NOT RECOMMENDED FOR FULL-TEXT PUBLICATION

File Name: 16a0195n.06

No. 15-6010

UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT

MICHAEL A. CANNON, Executor for and on 

behalf of the Estate of Christine Cannon,

Plaintiff-Appellant,

v.

PNC FINANCIAL SERVICES GROUP AND 

AFFILIATES LONG TERM DISABILITY 

PLAN,

Defendant-Appellee.

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ON APPEAL FROM THE UNITED 

STATES DISTRICT COURT FOR 

THE WESTERN DISTRICT OF 

KENTUCKY

BEFORE: MERRITT, SUHRHEINRICH, and DONALD, Circuit Judges.

PER CURIAM. Michael A. Cannon, executor for and on behalf of the Estate of Christine 

Cannon, appeals the district court’s judgment on the administrative record in favor of The PNC 

Financial Services Group, Inc. and Affiliates Long Term Disability Plan (“Plan”) in this action to 

recover long term disability (“LTD”) benefits pursuant to the Employee Retirement Income 

Security Act of 1974 (ERISA), 29 U.S.C. § 1132(a)(1)(B). 

Christine Cannon worked for The PNC Financial Services Group as an investigations 

senior analyst, a sedentary job involving computer and telephone use. After undergoing a 

hysterectomy on October 26, 2012, Cannon returned to work on December 31, 2012, but stopped 

working a few days later due to abdominal and pelvic pain. Cannon reported that she could 

“type[] and do everything except sit.” (RE 22, Page ID # 89). Cannon subsequently made a 

claim for LTD benefits under the Plan, which was administered by Liberty Life Assurance 
No. 15-6010, Cannon v. PNC Fin. Servs. Group & Affiliates Long Term Disability Plan

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Company of Boston (“Liberty”). To be eligible for LTD benefits under the Plan, the participant 

must be disabled, which means for the first two years that “your disability makes you unable to 

perform the material or essential duties of your own occupation as it is normally performed in the 

national economy.” (RE 22-4, Page ID # 283). Liberty initially determined that Cannon was 

eligible to receive LTD benefits but advised her that “we will continue to review your claim and 

request medical documentation to support your continued disability.” (RE 22-2, Page ID # 202). 

After referring her claim for medical and vocational reviews, Liberty discontinued Cannon’s 

LTD benefits on the basis that she no longer met the Plan’s definition of disability. Cannon filed 

an appeal, which Liberty denied, maintaining that she no longer met the Plan’s definition of 

disability.

Cannon then brought this ERISA action to recover LTD benefits under the Plan. The 

district court granted judgment on the administrative record in favor of the Plan, concluding that 

Liberty’s decision to deny Cannon’s LTD benefits was neither arbitrary nor capricious. This 

timely appeal followed.

Where, as here, the plan grants the plan administrator “discretionary authority to 

determine eligibility for benefits or to construe the terms of the plan,” we “review the 

administrator’s denial of benefits under the arbitrary-and-capricious standard.” Shaw v. AT & T 

Umbrella Benefit Plan No. 1, 795 F.3d 538, 546 (6th Cir. 2015) (quoting Firestone Tire & 

Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989)). “Under the arbitrary-and-capricious standard, 

we must uphold the plan administrator’s decision if it is ‘the result of a deliberate, principled 

reasoning process’ and ‘supported by substantial evidence.’” Id. at 547 (quoting DeLisle v. Sun 

Life Assurance Co. of Can., 558 F.3d 440, 444 (6th Cir. 2009)). Our review, however, “is not a 

rubber stamp. We must still evaluate the quality and quantity of the medical opinions on both 

sides.” Cox v. Standard Ins. Co., 585 F.3d 295, 302 (6th Cir. 2009).
No. 15-6010, Cannon v. PNC Fin. Servs. Group & Affiliates Long Term Disability Plan

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In her initial interview with Liberty, Cannon reported that she was suffering from 

abdominal and pelvic pain, that sitting caused the worst pain, and that she could “type[] and do 

everything except sit.” (RE 22, Page ID # 89). Cannon’s activities questionnaire submitted in 

support of her claim for LTD benefits indicated that she was unable to sit for any length of time 

and that she could not engage in any gainful employment because of “sever[e] pain” and an 

inability to sit. (RE 22-1, Page ID # 176, 178). Cannon’s records from several physicians and 

from physical therapy reflected her complaints of severe pelvic or vaginal pain, particularly 

when sitting. (RE 22, Page ID # 129; RE 22-1, Page ID # 158, 163; RE 22-2, Page ID # 186, 

189, 191, 214-15, 217-18, 231-32). After performing a cystoscopy and laparoscopy on March 

26, 2013, Dr. Robert McQuady with the Pelvic Pain Regional Specialty Center diagnosed 

Cannon with pelvic abdominal pain, intra-abdominal adhesions, and pudendal neuralgia. (RE 

22-2, Page ID # 237). Dr. McQuady instructed Cannon to be off work from the date of the 

surgery until approximately April 23, 2013, and noted that her “[r]eturn to work will be further 

discussed at post-operative appointments.” (RE 22-2, Page ID # 230). 

