The Honor able J. Ronni e Gr eer , United States Dist ri ct J udg e for the Easter

n District of * Tenne ssee, sitting by

desig nation. NO T R EC OM M EN DE D F OR F UL L- TEX T P UB LIC AT ION F ile Nam e: 10a0577n.06 No. 08-2216 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT KELLYWI LLIA M S, )

P laintif f-App ellant, ) ) v. ) ON AP P EA L F RO M THE ) UN ITED STA TES D ISTRIC T ) COURT F OR THE E ASTERN RELIANCE ST ANDAR D LIF E INSURANCE ) DISTRICT OF MICHIG AN COMP ANY, )

De fend ant -A ppe lle e . ) OP IN ION Before: BATCHELDER, Chief Judge; WHITE , Circuit Judge; and GREER, Distric t Judge. * GREER, District Judge . Kelly Wil liams ( “Willi ams”) appea ls the district c ourt’s g rant of summary judgme nt to Reliance Standar d L i fe I nsuranc e Company (“Relianc e”) . Wil liams sued under the Employ

ment Retirement I

ncome Sec urity

Act (“ERI SA”) for disability benef its under a g ro up l o n g t e r

m d i s a b i l i t y i n s u r an c e p l an( t h e “ P l an ” ) i s s u e d b y R e l i an c e an d

o f f e r e d a s a b e n e fi t to e mpl oy e e s b y Qu ic ke n L oa ns , Williams’ s emp loy e r. F or the re a so ns wh ic h f

oll ow , w e AF F I RM. I. Bac kgr ound Wil liams was employ ed by Quicken L oans from November 14, 2005, until Marc h 11, 2006. Whil e employ ed at Quicken L oans, Wil liams w as cover ed by a long term disability

policy offe red to Quicken L oan employ ees a s a par t of an e mploy ee we lfare benef it plan. Wi lliams filed an2

a p p li c a ti o n f

o r d is a b il it y b e n e f it s u n d e r th e Pl an o n M ar c h 9 , 2 0 0 6

. Re li an c e is th e in s u r e r of the Plan as well as the de leg ated de cision maker. The Plan includes a

pre- exis ting c ondition li mitation which applies to a clai m an t s u ch as Wil liams who has not been insured under the P lan for twelve consec utive months. Bene fits will not be paid f or a total disability

“ca used by ; contributed to by ; or resulting from; a Pre -existi ng condition.” A “Pre -existi ng condition” is defined by the Plan as “a

ny Sickness or Injury

for whic h the I ns ur e d r e c e ive d me dic a l tr e a tme nt, c onsu ltatio n, c are or se rv ic e s, inc lud ingdia g no sti c proce dures, or took presc ribed drugs or medicine, dur ing the three months im mediately prior to the I nsured’ s eff

ective da te of insura

nce.” Wil liams became insured unde r the Plan on De cembe r 1, 2005. Willi ams ’s app li c a tio n f or lon g te rm

dis a bil ity be ne fi ts a lle g e d in a

bil ity to w or k d ue to “Panic Attac ks, Depre ssion.” Wil liams disclosed on her a pplication t h at s h e wa s first treated for these sy mptoms in Marc h, 1999, and that the sy mptoms had been rec urring “for sev er al y ea rs.” Re lyingon

Willi a ms’ s me dic a l r e c or ds and an in de pe nd e nt r e vie w o f h e r c la im f ile by Kev in P

. Hay es, M.D., a board certified psy chiatrist and neurolog ist, Reliance conclude d that Wil liams had been tr eate d for these conditions dur ing the three months immediately prior to the ef fec tive date of her in s u r an c e an d d e n ie d h e r c la im u n d e r th e Pl an o n N o v e mb e r 1 7 , 2 0 0 6

. Wi ll ia ms th e n f iled a complaint in the Circuit Court for the County of W ay ne, S tate of Michig an, and he r complaint wa s subsequently

remove d to the district court. Afte r the filing of motion s fo r sum mary judgme nt by both Wi lliams and Reliance, the district court g rante d Reliance ’s motion for summary judgme nt and enter ed judg ment in favor of Reliance . This appea l followed.The c on fl ic t of in te re st th at e xi st s w he n th e in sure r bo thd ec id es w he th er th e em pl oy ee is e li g ib le 1 for be nefits an d p ay s tho se b enefits is a fac tor for the co urt to consid er w hen decidin g w hether the d ecision to de ny ben efits w as arb itrary

and cap ricious. Evan s v. U

num Prov ident Cor

p . , 43 4 F

. 3d

8 66 , 8 76 ( 6th C ir

. 2006 ). I n co nsideringthis factor, the co urt co nsiders whe ther th ere is ev idence that the con flict influen ced the p lan ad

m inistrator’s decision

. Id. A lt ho ug h Wil li am s m ad e an a rg um en t i n th e di st ri ct

c ourt t hat D r. H ay es ’s o pi ni on

w as “ m anuf

ac tu re d to g iv e co lo r to an un de rl y in g ‘ ru bb er s ta m pi ng ’ of th e in it ia l d en ia l” of b en ef it s, th e ar g um en t w as n ot f urth er de v el op ed

