United States Court of Appeals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued May 5, 2017 Decided June 30, 2017

No. 16-7125

JILL MARCIN,

APPELLEE

v.

RELIANCE STANDARD LIFE INSURANCE COMPANY AND MITRE 

CORPORATION LONG TERM DISABILITY INSURANCE PROGRAM,

APPELLANTS

Appeal from the United States District Court

for the District of Columbia

(No. 1:13-cv-01308)

Joshua Bachrach argued the cause and filed the briefs for 

appellants.

Scott B. Elkin argued the cause and filed the brief for 

appellee. 

Before: TATEL, PILLARD and WILKINS, Circuit Judges.

Opinion for the Court filed by Circuit Judge WILKINS.
2

WILKINS, Circuit Judge: This appeal concerns Jill 

Marcin’s recovery of long-term disability benefits under an 

ERISA-governed plan. In 2008, Ms. Marcin filed for 

disability benefits under the Mitre Long Term Disability Plan, 

Group Policy Number 111701 (the “Plan” or “Policy”), citing 

numerous ailments that affected her cognitive abilities and 

motor functioning. Reliance Standard Life Insurance 

Company (“Reliance”), the Plan administrator, denied Ms. 

Marcin’s request for benefits, explaining that she did not meet 

the definition of “Total Disability.” In particular, Reliance 

concluded that Ms. Marcin was capable of performing all 

material duties of her employment on a full-time basis.

Following an unsuccessful administrative appeal, Ms. Marcin 

filed suit against Reliance and the Plan in District Court in 

2010. See Marcin v. Reliance Standard Life Ins. Co. (Marcin 

I), 895 F. Supp. 2d 105 (D.D.C. 2012). The District Court

remanded the case to Reliance, requesting additional 

explanation as to how the record supported Reliance’s 

conclusion that Ms. Marcin was not disabled.

In early 2013, Reliance again denied Ms. Marcin’s claim 

for disability benefits. Ms. Marcin filed a second lawsuit in 

District Court, which serves as the basis for this appeal. See 

Marcin v. Reliance Standard Life Ins. Co. (Marcin II), 138 F. 

Supp. 3d 14 (D.D.C. 2015). Following an additional remand, 

the District Court entered judgment in favor of Ms. Marcin on 

October 14, 2015. Specifically, the District Court found that 

there was not substantial evidence in the record to support 

Reliance’s denial of disability benefits, though it cautioned 

that it was not making a finding that Ms. Marcin was Totally 

Disabled. Id. at 30. In subsequent orders, the District Court 

determined that Ms. Marcin was entitled to disability benefits 

in the amount of $2,409.74 per month, along with postjudgment interest at the rate of 0.27 percent per annum from 
3

October 14, 2015, and attorney’s fees in the amount of 

$72,240. 

Reliance timely appealed, arguing that the District Court 

erred by awarding Ms. Marcin disability benefits and

miscalculating the amount of benefits owed. Reliance’s 

strongest argument on appeal is that benefits under the Plan 

cannot be awarded without a factual finding of Total 

Disability. Given that the District Court explicitly disavowed 

making this determination, Reliance contends that an award 

of benefits was legally precluded. While we agree with 

Reliance that a finding of Total Disability was a prerequisite 

to the receipt of benefits, we are mindful of our de novo 

standard of review for summary judgment. Pursuant to this 

standard, we may affirm the District Court on any ground, and 

elect to do so on the basis that Ms. Marcin proved Partial 

Disability. According to the express terms of the Plan, Partial 

Disability is equivalent to Total Disability, and we find that 

Ms. Marcin was Totally Disabled within the relevant period. 

We also affirm the District Court’s calculation of disability 

benefits owed to Ms. Marcin. 

I.

For almost seven years, Ms. Marcin has been engaged in 

litigation under the Employee Retirement Income Security 

Act (“ERISA”) to recover disability benefits owed under the 

Plan. To date, the litigation has spanned two lawsuits, at least 

three remands, and now an appeal. While the procedural 

posture of this case is tortuous, the issue we must decide is 

relatively straightforward: did Ms. Marcin prove Total 

Disability in accordance with the terms of the Plan? The 

factual evidence in this case shows that she did. 
4

A.

Prior to developing her disability, Ms. Marcin “worked as 

a multi-discipline systems engineer at Mitre, a non-profit 

organization that supports federally funded research and 

development centers with systems engineering and 

information technology assistance.” Marcin I, 895 F. Supp. 2d

at 107. Beginning January 1, 2005, Reliance issued Group 

Long-Term Disability Insurance Policy No. LTD 111701 to 

Mitre, and Ms. Marcin subsequently received coverage

pursuant to the terms of this Plan. See id. As the claims 

review fiduciary, Reliance is responsible for determining 

eligibility for benefits under the Policy. Id. 

