Opinion ID: 152240
Heading Depth: 3
Heading Rank: 7

Heading: The Moving Target

Text: Another sign of MetLife's arbitrary and capricious decision-making is that it repeatedly moved the target. Over the course of the administrative appeals, MetLife invited additional evidence to establish disability, but when Holmstrom provided it, MetLife repeatedly found that the new evidence was not sufficient under new standards or expectations that had not been communicated to Holmstrom. Such conduct frustrates fair claim resolution and is evidence of arbitrary and capricious behavior. See Dabertin v. HCR Manor Care, Inc., 373 F.3d 822, 831 (7th Cir.2004) (administrator unfairly imposed new, undisclosed requirements on claimant for severance benefits; an ERISA benefit cannot be a moving target where the plan administrator continues to add conditions precedent to the award of benefits); Bard v. Boston Shipping Ass'n, 471 F.3d 229, 237 (1st Cir.2006) (awarding disability benefits where claimant was faced with a constant shift in what he was required to show, and thus administrator's conduct was arbitrary and capricious in that it failed to consider the evidence he submitted in an attempt to meet a moving target). [14] As described above, MetLife moved the target regarding both the cognitive testing and functional capacity evaluation. MetLife made general requests. Holmstrom complied with the requests as a reasonable person would understand them. MetLife then rejected the new information for failure to meet new requirements that had not been revealed beforehand. An even more troubling example of moving the target was MetLife's decision to discount all medical evidence obtained after the initial termination of benefits on August 5, 2005. Since that date, MetLife has asked for a significant amount of medical data, some of which could be provided only by conducting new tests. Yet in its final October 2007 denial, MetLife stated its general disregard for Holmstrom's many 2007 submissions because it would instead need additional medical information dating to the time the claim was terminated. In the same denial letter, MetLife employed a similar strategy to get around its own consultant's determination that Holmstrom indeed had disabling physical deficits: Although [Dr. Manolakas] noted that currently [Holmstrom] would be limited to occasional [function] in an eight hour work [day], the time period in review is effective August 6, 2005. In its brief on appeal, MetLife emphasized Dr. Manolakas' use of the word currently to express only Holmstrom's condition as of September 2007, claiming that she had failed to establish that she was disabled as of August 2005. MetLife Br. 30. As the district court properly pointed out, accepting this argument would mean that MetLife's initial termination of benefits for lack of supporting evidence could never be successfully appealed if the claimant had not already undergone functional testing (that satisfied MetLife's precise but not-yet-unarticulated specifications) before the August 2005 termination decision. Holmstrom v. Metropolitan Life Ins. Co., 615 F.Supp.2d 722, 745 (N.D.Ill.2009). MetLife asked Holmstrom to undergo more testing, and rejected the results at least in part because the testing was not done before it made the request. That behavior also reflects arbitrary and capricious decision-making.