ERISA using an abuse of discretion standard. See ECF Nos. 35 & 38 at
29–30; Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989); Williams v. Metro. Life
Ins. Co., 609 F.3d 622, 629–30 (4th Cir. 2010). Under the abuse of discretion standard, the
Court “must not disturb the [administrator's] decision if it is reasonable, even if the court itself
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would have reached a different conclusion.” Fortier v. Principal Life Ins. Co., 666 F.3d 231, 235
(4th Cir. 2012).
When the same party is both the claims administrator and the insurer responsible for
paying a claim, a structural conflict of interest exists. The conflict does not alter this Court’s
standard of review; rather the structural conflict may be considered as one of many factors in
evaluating the administrator’s decision. See DuPerry v. Life Ins. Co. of N. Am., 632 F.3d 860,
869 (4th Cir. 2011) (internal quotation marks and citation omitted); Elliott v. Sara Lee Corp.,
190 F.3d 601, 605 (4th Cir. 1999); Ferguson v. United of Omaha Life Ins. Co., 3 F. Supp. 3d
474, 481 (D. Md. 2014). The significance accorded to the conflict depends on the circumstances
of the particular case. DuPerry, 632 F.3d at 869; Ferguson, 3 F. Supp. 3d 480–81.
Critically, “[w]here an ERISA administrator rejects a claim to benefits on the strength of
substantial evidence, careful and coherent reasoning, faithful adherence to the letter of ERISA
and the language in the plan, and a fair and searching process, there can be no abuse of discretion
— even if another, and arguably better, decision-maker might have come to a different, and
arguably a better, result.” Evans v. Eaton Corp. Long Term Disability Plan, 514 F.3d 315, 325
(4th Cir. 2008). While it “is certainly possible that the evidence on each side of a disability
dispute might be so lopsided that a decision for the less persuasive one is an abuse of discretion,”
a court must refrain from re-weighing the evidence in close cases, such as this one, and an
analysis as to the “greater and lesser persuasiveness” of the physicians’ reasoning is
inappropriate. Id. at 325-26.
The Court considers eight nonexclusive factors in reviewing the administrator’s decision,
also known as the “Booth factors.” Not all factors are present in any given case, and include:
(1) the language of the plan; (2) the purposes and goals of the plan; (3) the adequacy of
the materials considered to make the decision and the degree to which they support it; (4)
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whether the administrator’s interpretation was consistent with other provisions in the plan
and with earlier interpretations of the plan; (5) whether the decision-making process was
reasoned and principled; (6) whether the decision was consistent with the procedural and
substantive requirements of ERISA; (7) any external standard relevant to the exercise of
discretion; and (8) the administrator’s motives and any conflicts of interest it may have.
See Blanch v. Chubb & Sons, Inc., 124 F. Supp. 3d 622, 638 (D. Md. 2015); see also DuPerry,
632 F.3d at 869.
With this framework in mind, the Court turns to the parties’ motions.
III.
DISCUSSION
Under the Plan, a claimant is considered totally disabled and entitled to coverage when
she shows she is “limited from performing the material and substantial duties of [her] occupation
due to [her] sickness or injury” for a minimum of 365 days. UA-CL-LTD-POL-00016, UA-CLLTD-POL-00032–35. Reidy argues that Unum was on a “predetermined course” to deny
disability benefits. See ECF No. 38. Reidy more particularly attacks the adequacy of
Defendants’ review process, arguing that it was characterized by the reviewing physicians’
pervasive, unethical conflicts of interest, and failure to “address nearly the entirety of Ms.
Reidy’s extensive medical history.” See generally ECF No. 38. Defendants counter that the
claim review process was through and considered all evidence submitted in support of Reidy’s
LTD claims. ECF No. 35.
a. Significance of Social Security Determination
As an initial matter, Reidy contends reversal is supported because the Social Security
Administration found Reidy’s effective date of disability to be March 27, 2014. ECF No. 38 at
6; UA-CL-LTD-006884. Social Security determinations, while relevant in ascertaining “the
arbitrariness of a decision to terminate benefits under an ERISA plan,” are not dispositive.