To be eligible for disability benefits, the Plan explicitly 

requires an insured to satisfy four elements. First, the 

individual must be “Totally Disabled as the result of a 

Sickness or injury covered by this Policy.” J.A. 2131. The 

term “Totally Disabled” (or, alternatively, “Total Disability”) 

means: 

(1) during the Elimination Period and for the 

first 24 months for which a Monthly Benefit 

is payable, an Insured cannot perform the 

material duties of his/her regular occupation;

(a) “Partially Disabled” and “Partial 

Disability” mean that as a result of an 

Injury or Sickness an Insured is capable 

of performing the material duties of 

his/her regular occupation on a parttime basis or some of the material 

duties on a full-time basis. An Insured 

who is Partially Disabled will be 

considered Totally Disabled, except 

during the Elimination Period;
5

(b) “Residual Disability” means being 

Partially Disabled during the 

Elimination Period. Residual Disability 

will be considered Total Disability; and 

(2) after a Monthly Benefit has been paid for 24 

months, an Insured cannot perform the 

material duties of any occupation. Any 

occupation is one that the Insured’s 

education, training or experience will 

reasonably allow. We consider the Insured 

Totally Disabled if due to an Injury or 

Sickness he or she is capable of only 

performing the material duties on a part-time 

basis or part of the material duties on a Fulltime basis. 

J.A. 2123. In other words, an insured is entitled to disability 

benefits under this first prong of the Policy if, due to her 

ailments, she was incapable of performing all of the material 

duties of her occupation on a full-time basis. A Partial 

Disability under the Policy is equivalent to Total Disability. 

Further, the Policy provides that the insured’s coverage 

will terminate on “the first of the Policy month coinciding 

with or next following the date the Insured ceases to meet the 

Eligibility Requirements.” J.A. 2129, 2156. To meet the 

Eligibility Requirements, an insured must be an “Eligible 

Person,” meaning that she is a full-time or part-time employee 

actively at work. The term “Actively at Work” means that the 

insured is performing the material duties of her job on a fulltime or part-time basis in the place and manner in which the 

job is normally performed. This encompasses approved time 

off, including vacation and jury duty, but does not include 

time off as a result of injury or sickness. Thus, an insured’s 
6

disability must develop while she is still covered by the Plan. 

A disability that arises after coverage has ceased is not 

eligible for benefits. 

Second, the insured must be under the regular care of a 

physician. Third, the individual must have completed the 

“Elimination Period.” The Elimination Period is defined by 

the Policy as a “period of consecutive days of Total Disability 

. . . for which no benefit is payable. It begins on the first day 

of Total Disability,” J.A. 2122, and is “[t]he greater of 

expiration: 180 consecutive days of Total Disability or the 

end of The MITRE Corporation’s continuation program,” J.A. 

2120. Accordingly, an insured must show that during this 

180-day period, she was incapable of performing the material 

duties of her regular occupation on a full-time basis. Fourth, 

the individual must submit “satisfactory proof of Total 

Disability” to Reliance. J.A. 2131. For any Total Disability, 

the insured must send written proof within ninety days after 

the Total Disability occurs or as soon as reasonably possible. 

If an insured satisfies these four requirements, then Reliance 

is obligated to pay monthly benefits under the Plan. Only the 

first element is at issue in this case. 

B.

Beginning November 2005, Ms. Marcin was diagnosed 

with numerous medical conditions, including kidney cancer, 

portal vein thrombosis, Factor V Leiden, splenorenal shunt, 

anemia, and polycystic ovarian syndrome. See Marcin I, 895 

F. Supp. 2d at 108. The joint appendix chronicles the myriad 

doctors’ appointments, diagnoses, and medical procedures 

that Ms. Marcin underwent starting in 2005. According to the 

record, Ms. Marcin submitted an application for long-term 

disability benefits under the Plan on March 25, 2008. In this 

application, Ms. Marcin claimed that her last day of work 
7

before becoming disabled was August 19, 2007. See id. While 

Ms. Marcin did return to work between November 2007 and 

February 2008, it was only on a part-time basis, and she 

ceased working altogether on February 15, 2008. On 

December 18, 2007, Mitre notified Reliance of Ms. Marcin’s 

disability claim. Id. 

In support of her disability claim, Ms. Marcin provided 

Reliance with voluminous medical records, her work history, 

witness statements, and scientific literature concerning her 

illness. Ms. Marcin’s medical records showed a decline in her 

well-being and functional capabilities from August 2007 to 

March 2008. Following her kidney surgery in late August 

2007, a Preliminary Report dated October 26, 2007 by Dr. 

Richard Guido noted that Ms. Marcin “is doing fairly well.” 

J.A. 76. Ms. Marcin was then released by her doctor to return 

to work, but only “as tolerated.” At a follow-up visit on 

November 30, 2007, Dr. Anthony Felice explained that Ms. 

Marcin “feels reasonably well” and “has no pain.” J.A. 89, 

2063. Approximately one month later on December 31, 2007, 

Dr. Felice stated in a Progress Note that Ms. Marcin “is 

reasonably well although [she] has some mild fatigue,” and 

will take iron to counteract her anemia. J.A. 91, 2065. 

