Opinion ID: 2791708
Heading Depth: 1
Heading Rank: 3

Heading: analysis

Text: “We review the district court’s order granting summary judgment de novo.” Koessel v. Sublette Cnty. Sheriff’s Dep’t, 717 F.3d 736, 742 (10th Cir. 2013). Summary judgment is available if “there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). “There is no genuine issue of material fact unless the evidence, construed in the light most favorable to the non-moving party, is such that a reasonable jury could return a verdict for the nonmoving party.” Koessel, 717 F.3d at 742 (internal quotation marks omitted). In order to survive summary judgment, “[f]or dispositive issues on which the plaintiff will bear the burden of proof at trial, he must go beyond the pleadings 2 Alternatively, the insurer moved for summary judgment claiming Matthews failed to prove he was receiving the regular and personal care of a physician for his disability as required by the policy. The district judge did not address this issue. See Aplt. App. Vol. 2 at 705 n.4. 3 Judgment was also entered in favor of the insurer on Matthews’s claim for bad faith breach of contract. Matthews does not appeal from that decision. -6- and designate specific facts so as to make a showing sufficient to establish the existence of an element essential to his case.” Cardoso v. Calbone, 490 F.3d 1194, 1197 (10th Cir. 2007) (alterations omitted) (internal quotations marks omitted). Matthews had the burden to prove he was totally disabled due to an injury as defined by the policy. See Winchester v. Prudential Life Ins. Co. of Am., 975 F.2d 1479, 1487-88 (10th Cir. 1992) (“In order to prevail on the merits [of his claim that he was entitled to accidental death benefits under a policy that required the injury to arise directly and independently of all other causes he] had to prove that the death occurred independently of any other cause, including a preexisting bodily infirmity.”). In interpreting nearly identical language in an accidental death policy, this court held “the words ‘directly and independently of all other causes’ . . . are not ambiguous.” Pirkheim v. First Unum Life Ins., 229 F.3d 1008, 1010 (10th Cir. 2000). Given this lack of ambiguity, we concluded this policy language “imposes two obvious conditions. First, the loss must result directly from accidental bodily injury. Second, the loss must result independently of all other causes. . . . Any other interpretation in this context is contrived.” Id. at 1010-11. Matthews tries to create the illusion of a genuine issue of material fact by engaging in a selective, hyper-technical parsing of the evidence. His efforts are not convincing. We have independently examined the evidence as part of our de novo review and agree with the trial judge’s well-stated conclusion: -7- All of the physicians who either treated Matthews or reviewed his medical records could not determine a precise cause of his back pain and indicated that his preexisting back condition may have been exacerbated by his riding accident. Not one physician concluded that the riding accident was the sole and independent cause of Matthews’ back pain. Because the undisputed evidence shows that the horse riding accident, at most, exacerbated or contributed to Matthews’ low back pain and degenerative disc disease, the court concludes that the accident was not the sole and direct cause of his disabling condition. Aplt. App. Vol. 2 at 705. Matthews continues to press particularly hard on one issue: whether his own declaration was sufficient to create a genuine issue of material fact as to whether the horseback riding injury was the direct and independent cause of his disabling back pain. Despite the fact that “[n]ot one physician concluded that the riding accident was the sole and independent cause of [Matthews’s] back pain,” id., Matthews offered his own contrary medical opinion: The pelvis, pubis, lower spine, L4-S5, SI joints and hips are all generally in the same body quadrant and same plane. Pain originating in any of these areas could be described as lower back pain. . . . When speaking of low back pain, Matthews attests that he at all times has described all the pain in this area from his SI joints and pelvic diastasis as low back pain. In fact, on January 3, 2014, he purchased diagnostic injections into the nerves associated with his pelvic diastasis and SI Joint disruption. This temporarily relieved most of his pain. Because of this he can attest his pain is caused by his diastasis symphysis pubis and SI Joint disruption. Aplt. Supp. App. at 716. Matthews’s continued reliance on the results achieved from the injections is disingenuous because it is based on a proposed addendum to Dall’s expert report, in -8- which Dall “opined that because [Matthews] experienced good results from the injections, it strongly suggested that [his] pain was, in fact, coming from his sacroiliac joints, which supports [his] claim that his disability is caused solely by the horse-riding accident.” Aplee. App. at 10. Upon a motion, the district judge struck the addendum, which contains improper rebuttal testimony; it presents new evidence that is being used to bolster [Matthews’s] case-in-chief. Id. at 11. We reject Matthews’s attempt to end run the court’s order by adopting Dr. Dall’s stricken medical opinion as his own. More to the point, Matthews is not qualified to give a medical opinion. Matthews cites cases reciting the unremarkable proposition that a lay witness can testify as to the state of his or her own physical health. However, the opinion of a lay witness “is limited to one that is: [] rationally based on the witness’s perception; [] helpful to clearly understanding the witness’s testimony or to determining a fact in issue; and [] not based on scientific, technical, or other specialized knowledge within the scope of [the rule on expert testimony].” Fed. R. Evid. 701 (emphasis added). Matthews’s “opinion” is based on scientific, technical, or other specialized knowledge and is not admissible on summary judgment. See Fed. R. Civ. P. 56(c)(4) (“An affidavit or declaration used to support or oppose a motion [for summary judgment] must be made on personal knowledge, set out facts that would be -9- admissible in evidence, and show that the affiant or declarant is competent to testify on the matters stated.”). AFFIRMED. Entered for the Court Terrence L. O’Brien