Opinion ID: 171114
Heading Depth: 3
Heading Rank: 2

Heading: Chalker’s Arguments

Text: Chalker briefly advances several arguments in an effort to prove that MetLife’s decision was arbitary and capricious. We consider each in turn. 1. MetLife did not consider information provided by Chalker’s treating physicians Chalker’s argument that MetLife failed to consider information provided by his treating physicians is unavailing. There is no evidence in the record suggesting that MetLife ignored the reports of Drs. McBride and Jepson; indeed, the evidence is to the contrary. MetLife consistently provided the reports of Drs. McBride and Jepson to the IPCs who independently evaluated Chalker’s condition. Although Chalker may disagree with the analysis of the IPCs, there is simply no evidence that MetLife failed to consider the materials provided by his treating physicians. As the Supreme Court indicated in Black & Decker Disability Plan v. Nord, 538 U.S. 822, 834 (2003): Plan administrators, of course, may not arbitrarily refuse to credit a claimant’s reliable evidence, including the opinions of a treating physician. But, we hold, courts have no warrant to require administrators automatically to accord special weight to the opinions of a claimant’s physician; nor may courts impose on plan administrators a discrete burden of explanation when they credit reliable evidence that conflicts with a treating physician’s evaluation. Thus, it was not arbitrary and capricious for MetLife to credit the reports of the two IPCs rather than the reports of Drs. McBride and Jepson; MetLife did not - 11 - owe the opinions of Drs. McBride and Jepson any special deference. Meraou v. Williams Co. Long Term Disability Plan, 221 Fed. App’x 696, 702 (10th Cir. 2007) (unpublished opinion) (asserting that “[i]n ERISA cases no special deference is due the opinion of the claimant’s treating physician.”). 2. MetLife relied upon a flawed and inconsistent FCE Chalker also asserts that numerous flaws with the FCE rob it of any utility in assessing whether he ought to receive LTD benefits. In Buckardt, 221 Fed. App’x at 736, this court considered the utility of FCEs that “contain[ed] some contradictory findings....” At issue there were FCEs that asserted the claimant had to change postures frequently during the evaluation, experienced high pain levels at certain times during the testing, reported difficulty sitting, standing, walking, and lifting, and reported pain that prevented her from hobbies, sports, sexual relations, chores, and work. However, despite noting these difficulties, both [FCEs] ultimately concluded that [the claimant] was capable of modified sedentary work. Id. Despite these contradictory findings, this court nevertheless asserted that the administrator could rely on the FCEs, as under the arbitrary and capricious standard of review, “‘[t]he Administrator[’s] decision need not be the only logical one nor even the best one. It need only be sufficiently supported by facts within [his] knowledge to counter a claim that it was arbitrary and capricious.’” Id. (quoting Kimber, 196 F.3d at 1098.) The same notion rings true in this case. Although there may well be some flaws with the FCE, it is not so flawed that it could not have provided MetLife - 12 - with any reasonable basis to terminate Chalker’s LTD benefits. That is, the evidence is of the sort that “a reasonable mind could accept as sufficient.” Adamson v. UNUM Life Ins. Co. of Am., 455 F.3d 1209, 1212 (10th Cir. 2006). 3. MetLife relied upon the opinions of IPCs whose qualifications with respect to fibromyalgia were not established Next, Chalker contends that the qualifications of Drs. Schmidt and Mody with respect to fibromyalgia were not established. Drs. Schmidt and Mody, however, are both Board Certified in Rheumatology; “rheumatology is the relevant specialty for fibromyalgia.” Howell v. Astrue, 248 Fed. App’x 797, 798 (9th Cir. Sept. 19, 2007) (unpublished). Nevertheless, Chalker contends that “[a]lthough fibromyalgia may generally be included within the field of rheumatology, that does not mean all rheumatologists are qualified to handle fibromyalgia cases.” While it is no doubt true that some rheumatologists have more expertise in fibromyalgia than others, it cannot be said that MetLife’s reliance on the opinions of two independent, board certified rheumatologists was arbitrary and capricious. Although MetLife may have been better served by finding rheumatologists with fibromyalgia specialties, it cannot be concluded that doing so was required under the arbitrary and capricious standard of review. Again, the opinions of Drs. Mody and Schmidt, provided evidence of the sort that “a reasonable mind could accept as sufficient.” Adamson, 455 F.3d at 1212. - 13 - 4. Defendants relied upon the opinions of IPCs who disagreed Next, Chalker points out that Drs. Mody and Schmidt disagreed regarding the level of work he was capable of performing. In this respect, Dr. Mody concluded that Chalker was capable of sedentary work, while Dr. Schmidt concluded that Chalker was capable of light level work. This disagreement, however, is of no aid to Chalker’s claim. While Drs. Mody and Schmidt may have disagreed about the level of work Chalker was capable of, they did not disagree that Chalker was capable of performing some level of work. And whether that work be at a sedentary or light level is immaterial in deciding whether MetLife arbitrarily and capriciously denied Chalker LTD benefits. 5. Defendants failed to consider Chalker’s medication/pain/or other circumstantial evidence in determining whether he was disabled Finally, Chalker asserts, without elaborating, that MetLife ignored Chalker’s medication schedule, constant pain, and “other circumstantial evidence” in concluding that he was no longer qualified for LTD benefits. Because Chalker does not extrapolate on these arguments, it is difficult to determine his precise claims. In any case, the arguments are of no aid to Chalker in surmounting the arbitrary and capricious standard of review. Again, the question for this court is not whether MetLife made the “correct” decision in terminating Chalker’s LTD benefits. Instead, the question is whether MetLife had a reasonable basis for the decision that it made. We are - 14 - confident that it did. In determining that Chalker was not qualified for LTD benefits, MetLife relied on the evaluations of two independent, board certified rheumatologists as well as the independent FCE, all of which suggested that Chalker could perform some level of work. While Chalker may be able to dispute this evidence, he cannot contradict it to such an extent that it can be said MetLife’s decision was arbitrary and capricious.