However, on February 29, 2008, Dr. Felice acknowledged 

that although Ms. Marcin “is feeling better,” she “still has 

much fatigue,” which “limits her ability to work.” J.A. 82. 

Dr. Felice’s findings were further confirmed by Dr. 

Kareem Abu-Elmagd on March 20, 2008, when he noted that 

Ms. Marcin “is currently in Pittsburgh for additional testing” 

and “will need to remain off of work until further notice, 

pending test results.” J.A. 2205. Five days later, Dr. AbuElmagd completed an Attending Physician Statement 

(“APS”), in which he stated that Ms. Marcin suffered from 

“extreme fatigue, [and] frequent illness.” J.A. 2025. Dr. Abu-
8

Elmagd included his assessment that Ms. Marcin was, at 

most, capable of sedentary work, that she had not yet 

achieved maximum medical improvement, and that it was 

“unknown” whether she would make a full recovery. J.A. 

2026, 2205. Finally, an October 24, 2008 Functional Capacity 

Evaluation (“FCE”) reported that Ms. Marcin has a “below 

part time workplace tolerance” and “is unable to return to 

work in her previous position or any other position.”1 J.A. 

559. Dr. Costa explained on this FCE that Ms. Marcin 

suffered from these same work restrictions from August 2007 

through October 2008. 

Indeed, Ms. Marcin’s medical assessments are further 

substantiated by her inability to engage in full-time 

employment. An examination of Ms. Marcin’s sick leave 

shows that she never returned to work full time after the onset 

of her disability in August 2007. Rather, the number of sick 

days Ms. Marcin took increased exponentially from 

November 2007 to February 2008, and Ms. Marcin never 

worked a 40-hour week during that time period. 

Despite this evidence, Reliance denied Ms. Marcin’s 

disability claim. See Marcin I, 895 F. Supp. 2d at 108.

Reliance based its denial on the grounds that “the medical 

records on file do not support work impairment at date of loss 

or beyond 11/6/07 when you were released to work status post 

nephrectomy.” J.A. 1993; see Marcin I, 895 F. Supp. 2d at 

108. In support of its decision, Reliance noted that there was 

no written documentation from Ms. Marcin’s physicians 

supporting her inability to work. Reliance relied upon notes 

from Ms. Marcin’s doctors stating that she only had “some 

mild fatigue,” but overall “look[ed] well.” J.A. 1993. All of 

 1 The October 24, 2008 FCE was not included in the original claim 

record, but was added to the record after Reliance’s first denial of 

benefits. 
9

Ms. Marcin’s labs on file document hemoglobin slightly 

below normal, but Reliance inferred that these labs did not 

support work impairment. Reliance thus concluded that Ms. 

Marcin did not meet the Plan’s definition of disability. 

Ms. Marcin appealed her claim denial on December 29, 

2008, and Reliance denied the appeal on September 29, 2009. 

Specifically, Reliance re-examined the claim record and 

evaluated the medical opinions of two physicians hired by 

Reliance – Dr. Stuart Shipko and Dr. Herbert Dean. Reliance 

found that Ms. Marcin’s own doctor released her to return to 

work “as tolerated” on November 6, 2007, and that Ms. 

Marcin did in fact work part time from November 2007 to 

February 2008. It was Reliance’s position, “based on the 

totality of information in the claim file, that Ms. Marcin was 

capable of performing the material duties of her own 

occupation at the time that she was released to return to work 

on 11/6/07 following her nephrectomy.” J.A. 2004.

C.

Ms. Marcin filed suit in the District Court on October 26, 

2010, challenging Reliance’s denial of disability benefits. 

Marcin I, 895 F. Supp. 2d at 112. After conducting a detailed 

analysis of the record, the District Court found that Reliance 

“failed to adequately explain how the evidence in the record 

supports its determination that [Ms. Marcin] is not entitled to 

disability benefits.” Id. at 123. The District Court observed 

that Ms. Marcin clearly suffered from severe medical 

conditions, but thought she had done “little to meet her 

burden under the policy to demonstrate that she was disabled” 

during the relevant time period. Id. at 122. At the same time,

the District Court also noted that Reliance had “failed to point 

to much evidence to support the finding” that Ms. Marcin was 

not disabled at the relevant time. Id. Accordingly, the District 
10

Court stated that “whether the insurer’s determination was 

reasonable on this record depends in large measure on what 

that determination was and the stated reasons behind it.” Id. at 

119. The District Court, however, was unable to decipher 

Reliance’s rationale for denying disability benefits and 

remanded the case. Id. at 123. 

