Opinion ID: 170023
Heading Depth: 3
Heading Rank: 1

Heading: Necessity of Extra-Record Evidence

Text: First, extra-record evidence must be necessary to the district court's de novo review. Hall, 300 F.3d at 1203. Necessary is a term with a spectrum of meanings. At one end, it may import an absolute physical necessity, so strong, that one thing, to which another may be termed necessary, cannot exist without that other; at the opposite, it may simply mean no more than that one thing is convenient, or useful, or essential to another. M'Culloch v. Maryland, 4 Wheat. (17 U.S.) 316, 413, 4 L.Ed. 579 (1819); cf. Colautti v. Franklin, 439 U.S. 379, 400, 99 S.Ct. 675, 58 L.Ed.2d 596 (1979) (necessary in abortion statute suggested indispensable); Comm'r v. Tellier, 383 U.S. 687, 689, 86 S.Ct. 1118, 16 L.Ed.2d 185 (1966) (necessary in tax statute meant appropriate and helpful). Neither end of this spectrum, we think, is appropriate here. Too strict a view of necessity is foreclosed by our very holding in Hall. There, we allowed admission of evidence regarding two surgeries which took place after the closing of the administrative record. The decisive issue in Hall was the degree of the plaintiff's enduring pain, and we agreed with the district court that the fact the plaintiff chose to undergo the surgeries was strong evidence that her pain was real and unrelenting. 300 F.3d at 1206 (internal quotation marks omitted). The evidence was not, however, absolutely indispensable to reviewing the plan administrator's decision. On the other hand, necessary evidence in this context cannot be evidence that is merely convenient, or useful, or conducive to the end of conducting review. Cf. M'Culloch, 4 Wheat. at 413, 415, 4 L.Ed. 579. If this were what the term meant, the admission of extra-record evidence would not be limited to unusual cases or extraordinary circumstances, as we require. See Hall, 300 F.3d at 1206 (quoting Quesinberry, 987 F.2d at 1025). [3] Rather, the term necessary, as we used it in Hall, must be harmonized with its context. Armour & Co. v. Wantock, 323 U.S. 126, 130, 65 S.Ct. 165, 89 L.Ed. 118 (1944). We are guided by our qualification in Hall, following the Fourth Circuit's opinion in Quesinberry, that extra-record evidence may be admitted when `necessary to conduct an adequate de novo review of the benefit decision.' Hall, 300 F.3d at 1202 (emphasis added) (quoting Quesinberry, 987 F.2d at 1025). If, for instance, the administrator based its decision on information not in the record perhaps on principles generally known within the medical communitythe district court likely could not meaningfully review the decision without the admission of that evidence. Or if the court cannot understand abstruse medical terminology central to the issues of a case, the claimant may supplement the record with explanatory evidence. Likewise, if the administrator simply neglected to include in the record exhibits the claimant had submitted to it, those may be offered to the district court. (Even necessary evidence, however, may only be admitted if the other three prongs of the Hall test are satisfied. The consequences of a record insufficient to allow meaningful review will be borne by the party responsible for the insufficiency.) Mr. Jewell suggests that admission of the letters of Dr. Peters and Dr. Caster was justified by one or more of the exceptional circumstances which we said in Hall could warrant the admission of additional evidence. 300 F.3d at 1203. First, Mr. Jewell argues that the proper diagnosis of his disorder is a complex medical question and requires additional explanatory evidence. Appellee's Opening Br. 32. The letters, however, provide no assistance to a court seeking to resolve on de novo review the medical complexities of the case. They state a diagnosis, but there are other diagnoses already in the recordfrom Dr. Peters and Dr. Caster as well as from four other doctors. The letters do not elucidate the medical principles or terminology, nor offer any account of how the facts support the diagnosis. The letters are, in a sense, black boxes: facts go in, diagnoses come out. When doctors offer new or revised diagnoses several years after the fact, one would expect to see explanations of what has changed and why. A doctor's mere announcement of a new conclusion is not evidence genuinely directed toward helping a court engage in de novo review of the decision previously made. Second, Mr. Jewell argues that, by disbelieving what he claims was his doctors' diagnosis of an organic disorder, LINA put the doctors' credibility at issue. The question of the credibility of an expertas opposed to the question of the reliability of the expert's conclusionsconcerns whether the expert is believable. See, e.g., Washington v. Schriver, 255 F.3d 45, 52 (2d Cir.2001). Credibility embraces such matters as professional qualifications, mental capacity, bias and interest, and bad moral character. So, for instance, the size of an expert's fee or the fact that he only testifies for plaintiffs in civil cases may be relevant to his credibility. See Edward J. Imwinkelried, The Silence Speaks Volumes, 1998 U. Ill. L.Rev. 1013, 1034-35. Whether, as is important here, these doctors were correct, or whether their conclusions were based on sufficient evidence and sound medical science, bears on their credibility in no genuine sense. And although LINA's brief before this Court contains a few vague references to the doctors' credibilitycalling them loyal to Mr. Jewell and stating that for reasons we do not know, a few doctors agreed to modify their diagnoses, Appellant's Opening Br. 39, 63those comments were in reaction to the recent letters; the letters were not responsive to any pre-existing challenges to the doctors' credibility. Even if they were, the statements and diagnoses contained in these letters have nothing to do with the doctors' qualifications, bias or interest, or the like. We cannot conclude that consideration of these letters would be at all helpful to evaluating the doctors' credibility, properly understood; still less that the district court could not conduct meaningful review without them. Mr. Jewell further argues that the letters are necessary to prove that his disability is ongoing. Dr. Caster's letter, in particular, indicates that, although Mr. Jewell's financial situation had improved by the time of writing, nevertheless this man can not be gainfully employed, and his [sic] is unable to adequately function, not only because of poor cognitive processing and poor attention and difficulties around cognition, but also because of a worsening at these times of his depression. App. 744. LINA, however, does not contest that Mr. Jewell is disabled, or indeed that he has been since it began paying him benefits in 1998. The issue in this case is the cause of his disability, not its duration. Nor has Mr. Jewell presented any evidence or argument tending to show that the ongoing character of his disability would be proof of an organic cause. Because the necessity of extra-record evidence must be established by its proponent, see Hall, 300 F.3d at 1203, Mr. Jewell has not met his burden with respect to this argument.