Opinion ID: 722162
Heading Depth: 2
Heading Rank: 4

Heading: Clarification of Jelinek's Disability

Text: 20 Jelinek argues on appeal that the CA abused its discretion in failing to request clarification from Jelinek's treating physicians regarding the extent of her disability from lupus and depression. 21 It was not an abuse of discretion for the CA to render its decision without seeking clarification from Jelinek's physicians. Jelinek's treating physicians had already concluded that Jelinek's physical condition did not render her totally disabled from performing all occupations. Therefore, further clarification as to whether Jelinek was totally disabled was simply unnecessary. 22 Moreover, the Plan in the present case places the burden on the claimant to submit all evidence necessary to support a claim for benefits. 2 Therefore, the burden rested with Jelinek to present evidence in support of her claim for benefits. It was not the responsibility of the CA to seek further evidence regarding the extent of Jelinek's disability. The court in Sandoval v. Aetna Life and Casualty Ins. Co., 967 F.2d 377, 381 (10th Cir.1992), explained that: 23 If a plan participant fails to bring evidence to the attention of the administrator, the participant cannot complain of the administrator's failure to consider this evidence. Sandoval is not entitled to a second chance to prove his disability. The district court's responsibility lay in determining whether the administrator's actions were arbitrary or capricious, not in determining whether Sandoval was, in the district court's view, entitled to disability benefits. In effect, a curtain falls when the fiduciary completes its review, and for purposes of determining if substantial evidence supported the decision, the district court must evaluate the record as it was at the time of the decision. 24 In sum, the CA did not abuse its discretion in failing to seek clarification from Jelinek's physicians regarding the extent of her disability. 25