On January 7, 2013, Reliance responded to the remand by 

again denying Ms. Marcin’s claim for disability benefits. As 

an initial matter, Reliance clarified that eligibility for longterm disability benefits “depends on whether the definition of 

Total Disability is met, which includes a determination 

regarding Partial Disability.” J.A. 2013. In its prior denial, 

Reliance found that Ms. Marcin did not meet the definition of 

Total Disability and was capable of performing the material 

duties of her occupation with Mitre. However, in accordance 

with the District Court’s order, Reliance addressed whether, 

based upon the medical evidence, Ms. Marcin was Totally 

Disabled, taking into consideration Partial Disability, as 

defined by the Policy. Unsurprisingly, Reliance concluded 

that Ms. Marcin was not Partially Disabled because “the 

medical evidence supports that she is capable of performing 

all of the material duties of her occupation on a full-time 

basis.” J.A. 2013; see J.A. 2015. 

Ms. Marcin again appealed Reliance’s denial of her 

disability claim on June 28, 2013. Along with this appeal, Ms. 

Marcin “submitted voluminous materials to Reliance,” 

including a copy of the Social Security Administration’s 2010 

decision awarding Ms. Marcin disability benefits, and a new 

report from a vocational specialist. Reliance, however, 

refused to entertain another appeal, stating that its internal 

guidelines only provide for one appeal and Ms. Marcin 

exhausted this remedy. 
11

D.

Following Reliance’s second denial of her disability 

claim, Ms. Marcin filed the complaint in this case on August 

28, 2013. Reliance filed a motion for summary judgment on 

July 29, 2014. The District Court remanded the case to 

Reliance again, and Reliance issued its response to the second 

remand on May 22, 2015. In its response, Reliance denied 

Ms. Marcin’s disability claim a third time. In addition to 

addressing the Social Security Administration’s disability 

decision, Reliance also tackled the important question of 

whether Ms. Marcin was Partially Disabled or Residually 

Disabled before March 1, 2008. Reliance explained that 

because “the evidence failed to show that [Ms. Marcin’s] 

impairments prevented her from performing all the material 

duties of her regular occupation on a full-time basis,” she 

could not be Partially Disabled or Residually Disabled. J.A. 

2183. Reliance expressly acknowledged that it “reviewed the 

evidence indicating that Ms. Marcin worked on a part-time 

basis between November 6, 2007 and March 1, 2008,

however, the medical evidence did not support her inability to 

maintain a full-time schedule.” J.A. 2183. Therefore, Reliance 

concluded that because Ms. Marcin could work full time, she 

was not Partially Disabled. 

Faced with Reliance’s final determination, the District 

Court entered judgment in favor of Ms. Marcin on October 

14, 2015. The District Court found that “although certain 

aspects of Reliance’s Final Decision were reasonable, the 

insurer’s ultimate conclusion that [Ms. Marcin] ‘was capable 

of performing all of the material duties of her regular 

occupation on a full time basis between November 6, 2007 

and March 1, 2008’ is not supported by ‘substantial 

evidence.’” Marcin II, 138 F. Supp. 3d at 22 (citation 

omitted). Specifically, the District Court noted that “Reliance 
12

entirely failed to grapple with the fact that [Ms. Marcin] never 

worked full time between November 2007 and February 

2008, and that the hours she did work declined sharply in the 

weeks before she stopped altogether.” Id. at 23. Therefore, the 

District Court could not “conclude that Reliance’s 

determination that [Ms. Marcin] was capable of working fulltime on March 1, 2008, was ‘reasonably supported by the 

administrative record.’” Id. 

In making this determination, however, the District Court 

expressly limited the scope of its opinion. The District Court 

explained that its holding was restricted to whether substantial 

evidence existed in the record to support Reliance’s 

conclusion that Ms. Marcin was capable of full-time work. 

See id. at 30. Although the District Court acknowledged that 

“the medical evidence might well support a decision based on 

a finding that [Ms. Marcin] was not ‘totally disabled’ at the 

relevant time,” it could not “see how the records provide any 

support for the conclusion that [Ms. Marcin] ‘was capable of 

perform[ing] all of the material duties of her regular 

occupation on a full time basis’ when she stopped working.” 

Id. at 28. However, the District Court expressly cautioned 

“that it has not made a determination about whether [Ms. 

Marcin] was or was not ‘totally disabled’ within the meaning 

of the plan.” Id. at 30. “Rather, its holding is that the record in 

this case does not reasonably support the plan administrator’s 

decision that [Ms. Marcin] was capable of full-time work 

when she stopped, and since that is the basis for the denial of 

the benefits, the denial cannot stand.” Id. 

Following this determination, the District Court 

addressed the parties’ disagreement regarding the amount of 

damages that should be awarded. The District Court 

concluded that Ms. Marcin’s salary “was approximately 

$90,000 per year, or about $43 per hour, and that the first 24 
13

months of benefits should be calculated on that basis.” J.A. 

2284; see J.A. 2286-89. Based on the Policy benefit of 60% of 

covered monthly earnings, the District Court found that Ms. 

Marcin was entitled to disability benefits of $2,409.74 per 

month for the 24-month period between February 16, 2008 

and February 16, 2010, or $57,833.76, plus post-judgment 

interest at the rate of 0.27 percent per annum from October 

14, 2015. After a third remand, the District Court entered final 

judgment for Ms. Marcin “in the amount of $2,409.74 per 

month for the 103 months between February 16, 2008 and 

September 19, 2016, for a total award of $248,203.22.” J.A. 

