“Cleveland V. Liberty Life Assurance Company Of Boston”
2009 WL 649893 (E. D. Mich., March 10, 2009)
Mr. Cleveland was employed for 13 years by Compuware as a computer programmer/analyst. He became disabled from chronic severe heart conditions including congestive heart failure, cardiomyopathy, atrial fibrillation, ventricular tachycardia, other related conditions, and consequential pain and fatigue. He applied for and received short-term disability benefits and nine months of long-term disability benefits from Liberty. He also applied for and received Social Security Disability benefits. After paying LTD benefits for nine months Liberty terminated Mr. Cleveland’s benefits; Mr. Cleveland appealed; the appeal was denied, and Mr. Cleveland then hired us to file suit on his behalf.
The district court held that Liberty’s decision terminating Mr. Cleveland’s LTD benefits was arbitrary and capricious. The district court reasoned:
1. Liberty relied upon biased paper review doctors.
2. Liberty failed to conduct an in-person examination of Mr. Cleveland.
3. Liberty’s paper review doctors selectively relied on and analyzed the evidence and ignored overwhelming evidence of disability.
4. Liberty and its review doctors did not explain how someone in Mr. Cleveland’s condition could be expected to function on a daily basis in a working environment.
5. Liberty’s reviewing doctors did not explain why they disagreed with Mr. Cleveland’s doctor’s conclusions.
6. Liberty failed to offer any reasons for rejecting Mr. Cleveland’s doctors’ conclusions that Mr. Cleveland could not work.
7. Liberty and its reviewing doctors disregarded the medications Mr. Cleveland was taking.
8. Liberty did not ask Mr. Cleveland to participate in an IME or functional capacity evaluation.
9. Liberty failed to address the Social Security Administration’s decision awarding Mr. Cleveland SSDI benefits.
10. Liberty and its reviewing doctors disregarded Mr. Cleveland’s complaints of fatigue and pain.
11. Liberty and its reviewing doctors failed to consider how the stress of returning to work could adversely affect Mr. Cleveland given his cardiac condition.
12. Liberty asked its reviewing doctors to evaluate if Mr. Cleveland could perform sedentary work, not his own occupation, and thus asked the wrong question and did not connect the medical data to the issue presented: whether Mr. Cleveland could work at his own occupation.
The Court ordered Liberty to retroactively reinstate Mr. Cleveland’s benefits. We asked the Court to also award attorney’s fees; Liberty appealed the judgment. The parties then agreed on a settlement.