Opinion ID: 168760
Heading Depth: 4
Heading Rank: 1

Heading: O bjective Evidence of Disability

Text: M s. M eraou argues that the consultants’ opinions were flawed because they did not deny that she has the various conditions that she claims to be disabling, but nevertheless required “recent objective testing to indicate these conditions exist.” Aplt. Opening Br. at 25. She contends that in light of the diagnoses received from her own doctors over the years, it should have been unnecessary to provide objective findings to substantiate the existence of her conditions. M s. M eraou’s argument rests in large part on a misunderstanding of the consultants’ opinions. For the most part the consultants did not state that M s. M eraou needed objective evidence to document the existence of her medical conditions, already diagnosed by her doctors. O bjective evidence, in their opinion, was necessary primarily to confirm the disabling severity of these conditions. -13- Dr. Bowman, for example, acknowledged that M s. M eraou “has multiple medical conditions, including a seizure disorder, history of positive rheumatoid factor, lumbar and cervical disc disease, fibromyalgia, and migraine headaches.” Aplt. Supp. App., Vol. I, at 237. She noted, however, the lack of evidence regarding the currently disabling severity of these conditions. Specifically, there was no documentation concerning M s. M eraou’s response to recent medical procedures performed to alleviate pain, the functional deficits resulting from her alleged disc disease, any seizure activity within the past year, or any actively disabling arthritis symptoms. Dr. Bowman concluded that the available objective evidence did not establish the disabling nature of her medical conditions. Dr. Posner noted M s. M eraou’s “positive discogram at L4-5,” her complaints of pain, and the relief she obtained from spinal blocks and ablation therapies. Id., Vol. II, at 323. But he concluded that “there is no objective documented physical findings in the medical records which would, from an orthopedic point of view , indicate that this claimant is functionally totally disabled from performing any occupation.” Id. Dr. Posner concluded that, because of the lack of objective evidence, he could not quantify the effect of M s. M eraou’s spinal impairments on her ability to work. Dr. M endelssohn acknowledged that M s. M eraou had a history of depression and could be experiencing emotional and cognitive difficulties. She noted, however, that “the most recent documentation does not provide objective -14- findings or behavioral observations substantiating how the claimant’s difficulties are impacting her functioning and preventing her from performing useful work.” Id. at 327. Although Dr. Zane acknowledged M s. M eraou’s “slightly positive RA/A NA” (apparently referring to ragocyte and antinuclear antibody, see M cM anus v. Barnhart, No. 5:04-CV-67-OC-GRJ, 2004 W L 3316303, at  nn. 37, 38 (M .D. Fla. Dec. 14, 2004)), he “could not find any clinical evidence of objective joint findings, rashes, and hepato-renal involvement to confirm a connective tissue disorder such as Rheumatoid Arthritis or Systemic Lupus.” Aplt. Supp. App., Vol. II, at 320. Dr. Superfine agreed that M s. M eraou suffers from “fatigue, a possible connective tissue disorder, headaches, seizure disorder, irritable [bowel] and post-menopausal syndromes.” Id. at 317. But he concluded that there were “insufficient physical and diagnostic findings to support a functional impairment” of disabling severity. Id. The consultants did conclude, in some instances, that the diagnoses of particular ailments were unreliable because they were based on subjective reporting or w ere unsupported by available objective testing or other data. See, e.g., id. at 326 (“[I]t does not appear that any behavioral observations or objective data [concerning depression] were documented. Rather, this note primarily provides self reported symptoms.”). Even a reliance on this reasoning, however, -15- would not have been arbitrary and capricious. The Plan provides that “‘Total Disability’ means the inability of [the] Participant, based upon conclusive medical evidence, to engage in any gainful occupation for which he or she is reasonably fitted by education, training or experience, as determined by the Plan Administrator.” Id. at 404 (emphasis added). M s. M eraou fails to show that it was unreasonable for the Committee to interpret this definition to require recent, objective evidence of the existence of a condition, particularly when the consulting physicians stated that such evidence should have been provided but was not. “Generally, it is not unreasonable for a plan administrator to deny benefits based upon a lack of objective evidence.” Johnson, 437 F.3d at 813 (brackets and internal quotation marks omitted); see also, e.g., Kimber v. Thiokol Corp., 196 F.3d 1092, 1099 (10th Cir. 1999) (“A rational plan administrator could find [a letter and two reports by a physician] insufficient [to establish disability based on diabetes] because they do not contain supporting data for the conclusions reached.”).