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Nature of Suit Code: 890
Nature of Suit: Other Statutory Actions
Cause of Action: 

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United States Court of Appeals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued February 26, 2008 Decided March 28, 2008

No. 07-7097

JANE FITTS,

APPELLEE

v.

UNUM LIFE INSURANCE COMPANY OF AMERICA,

APPELLANT

Appeal from the United States District Court

for the District of Columbia

(No. 98cv00617)

Frank C. Morris, Jr. argued the cause for appellant. With

him on the briefs were Brian W. Steinbach and Ann M. Courtney.

John J. Witmeyer, III argued the cause and filed the brief for

appellee.

Before: RANDOLPH and GARLAND, Circuit Judges, and

EDWARDS, Senior Circuit Judge.

Opinion for the Court filed by Circuit Judge RANDOLPH.

Concurring opinion filed by Senior Circuit Judge Edwards.

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Fitts’s doctors diagnosed her as having Bipolar I Disorder and

Bipolar II Disorder. Bipolar I Disorder “is characterized by the

occurrence of one or more Manic Episodes.” AM. PSYCHIATRIC

ASS’N,DIAGNOSTIC &STATISTICAL MANUAL OF MENTAL DISORDERS

382 (4th ed. text rev. 2000). “A Manic Episode is defined by a

distinct period during which there is an abnormally and persistently

elevated, expansive, or irritable mood.” Id. at 357. Bipolar II

Disorder “is characterized by the occurrence of one or more Major

Depressive Episodes . . . accompanied by at least one Hypomanic

Episode.” Id. at 392. “The essential feature of a Major Depressive

Episode is a period of at least 2 weeks during which there is either

depressed mood or the loss of interest or pleasure in nearly all

activities.” Id. at 349. A Hypomanic Episode is “a distinct period

during which there is an abnormally and persistently elevated,

expansive, or irritable mood that lasts at least 4 days.” Id. at 365.

RANDOLPH, Circuit Judge: Jane G. Fitts was an attorney at

the Federal National Mortgage Association (“Fannie Mae”) until

1995, when bipolar disorder prevented her from working.1

 Fitts

applied for disability benefits under Fannie Mae’s long-term

disability insurance plan. Unum Life Insurance Company of

America administered the plan. Unum paid Fitts but informed

her that her benefits would end after two years pursuant to a

clause in the plan limiting benefits “for disability due to mental

illness.”

The plan defines “mental illness” as “mental, nervous or

emotional diseases or disorders of any type.” Fitts complained

that bipolar disorder is a physical illness, not a mental illness.

Unum disagreed. Fitts then sued Unum under the Employee

Retirement Income Security Act of 1974 (“ERISA”) for

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Fitts also invoked the Americans with Disabilities Act, the

District of Columbia Human Rights Act, and District common law.

The district court dismissed these claims. Fitts v. Fed. Nat’l Mortgage

Ass’n, 44 F. Supp. 2d 317, 331 (D.D.C. 1999). Fitts appealed the

dismissal of her claim under the Americans with Disabilities Act, and

we affirmed. Fitts v. Fed. Nat’l Mortgage Ass’n, 236 F.3d 1 (D.C.

Cir. 2001). Fitts later stipulated to dismiss all claims against Fannie

Mae, which she had also named as a defendant.

“benefits due . . . under the terms of [the] plan.”2 29 U.S.C. § 1132.

The district court reviewed Unum’s decision for abuse of

discretion and granted summary judgment to Unum. Fitts v.

Fed. Nat’l Mortgage Ass’n, 77 F. Supp. 2d 9, 25 (D.D.C. 1999).

We reversed and remanded, holding that the court should have

reviewed de novo Unum’s classification of Fitts’s illness as

mental. Fitts v. Fed. Nat’l Mortgage Ass’n, 236 F.3d 1, 4-6

(D.C. Cir. 2001). After the parties engaged in discovery, the

district court granted partial summary judgment to Fitts on the

ground that bipolar disorder is not a mental illness. Fitts v.

Unum Life Ins. Co. of Am., 2006 WL 449299 (D.D.C. Feb. 23,

2006). In a later decision, the court found that Fitts has bipolar

disorder and is disabled as a result. Unum appealed both rulings

but has chosen to argue only that bipolar disorder is a mental

illness.

In the district court Fitts argued that her bipolar disorder had

a physical cause and for that reason could not be considered a

mental illness. Unum maintained that a disorder is a mental

illness if it is listed in the Diagnostic and Statistical Manual of

Mental Disorders or if “there are no physical conditions that

must be present for a person to be diagnosed with the disorder.”

Id. at *4-5. Other courts have defined “mental illness” as a

disorder whose symptoms a layperson would classify as arising

from a mental illness, a disorder with no physical cause, or a

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disorder whose treatment involves psychotherapy and

psychotropic medication. Id. at *6. The district court held that

“[t]he lack of consensus on the meaning of mental illness . . .

indicate[s] that it is ambiguous. . . . All of these approaches have

a reasonable basis, yet given the same set of facts, they could all

reach a different conclusion.” Id. at *7. The court resolved this

ambiguity in favor of Fitts.