Graham v. Aetna Life ins. Co., No. 7:13-1093-TMC, 2014 WL 4716473, at *8 (D. S. Ca. Sept.
8
22, 2014) (quoting Glenn v. MetLife, 461 F.3d 660, 667 (6th Cir. 2006)). “[B]arring proof that
the disability standards for social security and the plan in question are analogous, [the Court]
would not consider an SSA award in an ERISA case.” Piepenhagen v. Old Dominion Freight
Line, Inc. 395 F. App’x 950, 958 (4th Cir. 2010) (citing Smith v. Continental Cas. Co., 369 F.3d
412, 420 (4th Cir. 2004) and Elliott, 190 F.3d at 607). Reidy has not demonstrated that the
Plan’s “total disability” triggering coverage mirrors the relevant definition in the SSA’s
regulations. Thus, Reidy’s receipt of social security benefits is of limited weight in the Court’s
analysis. See Piepenhagen, 395 F. App’x at 958.
b. Adequacy of Vocational Review
Reidy next argues that Defendants “minimized” her job responsibilities so as to facilitate
claim denial, and that their categorization of her job description as “Recruiting Director” does
not match Reidy’s actual work. See ECF No. 38 at 18–20. In assessing what kind of job a
claimant is expected to perform, administrators must use an “objectively reasonable” description
of the claimant’s occupation. Gallagher v. Reliance Stand. Insur. Co., 305 F.3d 264, 271 (4th
Cir. 2002). Reidy does not specify how “Recruiting Director” fails to capture objectively her
work duties, nor does she demonstrate how her actual position was more mentally or physically
rigorous than that described for Recruiting Director. See ECF No. 38. The Court, therefore,
does not find this argument persuasive.
Rather, the record amply supports that Defendants followed the Plan to arrive at the
appropriate category of job by assessing her occupation “as it is normally performed in the
national economy, instead of how the work tasks are performed for a specific employer or at a
specific location.” UA-CL-LTD-POL-000034; UA-CL-LWOP-000124. To do so, Unum
considered information from Patton Boggs and input from Reidy herself, collected through a
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Work Experience and Education Questionnaire and a February 16, 2015 telephone interview.
See UA-CA-LTD-000394–95; UA CL-LTD-004122–23; UA-CL-LWOP-000253–54. Reidy
self-described her position as Director of Professional Recruitment, and her duties to include
recruitment and hiring of law students, as well as supervising new associate programming. Id.
Unum found that Reidy’s position, as described, most closely matched the general occupation in
the national economy of “Recruiting Director,” defined in Unum’s directory as a complex
position that required analysis, presentations, “constant social interaction” across multiple
organizations, and “frequent adaption to change” and “independent planning.” See UA-CL-LTD000396. Unum’s chosen vocational label need only capture material and substantial duties to
that required by Reidy’s actual position. Indeed, nearly all of the qualities that Reidy argues
made her job difficult are captured in the Recruiting Director, a job described as cognitively
difficult with frequent travel and constant social interaction. See UA-CL-LTD-000395–97 (also
describing the position as requiring “memory and concentration,” supervision of others and
considerable personal responsibility, and complex analysis); see also UA-CL-LTD-000068–74.
Unum’s assessment of Reidy’s ability to work as in the generic occupation of “Recruitment
Director” was not an abuse of discretion.
c. Adequacy of Medical Review Process
Reidy next argues that Defendants’ failure to examine her physically, and instead rely
solely on “biased” internal physicians, constituted an abuse of discretion warranting reversal.
See ECF No. 38 at 32–34. It is true that Defendants did not physically examine Reidy.
However, neither ERISA nor the Plan required such an examination before making a benefits
determination. See Piepenhagen, 395 F. App’x at 957 (rejecting argument that plan
administrator had duty to conduct independent medical examination before denying benefits
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because claimant, not plan administrator, has duty to provide evidence of disability); Price v.
