Opinion ID: 150414
Heading Depth: 2
Heading Rank: 3

Heading: The administrative appeals and current lawsuit

Text: In April 2002, CUNA sent Gent a letter informing her that, because of the mental illness limitation, her benefits would end in July 2002. When CUNA stopped paying benefits in July 2002, Gent appealed, claiming that the two-year mental-illness cap on benefits did not apply to her because her disability now stemmed from a physical condition, specifically Lyme disease. According to Gent, approximately one year after CUNA started paying her monthly disability benefits (roughly June 2001) a tick bit her, infecting her with Lyme disease. CUNA asked Dr. Scott Yarosh, a psychiatrist, to review Gent's medical records. After review of these records, Dr. Yarosh concluded that Gent was psychiatrically impaired and that the medical records as a whole do not document specific criteria to suggest that there are other disabling medical conditions. CUNA denied Gent's appeal. From November 2002 to March 2006, Gent appealed the adverse benefits determination five more times. Throughout the appeals process, both Gent and CUNA supplemented the administrative record with medical opinions from various doctors. These doctors came to divergent conclusions, with some opining that Gent was disabled by Lyme disease and others that Gent, if disabled, was disabled by a depressive disorder. [2] CUNA rejected four of these five appeals, declining to consider her fifth, the sixth overall, on administrative exhaustion grounds. In June 2006, Gent filed this lawsuit in federal district court. In due course, both she and CUNA moved for summary judgment. As already noted, the district court granted summary judgment to CUNA, upholding the termination of disability benefits.