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Bowman v. Reliance Standard Life Insurance Co.

United States District Court, M.D. Alabama, Northern Division

July 12, 2019

ANTHONY BOWMAN, Plaintiff,
v.
RELIANCE STANDARD LIFE INSURANCE CO., Defendant.

          MEMORANDUM OPINION

          ANDREW L. BRASHER UNITED STATES DISTRICT JUDGE.

         This matter comes before the court on Plaintiff Anthony Bowman's Initial Submission in Support of Judgment. (Doc. 13). Upon consideration, the court holds that Defendant Reliance Standard Life Insurance Company (“Reliance”) is entitled to judgment in its favor and against Bowman.

         BACKGROUND

         Plaintiff Anthony Bowman has worked hard all his life, and he has the scars to prove it. Injuries have required Bowman to undergo multiple surgeries and endure chronic back and neck pain resulting in some level of disability. Bowman also complains that between his sleep disorder and pain medication, he lacks the ability to concentrate and perform even sedentary tasks requiring concentration.

         Because of his injuries, Bowman sought disability benefits from Defendant Reliance Standard Life Insurance Company. Reliance initially granted Bowman's disability application because he was unable to do his previous job as a Maintenance Mechanic, which required heavy exertion such as lifting 50-60 pounds. (Doc. 12-3 at 23; Doc. 12-5 at 100). Shortly after Reliance granted Bowman's claim, the Social Security Administration approved Bowman's claim for disability. (Doc. 12-4 at 42). As required by the policy, Reliance checked back in after two years to decide if long-term disability was warranted. (Id. at 90-91). Total disability after the initial two years requires that the claimant be unable to do any job, not just his previous one. (Doc. 12-1 at 11).

         Reliance sent Bowman a questionnaire, which he completed and returned. (Doc. 12-4 at 389-92). Reliance then contacted his three doctors: Dr. Cordover, Dr. Connolly, and Dr. DeBerry. In answer to a questionnaire, Dr. Cordover, a back specialist, noted he had examined Bowman and determined that he could “perform[] full time work” with some limitations. (Doc. 12-5 at 66). Specifically, Dr. Cordover was worried about “repetitive bending, squatting, stooping, etc., ” so he restricted Bowman to light lifting for six months, followed by medium lifting. (Id. at 66, 69). The questionnaire also asked the doctor to describe the effect of Bowman's medications as causing one of the following: (1) no significant effect, (2) some limitations, (3) severe and limiting side effects, or (4) total restriction and inability to function productively. (Doc. 12-4 at 35). Dr. Cordover chose the third option, severe and limiting side effects. (Id.)

         When Reliance contacted Bowman's primary care physician, Dr. DeBerry, the doctor passively noted that “[i]t has been determined that [Bowman] is disabled … and in my opinion has not improved over the past 2-3 years.” (Id. at 27). However, Dr. DeBerry explicitly “defer[red] all functional capacity evaluations and further prognosis to [Bowman's] back specialist Dr. Cordover.” (Id.)

         Finally, Reliance contacted Dr. Connolly, who had treated Bowman for idiopathic hypersomnia and obstructive sleep apnea. (Id. at 38). Dr. Connolly, however, did not remark on Bowman's level of disability. (Id.)

         Although Reliance agreed that Bowman suffered injuries resulting in disability, it disagreed that Bowman could no longer work in any capacity. Thus, Reliance denied Bowman's claim for total disability and Bowman appealed. During the appeal, Reliance received a note from Dr. Cordover that, although Bowman's neck symptoms were “progressing, ” there was “no change in [Bowman's] restrictions or forms that [Dr. Cordover] ha[d] filled out previously.” (Id. at 31). Dr. Cordover noted that a functional capacity evaluation could “further define” Bowman's capabilities, although no such evaluation ever occurred. (Id.)

         At this point, Reliance obtained advice from two independent medical examiners: Dr. Denver and Dr. Goldstein.

         Dr. Denver reviewed Bowman's medical history for an hour before conducting a one-hour physical examination. (Doc. 12-3 at 41). At the conclusion of the examination, Dr. Denver had concluded that Bowman could work full-time with accommodations at light physical demand duty, as long as he was allowed to change positions every forty minutes. (Id. at 56). Dr. Denver noted that Bowman's “current medications … do not contribute to any significant limiting physical or cognitive deficits.” (Id.) Dr. Denver also noted that Bowman “reports hydrocodone worsens insomnia and dulls his senses[, ] but the documentation fails to substantiate significant impairment in cognition or physical function resulting from hydrocodone use.” (Id.)

         For his part, Dr. Goldstein performed a pulmonary evaluation. He concluded that Bowman could work if his only problems were sleep apnea, narcolepsy, and hypersomnia. (Id. at 26). Dr. Goldstein noted that Bowman required treatment for chronic pain and would not be able “to return to his work as [Bowman] described” i.e. his original heavy-lifting job. (Id.)

         After reviewing all of the evidence, including Dr. Denver's and Dr. Goldstein's reports, Reliance denied Bowman's appeal. Bowman filed this action under 29 U.S. §1001 et seq. Then by agreement of Bowman and Reliance, the dispute over whether Reliance's decision was arbitrary and capricious was submitted to the ...


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