2302. 

Although Reliance concedes that Ms. Marcin is now 

totally disabled under its Policy – and indeed, unable to work 

in any occupation – the insurer maintains that Ms. Marcin was 

ineligible for benefits under its Policy when she stopped 

working in 2008. Reliance thus appeals four rulings from the 

District Court: (1) September 19, 2016 Final Judgment for 

Ms. Marcin in the amount of $248,203.22, along with prejudgment interest and attorney’s fees of $72,240; (2) August 

4, 2016 Memorandum Opinion and Order awarding disability 

benefits to Ms. Marcin at $2,409.74 per month; (3) October 

14, 2015 Memorandum Opinion denying Reliance’s motion 

for summary judgment and entering judgment in favor of Ms. 

Marcin; and (4) April 14, 2015 Memorandum Opinion and 

Order denying Reliance’s motion for summary judgment and 

remanding the claim for further action. Appellant Br. i-ii. This 

Court has jurisdiction to hear the appeal pursuant to 28 U.S.C. 

§ 1291.

II. 

Our review of this case is governed by the interplay of 

two separate standards. First, we review de novo the District 
14

Court’s decision to grant summary judgment. Grimes v. 

District of Columbia, 794 F.3d 83, 88-89 (D.C. Cir. 2015); 

Arrington v. United States, 473 F.3d 329, 333 (D.C. Cir. 

2006). Because this Court analyzes the District Court’s 

judgment, not its reasoning, we may affirm on any ground 

properly raised. EEOC v. Aramark Corp., 208 F.3d 266, 268 

(D.C. Cir. 2000). Summary judgment is appropriate if there is 

no genuine issue of material fact, and judgment can be 

granted as a matter of law. FED. R. CIV. P. 56(a). In assessing 

a summary judgment motion, the Court must view all facts 

and evidence in the light most favorable to the nonmoving 

party. Arrington, 473 F.3d at 333; Carter v. George Wash. 

Univ., 387 F.3d 872, 878 (D.C. Cir. 2004). Summary 

judgment will only be granted if no reasonable jury could find 

for the nonmoving party. See Jones v. Bernanke, 557 F.3d 

670, 674 (D.C. Cir. 2009); Carter, 387 F.3d at 878. To 

survive a motion for summary judgment, the party with the 

burden of proof at trial must offer evidence showing that there 

is a triable issue of fact regarding an essential element of the 

claim. Arrington, 473 F.3d at 335.

Second, although we review summary judgment 

determinations using a de novo standard, we must decide the 

appropriate framework through which to consider an ERISA 

plan. While ERISA is a “comprehensive and reticulated 

statute,” it does not set out the appropriate standard of review 

for actions challenging benefit eligibility determinations. 

Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 108-09 

(1989). The Supreme Court has held that a denial of benefits 

challenged under § 1132(a)(1)(B) of ERISA is to be reviewed 

under a de novo standard unless the benefit plan gives the 

administrator discretionary authority to determine eligibility 

for benefits or to construe the terms of the plan. Metro. Life 

Ins. Co. v. Glenn, 554 U.S. 105, 111 (2008); Firestone, 489 

U.S. at 115. Where the plan gives the administrator 
15

discretionary authority, then a deferential standard of review 

applies. Firestone, 489 U.S. at 111. This deferential standard 

is one of reasonableness. Pettaway v. Teachers Ins. & Annuity 

Ass’n of Am., 644 F.3d 427, 435 (D.C. Cir. 2011). 

In the present case, the ERISA policy provides that 

Reliance “shall serve as the claims review fiduciary with 

respect to the insurance policy and the Plan. The claims 

review fiduciary has the discretionary authority to interpret 

the Plan and the insurance policy and to determine eligibility 

for benefits.” J.A. 2238 (emphasis added). Thus, the 

deferential standard of review applies, and we must examine 

Reliance’s decision to deny disability benefits for abuse of 

discretion. See Firestone, 489 U.S. at 111. Accordingly, 

Reliance’s denial of benefits will not be overturned if it was 

the result of a deliberate and reasoned process and if it is 

supported by “substantial evidence,” which is “more than a 

scintilla but less than a preponderance.” Grand Canyon Air 

Tour Coal. v. FAA, 154 F.3d 455, 475 (D.C. Cir. 1998) 

(quoting Burns v. Dir., Office of Workers’ Comp. Programs, 

41 F.3d 1555, 1562 n.10 (D.C. Cir. 1994)).

Importantly, however, there is an inherent conflict of 

interest that arises when a plan administrator both evaluates 

claims for benefits and pays those benefits. Glenn, 554 U.S. at 

112. The Supreme Court has explained that this conflict of 

interest is a “factor” to be considered and that “any one factor 

will act as a tiebreaker when the other factors are closely 

balanced.” Id. at 117. While the factors to be examined in any 

ERISA case will vary based on the factual circumstances, 

Glenn makes clear that the conflict of interest factor must be 

evaluated alongside these other determinations. Thus, when 

reviewing the lawfulness of Reliance’s decision to deny 

disability benefits, we must remember the conflict of interest 

factor and weigh it appropriately. 
16

III. 

