Opinion ID: 2974356
Heading Depth: 2
Heading Rank: 3

Heading: Self-Employment

Text: Defendants argue that Plaintiff could be “gainfully employed” under the meaning of the Plan by reason of self-employment as a day-trader of securities or as a consultant, even if he could not find employment with an employer because of a need to take a long noon rest. Thus, it is imperative that we address whether “gainful employment” includes self-employment. Under the abovediscussed definition of “gainful employment,” there are obviously some circumstances where such self-employment would result in a sufficient income. For example, an individual who had previously established himself or herself as a consultant, who maintained a viable client list, and who had the potential to earn enough to sustain a livelihood, might be gainfully employed. There will be some circumstances where an individual may be unable to find work for an employer due to his or her disability, but has both the experience and the likelihood of a sufficient income from selfemployment to support a finding of “gainful employment.” As noted, Defendants cite to two possible income sources for Tracy: day-trading and selfemployment as a consultant. Here Tracy himself stated he had engaged in some day-trading and suggested he could earn a substantial income as a day trader when he asked Defendant to advance $3,000 to $5,000 to permit him to attend some additional training in that employment. Additionally, the ALJ’s opinion refers to the fact that Plaintiff spends five hours a day, five days a week daytrading. The record indicates that he may have spent even more time than that. It is silent, however, as to an amount he has actually earned from this endeavor. The extensive time he has devoted to 14 day-trading and his silence as to what he has actually earned justify the inference that he has been engaged in gainful employment. So does his previous conduct in continuing to draw disability while employed for over a year at full-time employment with two different employers. D. Alternatively, Even If We Do Not Rely on this Self-Employment, Has Tracy Established His Condition Prevents Him From Being Gainfully Employed? Our review of the evidence leads us to conclude that Tracy, who has the burden of proof, has not established that he is unable to be gainfully employed, by an employer, anywhere. Even though we may consider the findings by the SSA, we are not required to abide by its decision. We note initially that we do not have Plaintiff’s testimony or other testimony in the SSA proceeding, but only the ALJ’s opinion and Plaintiff’s applications. Hence, we have not been provided with sufficient evidence to determine independently that Tracy suffers from a disability preventing him from being gainfully employed. Although the SSA decision resulted in a finding of disability, we are provided only with the ALJ’s summary of medical and vocational reports that lead to that finding. While we give respectful weight to the findings of that court, such respect does not provide litigants carte blanche to transmute its findings to other circumstances in other fora. In sum, Tracy has not met his burden of establishing that he suffers from this disability. The only doctor’s report in the administrative record that supports his contention that he is unable to be gainfully employed is the response of Dr. Gungor to a work questionnaire. The following is the narrative portion of the report in its entirety: 6. In general, the patient has to take two naps a day. The first one up to one hour in the morning between 11 a.m. and 1 p.m. He takes the second nap between 3 p.m. to 6 p.m. This lasts for two hours. 15 9. The patient is impaired, all functions are interrupted. Once or twice a month, sometimes more often, the patient is unable to get out of bed all day. He gets up in the evening for a short period of time. He would eat, go back to the bedroom and then go back to sleep. 12. About twice a month, sometimes more often, the patient is unable to get out of bed all day. He gets up in the evening for a short period of time. He would eat, got back to the bedroom and go back to sleep. This would last for one or two days. J.A. at 266. Many of the questions posed by the questionnaire were unanswered. Notably, Dr. Gungor failed to answer question seven, which requested that he report the medical findings that led to his conclusions. Such scant evidence from an incomplete medical report, even if otherwise uncontradicted, would appear to be insufficient. Moreover, that evidence is controverted by other evidence in the record before us, but to which the ALJ makes no reference. First, there are medical reports indicating that Tracy is capable of work. Dr. Munson completed an attending physician’s report and wrote a letter dated January 22, 1999, which stated that to improve Tracy’s daytime functioning, “he should maintain a regular worksleep schedule. This should include a consistent starting and ending time to his workday, as well as a normal eight-hour shift without overtime. These restrictions should remain in effect indefinitely.” J.A. at 190. Also, Dr. Hurlbut’s report, contemporaneous with Dr. Gungor’s report and also provided by Tracy to support his appeal of the denial of benefits, paints a similar picture of Tracy: that of one who could work with accommodations. Second, we note that Tracy held two separate jobs while on initial disability leave with Upjohn. From 1997 to 1998 he worked at Westwood Squibb, Bristol-Myers, as a Manager of Global Marketing Research (J.A. at 193), and from 