. The di st ri ct c ourtd id n ot a dd re ss th e ar g um en t i n it s order, William s ha s no t raised the issu e in this co urt, and there is no ev idence in the reco rd to sug g est tha t the co nflict influ enced

the benefit denial decision

. Und er these circum stances, we will not address the issue fu rt he r. 3 II. Stand ard of Review “W e re view de novo the district court’s disposition of an ERI SA action base d upon the administrative re cord, a

nd apply the same le g al standar d as the district cour t.” Kovach v . Zurich Am. Ins. Co. , 5 8 7 F. 3 d

3 2 3 , 3 2 8 (6 t h C i r. 2 0 1 0 ) ( ci t i n g W ilkins v. Bapti st Healthcare Sys., Inc ., 150 F.3d 609, 613 (6th Cir. 1998)). B eca use the Plan g rante d discretionar y authority to Reliance as the Plan administrator t o interpre t the P lan’s terms and to deter mine its benef

its, we apply the arbitrary and capr icious standard. See F irestone Tire and Rubber Co. v. Bruch , 489 U.S. 101, 111-15 (1989). 1 Th e arbit ra

ry and c a pr ic iou s st and ard

is a de fe re nti a l st and ard

wh ic h r e qu ir e s th e Court to u ph old the administrator’s de cision if the administrato r’s discussion is “rational in light of the plan’ s p ro v isions.” Univ. Hosp. of Cleve land v. Eme rson Elec. Co. , 2 0 2 F

. 3 d 8 3 9 , 8 4 6 ( 6 th

Ci r . 2 0 0 0) (q u o t i n g Y

eager v . Reliance Standard Li fe Ins. Co. , 88 F.3d 376, 381 ( 6th Cir. 1996)). III. Discussion and A nal ys is The district c ourt held that Reliance had a r easone d explanation for the denia l of Wil liams’s

c la im a nd wa s n ot a rb itr ary and c a pr ic iou s in

its de nia l of lon g te rm dis a bil ity be ne fi ts t o Wil liams. Wil liams arg ued in the district cour t, and ar g ues her e, tha t h er disability is the result of “bipolar disorder,” which is “medica lly rec og nized as a sepa rate and distinct condition from depre ssion,” for4

whic h s h e w a s tr e a te d d

u r in g th e thr e e mo n th s im me d iate ly p r e c e d in g th e e f f e c ti v e d a te of her insurance . The re cord in the c ase e stablishes otherwise. As no te d a

bo ve , Wil liams p ro vid e d Re lia nc e wi th h e r s ta te me nt i n s up po rt of he r d isa bil ity

c la im. Un de r t

he se c tio n r e qu e sti nginf

or ma tio n a bo ut t he c on dit i o n

c a u s i ngthe dis a

bil ity , Wil liams indicated that he r first sy

mptoms wer e “Panic Attacks, Depression,” and t hat her sy mptoms had been “re -ac urring[si c] for sev er al y ear s.” She indicate d on the statement that she w as unable to work be c a us e of “ c ry ingsp e lls , c an’ t c on c e ntr a te and pa nic a tta c ks ,” and

that sh e wa s f

ir st tre a te d f

or the se sy mpt oms on

Marc h 10 , 19 99 . D ur ingthe thr e e month p e ri od pr ior to D e c e mbe r 1 , 2 00 5, Willi a ms

w a s s e e nb y D r . P h i l l i p F i s h e r o nS e p t e mb e r

1 9 , 2 0 0 5 , w i t h c o mp l a i n t s o f d e p r e s s i o nan d

an x i e t y. Dr. F isher pre scribed Z oloft and Will iams filled that presc ription on November 5, 2005. After Wil liams last worked, she w as trea ted primarily by Drs. L azar a nd Fa rooq. On May 19, 2006, Dr. L azar c ompleted a claim form in w hich he identified Wil liams’s primary diag nosis as

“ ma jor de pr e s s i o n - r e c u

r r e nt
. ” D r. F aro oq

ide nti fi e d Wil liams’ s sy

mpt oms a s d e pr e ssi on

and anxie ty and listed a diag nosis of bipolar disorder . Wil liams also rec eived tre atment on seve ral oc casions at St. Mary Mer cy Hos pita l w he re sh e wa s h os pit a lize d b e tw e e n M ay 17 and May 19 , 2 00 6, du e to complaints of depr ession and anxiety