In reaching this conclusion, the court thought there was “no

dispute over the possible causes and manifestations of bipolar

disorder. Both parties’ doctors acknowledge that bipolar

disorder is characterized by a combination of physical,

psychological, and social factors, and they generally agree as to

what those factors are.” Id. The courts of appeals disagree

whether a court may rely on a cause-based interpretation of

illness to find ambiguity in an ERISA-covered plan. The Fifth

Circuit believes that permitting a cause-based interpretation

would eliminate the distinction between mental and physical

disorders. Lynd v. Reliance Standard Life Ins. Co., 94 F.3d 979,

984 (5th Cir. 1996). The Eighth Circuit holds that it is improper

to consider the cause of a mood disorder because a layperson

classifies an illness by its symptoms, not its causes. Brewer v.

Lincoln Nat’l Life Ins. Co., 921 F.2d 150, 154 (8th Cir. 1990).

The Seventh, Ninth, and Eleventh Circuits hold that a causebased interpretation is permissible. Phillips v. Lincoln Nat’l Life

Ins. Co., 978 F.2d 302, 310-11 (7th Cir. 1992); Kunin v. Benefit

Trust Life Ins. Co., 910 F.2d 534, 541 (9th Cir. 1990); Billings v.

Unum Life Ins. Co. of Am., 459 F.3d 1088, 1090 (11th Cir.

2006).

Given the record in this case, it would be imprudent for us

to choose among the approaches just mentioned. If Fitts’s

disorder did not have a physical cause, we see no argument that

her illness was anything but mental. Yet at the summary

judgment stage, there was substantial disagreement about the

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causes of bipolar disorder in general and of Fitts’s illness in

particular. In her statement of undisputed facts, Fitts cited

testimony from two of Unum’s expert witnesses for the

proposition that “bipolar disorder is a physical disability.” One

of these witnesses agreed that “one of the causes that contributes

to bipolar disorder is a biological cause,” but Unum responded

that this testimony was taken out of context and that “the

augmented record evidence shows that bipolar disorder is not

caused by physical factors, but rather at most has physical

correlates found in some individuals with bipolar disorder that

may be the result of emotional factors or environmental stimuli.”

Unum’s other witness described a lack of consensus on the

causes of bipolar disorder: “Psychiatrists would tell you [that

there are] more biological based issues [for illnesses such as

bipolar disorder] . . .. But you have disagreements in the

psychiatric community . . ..” Unum argued that the witness “is

a psychologist and testified that he does not, as a psychologist,

relate everything back to physiology, [and] that not everyone

agrees with the psychiatrists’ bias.” In its own statement of

undisputed facts, Unum cited testimony that most scans of Fitts’s

brain have appeared normal, and that the only unusual results

returned to normal in subsequent scans. One of Unum’s

witnesses refused to identify a biological cause for Fitts’s illness,

saying only that he could not rule one out.

Summary judgment is proper only if “there is no genuine

issue of material fact and . . . the movant is entitled to judgment

as a matter of law.” FED. R. CIV. P. 56(c). In deciding a motion

for summary judgment, a court must “view the facts and draw

reasonable inferences in the light most favorable to the party

opposing the summary judgment motion.” Scott v. Harris, 127

S. Ct. 1769, 1774 (2007) (quotations, citation, and alteration

omitted). Because there was a genuine dispute about the

possible causes of bipolar disorder, and in light of Unum’s

evidence casting doubt on the cause of Fitts’s illness, the district

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court should not have granted partial summary judgment. We

therefore vacate the judgment and remand for further

proceedings consistent with this opinion.

So ordered.

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EDWARDS, Senior Circuit Judge, concurring: I join the

majority opinion and write briefly only to confirm my

understanding of our disposition. On remand, the parties should

be guided by the following principal points: 

First, the District Court erred insofar as it held that no

bipolar disorder can be a “mental illness” as defined in the

Unum policy. Even counsel for Fitts recognized that some

disorders can be accurately characterized as mental illnesses

under the policy – if not, the provision in question would be

rendered meaningless. Because the phrase “bipolar disorder”

covers a range of cases, some of which may be mental illnesses

and some which may not, whether a person’s disorder can be

characterized as “bipolar” is not, by itself, dispositive. To the

extent that the District Court held that bipolar disorder is never

a mental illness, its conclusion was wrong as a matter of law.

Second, if Fitts’ bipolar disorder did not have a physical

cause, appellees have presented no argument that it is not a

“mental illness,” and therefore it falls within Unum’s policy

limitation. The facts concerning the cause of Fitts’ disorder

were disputed, however, so summary judgment on this point was

inappropriate. The District Court never settled the question of

whether Fitts’ disorder had physical causes. Because Fitts offers

no viable argument that a non-physically caused bipolar disorder

is not a mental illness, the resolution of this factual question

may dispose of this case on remand.

Third, it is unclear whether Fitts’ bipolar disorder can be

properly characterized as a “mental illness” if it has been caused

in part by physical factors. Unum admits that some neurological

disorders with physical causes and behavioral symptoms – such

as Alzheimer’s disease or vascular dementia – are not mental

illnesses as defined by its policy. If it is determined that Fitts’

bipolar disorder does have a physical cause, then, at the very

least, the District Court must determine whether the causal

nexus between physical factors and behavior symptoms for

Fitts’ bipolar disorder are more similar to the neurological

disorders fully covered by Unum, or to traditional mental

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illnesses that are subject to the policy limitation. The evidence

on this point is disputed, so summary judgment is inappropriate.

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