Liberty Life’s Wrongful Denial Of Disability Benefits For Bipolar Disorder And Carpal Tunnel SyndromeOn Behalf of Disability Insurance Law Group | | Insurance Company Tactics
In the case, Suson v. The PNC Financial Services Group, INC., No. 15-CV-10817, 2017 WL 3234809, at *1 (N.D. Ill. July 31, 2017), Liberty Life Assurance Company of Boston, acting as the Plan administrator for PNC’s ERISA disability plan, denied long term disability benefits to Ms. Suson who was diagnosed with bipolar disorder in 1996 and had received regular psychiatric treatment since 1990. She had also been treated for bipolar disorder and diagnosed with fibromyalgia and several other degenerative joint diseases for which she received regular treatment. Ms. Suson filed her claim for long term disability benefits on July 24, 2014. She initially based her claim for benefits on bipolar disorder but on September 3, 204 advised Liberty Life that she was also disabled due to fibromyalgia and physical limitations. Liberty denied Suson’s claim for LTD benefits on October 8, 2014 stating that the records did not “reasonably support” that she had any “impairments attributable to the presence of mental illness that would preclude” her from working. Ms. Suson appealed the adverse determination and Liberty upheld its denial.
After Liberty Life issued its final denial, Ms. Suson sued to obtain the benefits to which she felt she was entitled under the terms of the PNC Long Term Disability Plan. She filed a Motion for Summary Judgment asserting that Liberty Life’s denial was arbitrary and capricious as it did not properly consider the medical evidence she provided. The Court found that Liberty acted arbitrarily because it “moved the target” by rejecting evidence on appeal that it stated was required to grant LTD benefits. Specifically, Liberty Life acted arbitrary and capriciously when it used an occupational analysis to deny Ms. Suson’s appeal without providing her any opportunity for a response and by failing to consider the effects of Ms. Suson’s carpel tunnel syndrome on her capacity to perform the material and essential duties of her occupation. Liberty Life’s occupational analysis listed one of Ms. Suson’s positional requirements as “frequent handling and fingering.” However, the Court found that Liberty did not act arbitrarily or capriciously in accepting the reviewing physicians’ opinions over those of her treating physicians as plan administrator’s are not required to accord special deference to the opinions of treating physicians. The Court held that that Liberty Life must reevaluate Ms. Suson’s claim, provide Ms. Suson with the opportunity to respond to Liberty’s occupational analysis, and address the effect of carpal tunnel syndrome on computer use as a relevant factor for her ability to perform the material or essential duties of her occupation.