. Wil liams r eturne d to St. M ary Merc y Hospital on Aug ust 18, 2006, with a chief

complaint of “de pression, suicidal thoug hts.” Dr . H ay e s ide nti fi e d Wil liams’ s ma in s y mpt oms a s a

nxie ty and de pr e ssi on . B a se d u

po n h is

re vie w o f t

he me dic a l r e c or ds , D r. Ha y e s c on c lud e d: The c laimant has bee n g iving conflicting repor ts a bout her sy

mptomatology , but the core sy mptoms appear to be anxiety an d d ep re s sion. Anx iety and depr ession are common sy

mptoms of either Unipolar or Bipolar Depr es s i o n . The tre atment providers w ho have e x amined the c laimant prior to the date of loss appea r to have5

utiliz ed a dia g nos i s o f Un i p o lar De pression as he r condition and this resulted in a diag nosis of Major De pressive D isorder. Dr. Ha y es opined that Willi ams rec eived tre atment for he r psy chiatric condition during the per iod September 1, 2005, throug h November 30, 2005, and that, reg ardle ss of whethe r she wa s diag nosed wi t h depre ssion or bipolar disorder , “it rea lly did not alter her

treatment significa

ntly beca use the

c or e tr e a tme nt r e ma ins anti de pr e ssa nt m e dic a tio n. ” As a

re su lt, Re lia

nc e c on c lud e d th a t Will iams suffe red from a disability “ca used by , contributed to by , or re sulting fr om” a pr eexisti ng condition and denie d her longterm disability claim. We a g re e wi th the dis tr ic t court that Reli anc e ’s de c isi on wa s not ar bit ra ry and c a pr ic iou s in t h i s c a s e . T h e e v i d e n c e i nt h e r e c o r d i s s u b s t an t i a l t h a tW i l l i a m s ’ s d i s a b i l i t y w a s “ c a

u s e d b y, contribut ed t o by , or re sult[ ed] from” a pree x isting condition, reg ardle ss of whethe r it is called depre ssion or bipolar disorder . She was se en by her doc tor for de pression and a nx iety , was pr e sc ri be d a

nti de press ant me dic a tio n a nd sh e he rs e lf

de sc ri be d h e r i na

bil ity to w or k a s “ du e to depre ssion.” As set forth a

bove, the p re- exis ting c ondition li mitation in W illiams’s poli cy is trigg ere d when the insure d person r ece ived “medic al treatment, consultation, care or ser vices, including diag nostic proce dures, or took prescr ibed drug s or medicine” as a re s ult of any “[s] ickness or [i ]nj ury ” during the three months prior to the eff ective date of the insura

nce. Williams admits s he was tre ated for depre ssion, and rec eived pr escr iption drugs f or the c ondition, withi n three months of De c e mbe r 1 , 2 00 5, the e ff e c tiv e date of

the ins ur anc e . Sh e c la ims , how e ve r, that he r d ia g no sis was subseque ntly

chang ed to bipolar di sorder , a condition “medically rec og nized as a sepa

rate and distinct condition from depression and the treatment she rec eived “ was not re lated to h er actualWil li am s pr es en te d to th e di st ri ct c ourtan arti cl e by

Joh n M. G ro ho l, P sy . D

. , e nt it le d “W ha t’ s 2 the D ifference Betw een Bipo lar D isorder and Dep ression, ” and a J une 3, 2008 “To Who m I t May C oncern ” letter from

D r. F arooq

statingthat “ [ u]pon furthe r exa m ination her d iag nosis was chang ed to B ipolar Diso rder.” The district court declined to consid er eithe r the article or the letter, and w e lik e wise do not consid er them

. Our “rev iew is lim ited to t he adm inistrativ e record of the benefit d eterm ination. ” Evan s , 4 34 F.3 d at 876 (6th C ir. 2 006). 6 condition.” Wil liams’s position, howeve r, “ig nores the f act that de pression is part a nd parc el of a 2 diag nosis of bipolar disorde r, ” as t he district cour t observed. B oth Dr. F arooq a nd Dr. Ha

y es

co n firm that anxiety

and depr ession are the basic sy mptoms of W illiams’s condition, no m atter whether it is called “major de pression” or “B ipolar Disorde r.” F urthermor e, the e v i d en ce in the

a dmi nis tr a tiv e re c or d e sta bli sh e s th a t the me dic a tio n p re sc ri be d d ur ingthe lim itatio n p e ri od wo uld not have c hang ed re g ardle ss of the for mer diag nosis of plaintiff’s condition. IV. Conclusion For the re asons set for

th above, the de cision of the district cour t is AFF I RMED.