SIXTH CIRCUIT REVERSES LOWER COURT AND DETERMINES THAT LIBERTY LIFE WAS ARBITRARY AND CAPRICIOUS
Tuesday, April 12th, 2016
A three judge panel in the Sixth Circuit has reversed a decision from the District Court of Kentucky, and has found Liberty Life to have improperly terminated a claim for a woman suffering from Pudendal neuralgia and pelvic floor muscle dysfunction. Liberty Life terminated the claim after having initially accepted liability for the long term disability insurance claim, and after determining that the claimant could function at a “light” physical demand level. The claimant was disabled on the basis that she could not tolerate sitting for any duration, but Liberty Life refused to provide any consideration to this functional restriction, despite strong support from her medical provider.
The Court found it problematic that Liberty Life rested its termination of the long term disability insurance claim on a review from a doctor who never examined the claimant, but simply reached a physical demand level of functioning and refused to credit the limitations provided by the claimant and her medical provider. The Court noted that the pain complained of was described well and articulated from the anatomic explanation offered by the claimant’s treating provider. Her doctor indicated that pain with sitting made it impossible to perform her job duties, which were performed from a seated position. Yet, Liberty Life failed to afford such complaints any consideration.
The Court was also troubled by Liberty Life’s refusal to consider on appeal the additional information offered by the claimant’s treating provider, determining that such conduct rendered the final decision to be arbitrary and capricious.
The Court, however, determined that a remand to Liberty Life for further claim consideration was the appropriate remedy.
Cannon v. Liberty Life