Faced with both de novo and discretionary review, our 

inquiry in this case is as follows: did Reliance act 

unreasonably when it denied Ms. Marcin disability benefits 

on the basis that she was capable of full-time work and, 

therefore, not Partially or Totally Disabled? To answer this 

question, we must first consider a related issue: did Ms. 

Marcin satisfy her burden of proof to show that she was 

Partially or Totally Disabled during the relevant period? We 

find that because Ms. Marcin proved Partial Disability, 

Reliance acted unreasonably in denying her benefits. 

1.

The record in this case favors a finding of Partial 

Disability. As an initial matter, we note that, pursuant to the 

terms of the Policy, Ms. Marcin’s disability had to arise 

before March 1, 2008, when her coverage terminated under 

the Plan.2 We begin first with Ms. Marcin’s lengthy medical 

records. There is no dispute that Ms. Marcin suffered from 

numerous ailments, including kidney cancer, portal vein 

thrombosis, Factor V Leiden, splenorenal shunt, and anemia. 

See Marcin I, 895 F. Supp. 2d at 108. Rather, the 

disagreement concerns whether these medical diagnoses were 

debilitating. In its denial letters, Reliance repeatedly claimed 

that Ms. Marcin was not Partially Disabled because she only 

suffered mild fatigue and had not been instructed by her 

doctors to stop working. In fact, Reliance emphasized that 

 2 Ms. Marcin’s last day of work was February 18, 2008. The Policy 

states that coverage will terminate on the first of the month 

following the date the insured ceases to meet the Eligibility 

Requirements. Thus, because Ms. Marcin stopped meeting the 

Eligibility Requirements in February 2008, her coverage under the 

Policy terminated on March 1, 2008. 
17

Ms. Marcin was cleared to return to work by her own doctor 

in November 2007. Reliance, however, misconstrues the 

evidence. 

A chronological examination of Ms. Marcin’s medical 

records shows a progression of her illness to the point of 

disability. Prior to returning to work, Ms. Marcin saw Dr. 

Guido on October 26, 2007 for a follow-up visit. At that time, 

Dr. Guido noted that Ms. Marcin “is doing fairly well.” J.A. 

76. Ms. Marcin was released to return to work in November 

2007 only “as tolerated,” clearly implying that her ability to 

work was partially impaired. Following her return to work, 

Ms. Marcin saw Dr. Felice on November 30, 2007. At this 

visit, Dr. Felice explained that Ms. Marcin “feels reasonably 

well” and “has no pain.” J.A. 89, 2063. Approximately one 

month later on December 31, 2007, Dr. Felice noted that Ms. 

Marcin “is reasonably well although [she] has some mild 

fatigue,” and suggested that Ms. Marcin take iron to 

counteract her anemia. J.A. 91, 2065. Accordingly, at the end 

of 2007, Ms. Marcin’s illness began producing recognizable 

symptoms. 

The medical evidence in support of disability becomes 

more prevalent in February and March of 2008. At a followup visit on February 29, 2008, Dr. Felice acknowledged that 

although Ms. Marcin “is feeling better,” she “still has much 

fatigue,” which “limits her ability to work.” J.A. 82. There is 

a marked change in Dr. Felice’s description of Ms. Marcin’s 

fatigue from “mild” in December 2007 to more severe in 

February 2008. Reliance completely ignores this clear 

alteration in terminology used by Dr. Felice.

Further, Dr. Felice’s characterization of Ms. Marcin’s 

symptoms is supported by Dr. Abu-Elmagd. On March 20, 

2008, Dr. Abu-Elmagd noted that Ms. Marcin is undergoing 
18

additional testing and “will need to remain off of work until 

further notice.” J.A. 2205. Reliance discredits this report 

because Dr. Abu-Elmagd instructed Ms. Marcin to cease 

working only after she quit her job at Mitre. While a doctor’s 

note explaining Ms. Marcin’s work limitations would have 

been helpful before she ceased working, it was by no means a 

prerequisite to the establishment of her disability. The fact 

that such documentation comes a mere twenty days later does 

not eliminate its probative value. Rather, Dr. Abu-Elmagd’s 

recommendation that Ms. Marcin remain off of work is still 

temporally related to Ms. Marcin’s decision to leave her 

employment in late February/early March 2008 and provides 

additional evidence that Ms. Marcin was Partially Disabled 

before the end of February. 

Moreover, Dr. Abu-Elmagd provided a more in-depth 

assessment of Ms. Marcin’s capabilities five days later in the 

APS. In that document, Dr. Abu-Elmagd characterized Ms. 

Marcin’s fatigue as “extreme” and explained that she also 

suffered from “frequent illness.” J.A. 2025. Thus, we see that 

from November 2007 to March 2008, Ms. Marcin progressed 

from having no fatigue to “mild” fatigue to “much” fatigue to 

“extreme” fatigue. Again, Reliance ignores this progression. 

