Opinion ID: 2821415
Heading Depth: 3
Heading Rank: 3

Heading: Shaw’s Application for LTD Benefits

Text: On April 22, 2010, Sedgwick sent Shaw a letter informing him that his STD benefits would expire on August 7, 2010, and that he might be eligible for LTD benefits. In order to determine Shaw’s eligibility, the letter instructed Shaw to complete the LTD application packet. The packet required, among other things, Shaw to provide new authorizations for the release of No. 14-2224 Shaw v. AT&T Umbrella Plan Page 6 medical records and “[p]roof that [he had] applied for Social Security Disability benefits.” (R. 14-1, PageID 112.) On May 14, 2010, a Sedgwick claims representative called Shaw to discuss the LTD application packet. The representative explained the LTD application process and obtained information about Shaw’s condition. On June 15, 2010, Shaw submitted his application. On July 27, 2010, Sedgwick sent Shaw’s application for LTD benefits to Dr. Xico Roberto Garcia, a family-practice physician. After reviewing the information, Dr. Garcia concluded that the “[m]edical information provided [did] not support incapacity from a sedentary job occupation.” (R. 14-1, PageID 84.) Dr. Garcia noted that although Shaw’s “[t]reating provider state[d] today that the employee ha[d] persistent neck pain, right upper extremity radiculopathy, limited neck range of motion, and inability to drive[,] . . . [t]here [were] no recent objective range of motion measurements provided . . . [and] no recent findings to support functional impairment.” (Id. at 83.) However, Dr. Garcia acknowledged that he received rangeof-motion measurements on July 6, 2010. As part of Shaw’s application, on July 30, 2010, Srilakshmi Sennerikuppam, a jobaccommodation specialist, performed a “transferrable skills assessment” that took into consideration Shaw’s “restrictions and limitations.” Sennerikuppam stated that a case manager had asked that it be assumed that “Shaw can perform sedentary work.” (R. 14-3, PageID 251.) According to Sennerikuppam, sedentary work “involves sitting most of the time, but may involve walking or standing for brief periods of time.” (Id.) Given his experience and education, Sennerikuppam identified three sedentary occupations Shaw could perform: information clerk, telephone solicitor, and customer service representative. (Id. at 252.)