Opinion ID: 794560
Heading Depth: 3
Heading Rank: 4

Heading: CCC and the District Court Failed to Consider Smith's Medications

Text: 73 Following the final denial letter sent to Smith by CCC on September 14, 2001, Smith contacted CCC and asked them to consider the effects of the multiple medications that she is required to take in order to control her symptoms. In support of her argument, Dr. Van Bussum drafted a letter listing Smith's many medications, including Synthroid, Prozac, Neurontin, Oxycontin, Lortab, Fioricet, Zanaflex, Trazadone, Vivelle, Vioxx, Toradol, and Pycnogenol. Van Bussum stated that in my medical opinion, it would be very difficult to function under any circumstances while under the influence of these medications. JA 143. CCC acknowledged receipt of this letter, and in their November 26, 2001, response stated [t]his information does not warrant a change in our decision. Previously, we reviewed a listing of your client's pharmacy statements and were aware of the medication being prescribed. JA 141. 74 In support of Smith's argument that the effects of her many medications should have been considered in her disability determination, she cites Adams v. Prudential Ins. Co. of America, 280 F. Supp 2d 731 (N.D.Ohio 2003). In Adams, the court found that the plan administrator's denial of Adam's disability benefits was arbitrary and capricious because the administrator failed to consider the effects of Adams' multiple medications on his ability to perform his job. Id. at 740. Like Smith, Adams was taking Oxycontin and other narcotic pain relievers to manage his symptoms. Id. Adams' personal physician opined that these medications would impede Adams' ability to work at any job. Id. However, Prudential's reviewing physician merely listed Adams' medications in his report without discussing any possible effects the drugs might have on Adams' ability to do his job. 75 Like Adams, Smith's personal physician opined that the effects of Smith's many medications would make it impossible for her to function under any circumstances. However, in the peer review letter, Kaplan does not address Smith's medications except to list some of them and state that Dr. Dubal has prescribed OxyContin, Vioxx, and Skelaxin and reported that `she is getting (the) most benefit out of this medication without side effects.' JA 179. In fact, Kaplan never saw the letter drafted by Van Bussum concerning Smith's medications at all, because CCC failed to forward it to him. 76 CCC argues that Adams is distinguishable, because Kaplan did address Smith's medications in his peer review report, as noted above. Further, CCC states that: [a]ppellant had taken the vast majority of the medications listed by Dr. Van Bussum while she performed the duties of her occupation before claiming disability. Br. of Appellee at 47. CCC argues that the only new medications added since Smith claimed that she was disabled were Trazadone, an anti-depressant, Toradol, a form of ibuprofen, and Pycnogenol, an anti-oxidant. Id. 77 We find CCC's argument unconvincing. CCC's failure to adequately consider the number and nature of the medications Smith was taking, its failure to have Dr. Van Bussum's letter evaluated by Kaplan coupled with Kaplan's cursory discussion and careful selection of a single comment in the pain specialist's progress note supports Smith's argument that her disability determination was arbitrary and capricious. 78