Further, Dr. Abu-Elmagd explained that given Ms. Marcin’s 

symptoms and diagnoses, she was, at most, capable of 

sedentary work. Specifically Dr. Abu-Elmagd stated that 

during an eight-hour day, Ms. Marcin could only stand, walk, 

and drive for one to three hours, and could sit for three to five 

hours. Additionally, Ms. Marcin could only lift ten pounds 

and it was “unknown” whether she would make a full 

recovery. 

Reliance discredited Dr. Abu-Elmagd’s findings by 

relying on the reports of two independent medical physicians 

– Dr. Dean and Dr. Shipko. After reviewing Ms. Marcin’s 
19

medical file, Dr. Dean, a hematologist and oncologist, opined 

that Ms. Marcin’s likelihood of cure from kidney cancer is 

greater than 90%, and that she should have no medically 

related problems from this procedure. This statement, 

however, does not address Ms. Marcin’s likelihood of cure 

from her other ailments. Dr. Dean also generally agreed with 

Dr. Abu-Elmagd’s findings in the APS with the exception of 

Ms. Marcin’s lifting and sitting capabilities. Dr. Dean found 

that Ms. Marcin should be able to sit for up to six hours, walk 

and stand for up to three hours, and drive for up to three 

hours. Additionally, Ms. Marcin should be able to lift up to 

twenty pounds occasionally and ten pounds frequently. Dr. 

Dean based part of his assessment on the fact that Ms. Marcin 

travels frequently to the University of Pittsburgh Medical 

Center, which is over 200 miles from her home, for follow-up 

visits. Accordingly, Dr. Dean stated that Ms. Marcin is 

capable of work that falls in the “light” category, which her 

job at Mitre satisfies. Further, both Dr. Dean and Dr. Shipko 

noted that Ms. Marcin did not have any cognitive disabilities 

that would impair her functioning. 

Our precedent is clear that “plan administrators are not 

obliged to accord special deference to the opinions of treating 

physicians.” Black & Decker Disability Plan v. Nord, 538 

U.S. 822, 825 (2003). While the plan administrator must 

provide a “full and fair” assessment of the claims and clearly 

communicate to the insured the “‘specific reasons’ for benefit 

denials,” these requirements “do not command plan 

administrators to credit the opinions of treating physicians 

over other evidence relevant to the claimant’s medical 

condition.” Id. Similarly, there is no heightened burden of 

explanation placed on the plan administrator if it decides to 

reject a treating physician’s opinion. Id. at 831. We have 

specifically held that, when “[f]aced with contradicting 

[medical] opinions and no requirement to prefer one opinion 
20

over another, we cannot conclude that [the plan administrator] 

acted unreasonably when it valued the opinion of its own 

personnel over that of [the insured’s] surgeon.” Pettaway, 644 

F.3d at 435. 

That said, it must be clear that the independent medical 

reviewer rendered a decision that is “reliable.” Black, 538 

U.S. at 834 (“[N]or may courts impose on plan administrators 

a discrete burden of explanation when they credit reliable

evidence that conflicts with a treating physician’s evaluation.” 

(emphasis added)). We think a “reliable” opinion is one that 

includes an examination of all pertinent evidence. Here, 

however, we cannot conclude that Dr. Dean grappled with the 

evidence concerning Ms. Marcin’s partial disability. Dr. Dean 

never contends with the fact that Ms. Marcin only returned to 

work part time, and says nothing about the progression of her 

fatigue. Rather, Dr. Dean only remarks that Ms. Marcin “does 

complain of fatigue, which can be [multifactorial], and is 

reported to be present in patients with portal hypertension as 

well as seen with depression.” J.A. 2146. While Dr. Dean 

offers a brief recitation of Ms. Marcin’s medical visits from

October 2007 through January 2009, he in no way explains 

how his conclusions are rationally related to the medical 

evidence. Rather, Dr. Dean relies on the fact that Ms. Marcin 

has a 90% chance of cure from renal cancer, and seemingly 

ignores the symptoms associated with her other diagnosed 

conditions as well as her cancer. See Marcin II, 138 F. Supp. 

3d at 28-29. Further, the availability of a cure has little 

bearing on whether Ms. Marcin is capable of working full 

time in her present condition. Id. at 29. It is difficult to credit 

a decision as “reliable” when the reviewer fails to link his 

conclusions to the patient’s medical history. See id. at 28 

(explaining that while Reliance was not obligated to accord 

special deference to Ms. Marcin’s physicians, its “selective 
21

description of the medical evidence further undermines the 

reasonableness of its decision”). 

While we make no ultimate determination as to the 

reasonableness of Reliance’s decision to credit Dr. Dean’s 

medical opinion, we note that Dr. Dean’s report is by no 

means compelling. Dr. Dean never addressed the fact that Ms. 