1998 to 1999 Tracy worked at Searle as a Marketing Research Manager for an entire year (J.A. at 193). Tracy has indicated that he was forced to leave 16 his job at Searle because he could not work eleven hours a day. Yet this says nothing about whether he could work a typical eight-hour day. The record does not explain why he left Westwood Squibb. Third and finally, Tracy has stated in various letters and interviews that he believes he is capable of work. In Tracy’s response to Dr. Munson’s request that he complete a medical evaluation form for Defendants, Tracy explained his situation candidly: I really need to qualify for [Upjohn]’s plan to be able to continue with their family healthcare coverage, and to potentially supplement my income, if it is ever needed. I feel like I am between a rock and a hard place. Although I cannot consistenly work eight hours a day, I can be productive. ... Therefore, I need to find temporary consulting positions. However, I need health insurance coverage for me and my family, if I am consulting - which [Upjohn] can provide. J.A. at 182. Tracy has simply not met his burden of establishing that he suffers from a disability preventing him from being gainfully employed. The court is confronted with only pieces of conflicting doctors’ reports that, read together, do not establish that he suffers from a disability preventing him from being gainfully employed anywhere. Based on the totality of the evidence submitted, we agree with the district court that he has not carried his burden to prove he cannot work anywhere. E. The Glenn Decision The recent decision of this court in Glenn v. MetLife, _ F.3d _, 2006 WL 2519293 (6th Cir. Sept. 1, 2006), is not to the contrary. While the decision was for the plaintiff in that case, the salient facts are distinguishable. Moreover, the reasoning in that case is in line with our own and bolsters our own conclusions. 17 Like Tracy’s benefits, Wanda Glenn’s disability benefits were reviewed after a two-year initial disability period. She suffered from “‘severe dilated cardiomyopathy,’ a disease of the heart muscle that causes the heart to become enlarged and, for that reason, to pump inadequately.” Id. at  (internal citations omitted). Her employer’s plan denied her permanent disability benefits after an administrative committee determined that she was not unable to be gainfully employed. That employer’s plan, however, defined permanent disability as, “completely and continuously unable to perform the duties of any gainful work or service for which [she is] reasonably qualified taking into consideration [her] training, education, experience, and past earning.” Id. (emphasis in original). In contrast, the Plan in the instant case defines permanent disability as, “unable to be gainfully employed anywhere,” a more stringent standard. More importantly, in Glenn, the plaintiff’s treating physician, whom she had been seeing for medical treatment for her condition since it was diagnosed, submitted multiple lengthy and thorough reports describing her condition and specifically recommending that she not return to work. Before she went on her initial two-year period of leave, he stated that her “main problem now is stress at work. She ... does have physical as well as psychological stress. ... I feel that she may not be able to continue to work in any kind of environment that would cause any significant physical or psychological stress and demands.” Id. (internal citations omitted). Although her doctor initially predicted that Glenn would be able to return to work, he later determined that her condition would not allow it. “She also continues to have significant difficulty in returning to even any kind of sedentary job because any kind of psychological stress at work causes significant problems with her cardiovascular condition and she decompensates fast.” Id. at 9 (internal citations omitted). In conclusion, the Glenn court held that the administrative committee had erred because, “there was 18 no adequate basis for the plan administrator’s decision not to factor in one of the major considerations in Glenn’s pathology, that of the role that stress played in aggravating her condition and, in the language of the MetLife policy, in preventing her return to ‘gainful work or service for which [she is] reasonably qualified taking into consideration [her] training, education, experience, and past earning.’” Id. at 12-13 (internal citations omitted). In this case, however, there has been no indication that work exacerbates Tracy’s condition or even that he is completely unable to work. Rather, one of his doctors has recommended, “a consistent starting and ending time to his workday, as well as a normal eight-hour shift without overtime” in order to improve his condition. J.A. at 190. While that letter from Dr. Munson is not as recent as Dr. Gungor’s report, it is part of an attending physician’s treatment history that is thoroughly presented in the record. While we would very much appreciate the insight of a more current evaluation, Dr. Gungor’s is sparse and, while the ALJ referred to Dr. Gungor as a treating physician, we have no record of any treatment or of any tests that would lead us to conclude that he is a treating doctor. Most significantly, Dr. Gungor does not explain on what his conclusions are based. Finally, Tracy’s history of work and stock-market activity over the past few years indicates that his present condition has not changed since Dr. Munson wrote his letter and as such does not render him “unable to be gainfully employed anywhere.” J.A. at 428.