Unum Ins. Co. of America, No. GJH-16-2037, 2018 WL 1352965, at *11 (D. Md. Mar. 14, 2018)
(upholding insurer’s peer review of claimant’s file for claim based on psychological injury);
Savoy v. Fed. Express Corp. Long Term Disability Plan, No. DKC-09-1254, 2010 WL 3038721,
at *1–2 (D. Md. July 30, 2010) (upholding insurer’s reliance on a psychologist’s peer review of
claimant’s file). Only where the administrator completely disregards the records and opinions
provided by a claimant’s treating physicians without explanation does the failure to conduct an
examination compel reversal. See Zhou v. Metro. Life Ins. Co., 807 F. Supp. 2d 458, 460–68 (D.
Md. 2011) (finding the denial without examination unreasonable where the reviewers did not
acknowledge medical records showing the plaintiff expressed suicidal ideation, could not do
menial tasks such as “washing the dishes” or driving, and was homeless with little motivation);
Smith v. PNC Financial Serv. Grp., No. MJG-15-2232, 2017 WL 3116689, at *13 (D. Md. July
21, 2017) (finding that the administrator’s decision was “arbitrary and capricious” because only a
“cursory file review” was performed and there was no independent medical examination);
Chilton v. Metro. Life. Ins. Co., No. 2:14-cv-67 TS, 2015 WL 2249983, at *6 (D. Ut. May 13,
2015) (finding the lack of independent examination reasonable because the administrator “did
not disregard” the treating physicians’ opinion and gave “multiple opportunities” for the
claimant’s doctors to substantiate their opinions “with additional medical evidence.”); accord
Sheppard & Enoch Pratt Hosp., 32 F.3d 120, 125 (4th Cir. 1994) (finding no abuse of discretion
where plan administrator relied on paper reviews of consulting physicians); Price, 2018 WL
1352965, at *11 (same).
This is not that case. The record evidence reflects that Defendants conducted multiple
phone interviews with Reidy and her treating physicians to assess the severity of her depression.
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Defendants further considered all treating physicians’ records prior to rendering a decision.
Failing to examine Reidy firsthand does not warrant reversal.
Regarding the adequacy of the actual reviews performed, Reidy goes to great lengths to
undercut the credentials of Unum’s consulting physicians, Drs. Brown, Kletti, and Shipko.
Reidy notes that other courts have rejected the physicians’ conclusions on occasion, points to
unfavorable “reviews,” and casts aspersions on the doctors’ compensation, work history, and
age. See ECF Nos. 38 at 23–29 & 38-6; see also UA-CL-LTD-000754–000866. Reidy,
however, does not successfully demonstrate that these doctors lacked the necessary bona fides to
render their opinions in this case. Thus, the Court assesses the reliability of the physicians’
opinions based on whether they are reasonable and supported by medical records made available
to them.
Reidy next argues that the Court should disregard Dr. Brown’s written determination
because Reidy was not given the opportunity to respond and was thus “sandbagged” by the final
claims determination. ECF No. 28 at 15; ECF No. 25-2. Reidy further argues that Dr. Brown’s
report violates ERISA because “[a]n administrator is bound by its initial decision and cannot
later assert a new rationale.” ECF No. 38 at 37–38.
Even if Reidy were correct, Dr. Brown’s report proffered no new reasons for denying
Reidy’s claim. Rather Dr. Brown merely responded to the evidence that Reidy submitted on
appeal. UA-CL-LTD-006836–46; UA-CL-LWOP-000414–422. Even more fundamental,
Reidy’s argument rests on a flawed understanding of ERISA. While ERISA does not allow an
employer from adding a new reason for claim denial in its final administrative review, see Saffon
v. Wells Fargo & Co. Long Term Disability Plan, 522 F.3d 863, 871 (9th Cir. 2008), ERISA also
does not provide the claimant endless opportunities to rebut medical opinions generated during
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the process. See Midgett v. Washington Group Int'l Long Term Disability Plan, 561 F.3d 887,
895 (8th Cir. 2009); see also Giles v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, 925
F.Supp.2d 700, 717-18 (D. Md. 2002) (noting that courts of appeal uniformly determined that
ERISA does not require an insurer to provide a claimant with medical opinion reports prior to
issuance of a final decision). Therefore, the Court finds that Unum’s process for reviewing
Reidy’s claim was reasonable and does not support reversal of Unum’s benefits denial.
d.
