Opinion ID: 1354269
Heading Depth: 3
Heading Rank: 3

Heading: Quality and Quantity of Medical Evidence

Text: In considering the medical evidence, we first address Sun Life's argument that the district court impermissibly shifted the burden of proof to Sun Life to disprove DeLisle's disability as of April 17. In support of its argument, Sun Life points to the district court's observation that Sun Life's file reviewers cannot state conclusively that [DeLisle] was not disabled on April 17. DeLisle, 2007 WL 3013075 at . While Sun Life is correct that DeLisle carries the burden of proving her disability, the district court's observation must be considered in its proper context, which was at the conclusion of its survey of the medical evidence submitted by both sides. In context, it becomes clear that the district court's observation is properly characterized as an evaluation of the quality of the reasoning process that Sun Life undertook and was not a burden shift. Notably, the district court's opinion did not rely on any failure by Sun Life to disprove DeLisle's disability. Rather, it concluded that given the [Sun Life] consultants' concessions, the SSA determination of total disability, and the inherent conflict of interest, the major factors to be considered fall in favor of Plaintiff. Id. A court's review for arbitrary and capricious decision-making inherently includes some review of the quality and quantity of the medical evidence and the opinions on both sides of the issues. McDonald, 347 F.3d at 172. The district court set forth general synopses from both sides' medical evidence, including six opinions submitted by DeLisle and six by Sun Life. DeLisle, 2007 WL 3013075 at -9. DeLisle's therapy notes and medical assessments in the months leading up to her firing include complaints of anxiety and depression. Her primary care physician, Dr. Rudy noted that she was coping with tremors, fatigue, spasms, and double-vision. Her neurosurgeon, Dr. Ho, who treated her on a monthly basis since January 1999 had prescribed a full neck brace, noted an increase in neck pain in December 2001, and recorded his recommendation, as soon as possible, after the holidays, she take some time to cut back on working and be off of her feet. That the medical providers who were treating DeLisle before her firing did not explicitly include in their medical opinions statements indicating that she was disabled is of little consequence because DeLisle affirmatively wanted to work through her ailments. Moreover, her treating physicians from that time periodas well as other physicians who began treating her after she stopped workingreviewed her medical records and concluded, among other diagnoses that she was suffering from major depressive disorder and anxiety disorder, memory retrogression, significant loss of psychological, physiological, personal and social adjustments of severe limitation. In an interview with Sun Life, Dr. Ho explained that although the disability date is 4/17/2002, the period of disability could have been long before that. Sun Life's experts, including Dr. O'Connor, Dr. Himber, Dr. Pies and Dr. Sarni, largely agreed with the diagnoses, but discounted the effect they had on DeLisle's ability to work. In addition, Dr. O'Connor and Dr. Johnston noted that DeLisle did not complain of neuropsychological or cognitive impairments until after she was fired. And Dr. Corzatt pointed out that Dr. Ho had not imposed restrictions on DeLisle's ability to work. Although Sun Life does not owe special deference to the opinion of DeLisle's treating physicians, see Black & Decker, 538 U.S. at 834, 123 S.Ct. 1965, it may not arbitrarily ignore them. Glenn, 461 F.3d at 671. Notably, Sun Life's medical professionals found support in DeLisle's medical records for the disorders described above, but discredited the date of disability on the basis that the records did not demonstrate a change in condition around April 17. None of Sun Life's reviewers confront Dr. Ho's characterization of the progressive nature of her medical conditions, which would not manifest itself by a significant change on a particular date. And, as noted above, it is unclear whether Sun Life's file reviewers knew of the Social Security determination of total disability, or were unfairly swayed by communications from Sun Life's in-house attorney. On this record, we find that the entirety of the medical evidence available to Sun Life was not reviewed in a deliberate or principled fashion, which is a factor suggesting that Sun Life's ultimate determination was arbitrary.