Marcin did not return to work full time, nor does he ever 

dispute Dr. Abu-Elmagd’s finding in the APS that Ms. Marcin 

suffered from severe fatigue and frequent illness. Nothing in 

Dr. Dean’s opinion substantially undermines Dr. AbuElmagd’s APS. At best, Dr. Dean’s report is an incomplete 

assessment of Ms. Marcin’s abilities. 

Finally, the FCEs contained in the record support a 

finding of Partial Disability. Ms. Marcin’s first FCE occurred 

on October 24, 2008, several months after she left her 

employment at Mitre. In this FCE, Carlos Martinez, a 

physical therapist, noted that Ms. Marcin has a “below part 

time workplace tolerance” and “is unable to return to work in 

her previous position or any other position.” J.A. 559. Several 

years later, on May 7, 2013, Dr. Costa echoed these findings, 

noting that Ms. Marcin could not complete an eight-hour 

work day on a sustained basis. As part of this evaluation, Dr. 

Costa stated that he agreed with Mr. Martinez’s findings in 

the October 24, 2008 FCE. Further, because Dr. Costa was 

one of Ms. Marcin’s treating physicians at the time her 

disability occurred, he was asked on the FCE if Ms. Marcin 

suffered from the same restrictions as indicated in the October 

24, 2008 FCE from August 2007 through October 2008. Dr. 

Costa responded in the affirmative. This shows that Ms. 

Marcin’s inability to work full time existed during her 

eligibility period from November 2007 to March 2008. While 

we are hesitant to place too much weight on the FCEs because 

they were conducted several months or years outside the 
22

disability period, we nonetheless acknowledge their findings 

as an important data point. 

When viewed in totality, the medical record shows that 

Ms. Marcin could not sustain a full-time work schedule. 

Reliance’s conclusions to the contrary based on this evidence 

are therefore unreasonable. 

2.

In addition to the medical record, Ms. Marcin’s work 

history supports a finding of Partial Disability. The parties do 

not dispute that Ms. Marcin never returned to work full time 

following her surgery in August 2007. To the contrary, the 

record is quite clear that Ms. Marcin experienced a significant 

decline in hours worked during January, February, and March 

2008. From November 12, 2007 through February 24, 2008, 

there were only five weeks in which Ms. Marcin did not miss 

a single day of work due to illness. Of these five weeks, two 

occurred between Christmas and New Year, when Ms. Marcin 

was only scheduled to work two hours each week. In contrast, 

there were five weeks where Ms. Marcin missed between 

20% and 40% of her scheduled work hours due to illness, and 

four weeks where Ms. Marcin’s disability caused her to miss 

greater than 50% of her scheduled work hours. Further, 

during late January and February 2008, when Ms. Marcin 

missed between 40% and 100% of her scheduled work hours, 

the medical records confirm that she was suffering from a 

severe sinus infection. Frequent infections are a side effect of 

leukopenia, which is one of Ms. Marcin’s numerous 

diagnoses. Dr. Abu-Elmagd even noted frequent infections as 

one of Ms. Marcin’s symptoms in the APS. Thus, there is a 

direct link in the record between Ms. Marcin’s sick days and 

her disability. Given this data, it is evident that Ms. Marcin 
23

suffered a disability that limited her capacity to work full 

time. 

Reliance, however, fails to adequately address this data in 

its numerous denial letters. Instead, while acknowledging that 

Ms. Marcin never returned to work full time, Reliance 

nonetheless argues that she is capable of full-time work. 

Reliance relies heavily on the fact that Ms. Marcin did not 

have a doctor’s recommendation to leave her employment, 

and instead was released back to work in November 2007 “as 

tolerated.” Through her work history, Ms. Marcin has proven 

that working part-time is the best she can “tolerate” given her 

disability. It is contradictory for Reliance to fault Ms. Marcin 

for not providing a medical recommendation to cease working 

when she was only ever released to work “as tolerated.” There 

would have been no reason for the doctors to inform Ms. 

Marcin to work only “as tolerated” if they believed that she 

was capable of working full time and that her medical 

condition would not affect her ability to work. Thus, provided 

Ms. Marcin’s work history and the “as tolerated” language in 

her release, Reliance’s conclusion that Ms. Marcin could 

work full time was unreasonable.

***

Given the above evidence and considerations, we find 

that Reliance acted unreasonably in denying Ms. Marcin 

disability benefits. The conflict of interest factor in the 

standard of review, combined with Ms. Marcin’s medical 

record, lack of full-time work, and release to return to work 

only “as tolerated” convince us that Ms. Marcin established 

Partial Disability as required by the Policy. Reliance has not 

satisfactorily supported its conclusion that Ms. Marcin was 

ever capable of full-time work after November 2007. 

Therefore, Ms. Marcin was Totally Disabled under the terms 
24

of the Policy and entitled to disability benefits. The judgment 

of the District Court on this issue is affirmed. Further, because 

we find that Ms. Marcin’s salary at the time of disability was 

$90,000, we affirm the District Court’s calculation of benefits 

owed. 

So ordered.