Opinion ID: 665833
Heading Depth: 2
Heading Rank: 2

Heading: Review of MetLife's Decision to Deny Benefits

Text: 18 Our review of MetLife's decision under the arbitrary and capricious standard is a review and not a rubber stamp. Nevertheless, we must conclude that MetLife's determination to deny Ms. Donato benefits was not unreasonable. As the district court stated, MetLife's decision simply came down to a permissible choice between the position of UMAC, MetLife's independent medical consultant, and the position of Ms. Donato's clinical ecologists, Drs. Shambaugh, Randolph, and Ross. Cf. Allison v. Dugan, 951 F.2d 828, 833 (7th Cir.1992) (finding decision not to be arbitrary and capricious where challenger to denial of benefits could not show that the denial decision  'was so implausible based on the evidence that it could not be ascribed to a difference in view' ) (citation omitted). The position of UMAC was that Ms. Donato's hypersensitivity, based on clinical ecology, which is not supported by the AMA, the American College of Physicians, or any other recognized medical body, was not an acceptable ground for finding total disability. Plainly, MetLife acted entirely reasonably in denying benefits for a disability based on such a questionable medical theory. 19 We need to touch briefly on two related matters. First, Ms. Donato emphasizes that she was granted Social Security benefits. At oral argument, her counsel asserted that, although MetLife was not bound to follow Social Security's determinations, it would have been arbitrary and capricious for MetLife not to have considered any medical evidence contained in that file. Whatever the merits of such an assertion, the fact is that, although MetLife was apprised of this contrary determination, the Social Security file was never before MetLife in making Ms. Donato's benefits determination, and MetLife was bound only to consider what evidence and information it had before it. Second, Ms. Donato maintains that, even if there is no scientific basis for a disability based on an environmental illness, a psychiatric basis for her symptoms should render her eligible for disability benefits. Again, Ms. Donato failed to submit any medical proof that she is psychiatrically disabled. UMAC II noted that her medical records indicated that a psychiatrist found Ms. Donato to be severely depressed; UMAC II also pointed out that the types of symptoms associated with environmental illness may be explained by a psychiatric disorder. However, no clinical evidence linking Ms. Donato's symptoms with such a psychiatric disorder was ever submitted. Nor was any evidence submitted to MetLife that would support the conclusion that Ms. Donato's depression, regardless of treatment, would constitute a total disability.