United States District Court, M.D. Alabama, Northern Division
L. BRASHER UNITED STATES DISTRICT JUDGE.
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.
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
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).
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.)
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.
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.)
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
point, Reliance obtained advice from two independent medical
examiners: Dr. Denver and Dr. Goldstein.
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.)
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.)
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 ...