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Reidy v. The Unum Life Insurance Company of America

United States District Court, D. Maryland

August 7, 2018

KARIN REIDY, Plaintiff,
v.
THE UNUM LIFE INSURANCE COMPANY OF AMERICA, et al . Defendants.

          MEMORANDUM OPINION

          PAULA XINIS UNITED STATES DISTRICT JUDGE.

         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 back-benefits 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. 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 treatment providers as two psychiatrists, Dr. Silver and Dr. Kamal Jojodia (“Dr. Jojodia”). UA-CL-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-LWOP-000323-26. 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-LTD-000538-546, UA-CL-LTD-000647-52; UA-CL-LTD-000656-57, UA-CL-LTD-000675; UA-CL-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-CL-LTD-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. UA-CL-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- 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. UA-CL-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 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-LTD-006807-08. 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.

         II. STANDARD OF REVIEW

         a. ...


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