Consideration of the Evidence
Reidy also contends that Defendant’s reviewing physicians “failed to address nearly the
entirety of Ms. Reidy’s extensive medical history” and that their reports consistently minimize
her depression. See generally ECF No. 38. The record belies Reidy’s contention. Defendants’
reviewing physicians acknowledge that Reidy struggles with a “chronic and complex psychiatric
condition” that was exacerbated by her termination in May 2014. See UA-CL-LTD-006820.
Defendants also found that with treatment, Reidy’s symptoms improved to a “baseline” point so
that as of January 29, 2015, she no longer qualified as disabled.
Defendants’ determinations were ultimately rendered after fair consideration of
competing evidence and opinions. Simply because the Plan Administrator’s reviewing physician
reaches a conclusion different than the claimant’s personal doctors does not render the decision
per se unreasonable. Vetter v. American Airlines, Inc. Pilot Long-Term Disability Plan, 299 F.
Supp. 3d 714, 726 (D. Md. 2018) (noting that “when there are conflicting medical opinions” the
administrator “has the discretion to deny benefits based on one set of opinions) (citing Booth v.
Wal-Mart Stores, Inc. Assocs. Health & Welfare Plan, 201 F. 3d 335, 342-43 (4th Cir. 2000)).
Where the administrator considers and explains any differences between its decision and that
recommended by the individual’s physicians, and the decision is supported by “substantial
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evidence,” it will be upheld. See Vetter, 299 F. Supp. 3d at 729; see also Soloman v. Bert
Bell/Pete Rozelle NFL Player Retirement Plan, 860 F.3d 259 (4th Cir. 2017). “Substantial
evidence,” is “ ‘more than a scintilla but less than a preponderance,’ ” such that a “ ‘reasoning
mind would accept [the evidence] as sufficient to support a particular conclusion.’ ” Donnell v.
Metro. Life. Ins. Co., 165 F. App’x 288, 295 (4th Cir. 2006) (quoting LeFebre v. Westinghouse
Elec. Cop., 747 F.2d 197, 208 (4th Cir. 1984)); see also Everette v. Liberty Life Assurance Co. of
Boston, No. TDC-16-1248, 2017 WL 2829673, at *7 (D. Md. June 29, 2017).
The record evidence demonstrates that Unum’s review was a fair and searching process.
Contrary to Reidy’s allegations, the record demonstrates a comprehensive review history, which
documents facts that both support and undermine a finding of disability. See UA-CL-LTD000244–48; UA-CL-LTD-000408–11; UA-CL-LWOP-000291–94; UA-CL-LTD-000507–10;
UA-CL-LTD-000678; UA-CL-LTD-006816–20. Defendants also, and in good-faith, augmented
the review process with additional records from Reidy’s treating physicians. See, e.g. UA-CLLTD-006823; UA-CL-LTD-006874.
Notably, all physicians agreed that Reidy suffered an intense and likely disabling period
of depression through much of 2014. However, Drs. Kletti, Shipko, and Brown noted that
beginning in September 2014, and much more consistently from January through March 2015,
Reidy’s treating physicians documented improvements in her depressive symptoms and
medication side effects. See, e.g. UA-Cl-LTD-000409; UA-CL-LTD-000507–09; UA-CL-LTD00542–45; UA-CL-LTD-000651–52. These findings are corroborated in interviews of Reidy
and Dr. Silver which reflect a markedly brighter affect and mood, and renewed efforts on her
part to explore career opportunities and participate in other activities, such as becoming a dog
trainer and volunteering at a horse farm. See UA-CL-LTD-000411; UA-CL-LTD-000675; UA-
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CL-LTD-006820. Although Dr. Silver still opined Reidy to be disabled in March 2015, UA-CLLTD-000652, Defendants did not reject his opinion out of hand. Rather, Defendants determined
that Dr. Silver’s opinion was of limited weight because it was unsupported by data or specific
diagnostic impressions regarding Reidy’s cognitive limitations. Dr. Silver also emphasized that
Reidy was a “woman with very longstanding depression who has managed to work over many
years, but not easily at times and not always consistently, and when pressed for more detail, Dr.