Liberty discontinued Cannon’s LTD benefits on April 15, 2013. In doing so, Liberty 

relied on a peer review prepared by Dr. Stuart Glassman with the Medical Consultants Network. 

Dr. Glassman stated that Cannon’s “impairments currently are subjective complaints of 

abdominal pain, no clear etiology,” failing to mention Dr. McQuady’s diagnosis of pudendal 

neuralgia. (RE 22-3, Page ID # 263). Dr. Glassman concluded:

It is felt that she does have a work capability, and it is at least light duty, lifting 20 

pounds maximally, 10 pounds frequently, 8 hours a day, 5 days a week. Her 

motor examination was normal, even with complaints of abdominal pain. It is felt 

that based upon her pain complaints, only occasional bending, kneeling, and 

squatting would be appropriate for her. She could drive occasionally, as well.

(Id.). Although Cannon’s sedentary job involved sitting most of the time and she complained of 

pain while sitting, neither Liberty nor Dr. Glassman addressed her ability to sit.
No. 15-6010, Cannon v. PNC Fin. Servs. Group & Affiliates Long Term Disability Plan

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In support of her appeal from the denial of LTD benefits, Cannon submitted a letter from 

Dr. McQuady stating: 

She is unable to work. Her job requires that she be able to sit and patient has 

intense pain with sitting. She was diagnosed with pudendal neuralgia as well as 

pelvic floor muscle dysfunction and these conditions are associated with pain with 

sitting and it is not possible for the patient to perform a job that requires that she 

sit.

(RE 22-3, Page ID # 269). In denying Cannon’s appeal, Liberty noted receipt of Dr. McQuady’s 

letter but stated that “no further contemporaneous examination or treatment records have been 

provided to validate his assertions that Ms. Cannon remained restricted and limited such that she 

was unable to work.” (RE 22-3, Page ID # 274). Liberty once again recited the restrictions 

identified by its medical reviewers without addressing Cannon’s ability to sit. 

Liberty’s decision to deny benefits was arbitrary and capricious for two reasons. First, 

Cannon asserted that she could not perform her job because her pelvic pain made her unable to 

sit. Liberty failed to consider that Cannon’s two diagnoses—pudendal neuralgia and pelvic floor 

muscle dysfunction—are associated with pain while sitting. Those diagnoses and their effects 

are precisely the anatomic explanation we require for a demonstration of pain. To fail to address 

them is an arbitrary and capricious denial of benefits. See Yeager v. Reliance Standard Life Ins. 

Co., 88 F.3d 376, 382 (6th Cir. 1996) (“In the absence of any definite anatomic explanation of 

plaintiff’s symptoms, we cannot find that the administrator’s decision was arbitrary and 

capricious.”). 

Second, Liberty’s failure to consider Dr. McQuady’s letter without supplemental medical 

evidence was arbitrary and capricious. See Glenn v. MetLife, 461 F.3d 660, 672 (6th Cir. 2006) 

(“[T]he failure to consider evidence that is offered after an initial denial of benefits renders a 

final denial of benefits arbitrary and capricious.”). Dr. McQuady’s letter provided an 

explanation for Cannon’s need for disability based on existing medical evidence—namely, 
No. 15-6010, Cannon v. PNC Fin. Servs. Group & Affiliates Long Term Disability Plan

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Cannon’s two diagnoses as a result of the recent surgery that he performed on her and that she 

was still recovering from—and should have been addressed by Liberty.

“[W]here the problem is with the integrity of the plan’s decision-making process, rather 

than that a claimant was denied benefits to which [s]he was clearly entitled, the appropriate 

remedy generally is remand to the plan administrator.” Shaw, 795 F.3d at 551 (quoting Elliott v. 

Metro. Life Ins. Co., 473 F.3d 613, 622 (6th Cir. 2006)). Because we cannot say that Cannon 

was clearly entitled to benefits, the appropriate remedy is to remand to Liberty for a full and fair 

inquiry into her claim for LTD benefits.

For the foregoing reasons, we VACATE the district court’s judgment and REMAND the 

case for proceedings consistent with this opinion.