Silver did not focus on Reidy’s current symptoms to support his determination, but instead
focused on the months immediately following her termination. UA-CL-LTD-006802–3; UACL-LTD-006819.
Based on this record evidence, Defendant’s conclusion that insufficient evidence existed
“to support continuous psychiatric impairment from last day worked March 26, 2014 through
March 26, 2015” is reasonable. In making this determination, Defendant found noteworthy that
contemporaneous medical records lacked detail regarding the nature and severity of Reidy’s
symptoms; that Reidy’s treating physicians gave conflicting diagnostic impressions, and that
neither Dr. Jajodia or Mr. Corrado would provide a recommendation for Reidy’s disability claim.
See, e.g. UA-CL-LTD-000546; UA-CL-LTD-006802–11. Defendant also gave Reidy
opportunities to supplement the record with her treating physicians’ notes and Dr. Parente’s raw
test data, further reflecting that the process was reasoned and principled.
In the end, Defendant’s determination was one that a “reasoning mind would accept [the
evidence] as sufficient” to deny long-term disability benefits. See Everette, 2017 WL 2829673,
at *7; see also Price, 2018 WL 1752965, at *12–13; Graham, 2014 WL 4716473, at *7–8; cf.
Harrison v. Wells Fargo Bank, N.A., 773 F.3d 15, 20–21 (4th Cir. 2014) (finding that the
administrator did not meet its obligations when it failed to contact the claimant’s doctors for
15
records and “chose to remain willfully blind to readily available information that may well have
confirmed [the claimant’s] theory of disability.”).
e. Conflict of Interest or Bias
Reidy attempts to make much of Unum’s “sordid history” as a biased claims reviewer in
urging the Court to import the same bias here. See ECF Nos. 26-1 7–9 & 39 at 39 (arguing that
all of the employees “have long histories of unfair claims review and have been clearly
influenced by Unum’s financial incentive plan”). It is undisputed that fourteen years ago, Unum
was penalized for bad claims practices. See UA-CL-LTD-000835–61; see also ECF Nos. 26 at
1–11 & 38 at 39. Reidy further argues that the 2008 financial crisis renders Unum ever more
motivated to deny otherwise valid disability claims to enhance its financial bottom line. ECF
No. 38 at 39.
The relevance of such bias evidence is heavily fact specific and turns on whether the
claimant can show such bias affected in some way the administrator’s decision. Glenn, 553 U.S.
at 108; Durakovic v. Building Serv. 32 BJ Pension Fund, 609 F.3d 133, 138 (2d Cir. 2010); see
also Griffin v. Hartford Life & Accident Ins. Co., No. 17-1251, 2018 WL 3624872, at *9 (4th
Cir. July 31, 2018); DuPerry, 623 F.3d at 869–74; Elliott, 190 F.3d at 605. No such connection
can be made here. Sweeping statements about Unum’s motives, absent evidence of actual bias
as to this claim, does not command reversal. See ECF No. 32 at 4–6; see also Price, 2018 WL
1352965, at *16; see also Kamerer v. Unum Life Insurance Company of America, 251 F. Supp.
349, 352 (D. Mass 2017). If the law were otherwise, Unum could never escape its past
misdeeds, no matter how isolated or remote in time. Reidy’s accusations do not render
Defendant’s decision an abuse of discretion.
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IV.
CONCLUSION
For the foregoing reasons, Defendants’ motion for summary judgment, ECF No. 35, is
GRANTED, and Reidy’s cross-motion for summary judgment, ECF No. 38, is DENIED. A
separate Order follows.
8/7/2018
Date
/s/
Paula Xinis
United States District Judge
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