{"id":7458,"date":"2020-04-06T18:03:38","date_gmt":"2020-04-06T23:03:38","guid":{"rendered":"https:\/\/www.nickortizlaw.com\/?p=7458"},"modified":"2024-04-29T16:51:53","modified_gmt":"2024-04-29T21:51:53","slug":"black-v-metlife-social-media-surveillance-leads-to-termination-of-benefits","status":"publish","type":"post","link":"https:\/\/www.nickortizlaw.com\/black-v-metlife-social-media-surveillance-leads-to-termination-of-benefits\/","title":{"rendered":"Black v. MetLife &#8211; Social Media Surveillance Leads to Termination of Benefits"},"content":{"rendered":"\n<p><strong>Case Name: <\/strong>Sherri Black v. Metropolitan Life Insurance Company<\/p>\n\n\n\n<p><strong>Court:&nbsp;<\/strong>U.S. District Court for the Western District of Michigan<\/p>\n\n\n\n<p><strong>Date of Decision:&nbsp;<\/strong>March 21, 2017<\/p>\n\n\n\n<p><strong>Type of Claim: <\/strong><a href=\"https:\/\/www.nickortizlaw.com\/practice-areas\/long-term-disability-insurance-erisa-lawyer\/\">Long-Term Disability<\/a><\/p>\n\n\n\n<p><strong>Insurance Company:&nbsp;<\/strong><a href=\"https:\/\/www.nickortizlaw.com\/insurance-companies\/metlife\/\">Metropolitan Life Insurance Company (MetLife)<\/a><\/p>\n\n\n\n<p><strong>Claimant\u2019s Employer:&nbsp;<\/strong>Visteon Corporation<\/p>\n\n\n\n<p><strong>Claimant\u2019s Occupation \/ Job Position:&nbsp;<\/strong><a href=\"https:\/\/www.nickortizlaw.com\/occupations-that-qualify-for-ltd\/managers\/\">Senior Human Relations Manager<\/a><\/p>\n\n\n\n<p><strong>Disabilities:&nbsp;<\/strong>After a motor vehicle accident in 2008, the claimant suffered exacerbated pre-existing problems that she had with her right shoulder, left knee, and neck. X-rays of the claimant\u2019s neck, right shoulder, and knees showed degenerative changes. The previous MRI study on the claimant\u2019s cervical spine revealed \u201ca lot of progression of the degenerative change described at C5-C6.\u201d<\/p>\n\n\n\n<p><strong>Definition of Disability:&nbsp;<\/strong>The subject Long Term Disability Policy defines \u201cdisabled\u201d or \u201cdisability\u201d as:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Due to Sickness or as a direct result of accidental injury:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>You are receiving Appropriate Care and Treatment and complying with the requirements of such treatment; and<\/li>\n\n\n\n<li>During the first 24 months of Sickness or accidental injury, You are unable to perform each of the material duties of Your own job; and<\/li>\n\n\n\n<li>After such period, You are unable to perform the duties of any gainful occupation for which You are reasonably qualified taking into account Your training, education and experience.<\/li>\n<\/ul>\n<\/blockquote>\n\n\n\n<p><strong>Benefits Paid?&nbsp;<\/strong>Yes. MetLife approved the claimant for continuing LTD benefits under the \u201cany gainful occupation\u201d portion of the definition of \u201cdisability.\u201d<\/p>\n\n\n\n<p><strong>Basis For Denial \/ Termination of Benefits:&nbsp;<\/strong>In the fall of 2014, MetLife\u2019s Special Investigation Unit requested Ethos Risk Services to perform an Internet Data Investigation of the <a href=\"https:\/\/www.nickortizlaw.com\/social-media-used-to-deny-claims\/\">claimant\u2019s activity on social media websites<\/a>. On October 21, 2014, MetLife received the Internet Data Investigation Report containing information for social media sites Facebook, MyLife, Pinterest, Google+, and LinkedIn. Based on the claimant\u2019s postings, the report disclosed that the claimant traveled from her residence in Northville, Michigan, to Chicago for dinner with friends on March 6, 2014, and attended a wedding on February 24, 2014. In addition, the report disclosed that the claimant was enrolled in a doctoral program through the Center for Values-Driven Leadership at Benedictine University in Illinois, with a graduation date of 2016. The report also indicated that the claimant had traveled to Dubai to present a paper at a conference.<\/p>\n\n\n\n<p>On December 15, 2014, MetLife sent the claimant a letter notifying her of MetLife\u2019s decision to terminate her LTD benefits because the medical information showed that she purportedly no longer met the definition of disability. In its letter, MetLife cited certain medical records indicating an improvement in the claimant\u2019s medical impairments and Dr. Peters&#8217; report.<\/p>\n\n\n\n<p><strong>Procedural History:\u00a0<\/strong>The claimant\u2019s LTD benefits were terminated. On June 15, 2015, the claimant filed an appeal with MetLife and submitted additional medical records and notes from physical therapy. In connection with the appeal, MetLife referred Black\u2019s claim file to Robert H. Bolt, M.D., an <a href=\"https:\/\/www.nickortizlaw.com\/responding-to-peer-review-reports-in-long-term-disability-appeals\/\" data-type=\"post\" data-id=\"7949\">independent physician consultant (IPC)<\/a> board-certified in orthopedic surgery, for his opinion on Black\u2019s restrictions and limitations. Dr. Bolt issued an initial report and two supplemental reports. In his initial report, dated February 16, 2015, Dr. Bolt conducted an extensive review of Black\u2019s medical file spanning 2008, just after the accident, through early 2015, noting her diagnoses of\u00a0<a href=\"https:\/\/www.nickortizlaw.com\/practice-areas\/long-term-disability-insurance-erisa-lawyer\/medical-conditions\/degenerative-joint-disease\/\">degenerative joint disease<\/a>\u00a0bilateral shoulders, degenerative joint disease bilateral knees,\u00a0cervical spine spondylosis\u00a0and radiculitis,\u00a0low <a href=\"https:\/\/www.nickortizlaw.com\/practice-areas\/long-term-disability-insurance-erisa-lawyer\/medical-conditions\/back-pain\/\">back pain<\/a>\u00a0secondary to deconditioning, and\u00a0<a href=\"https:\/\/www.nickortizlaw.com\/practice-areas\/long-term-disability-insurance-erisa-lawyer\/medical-conditions\/ptsd\/\">post-traumatic stress disorder<\/a>.<\/p>\n\n\n\n<p>Plaintiff sued Defendant MetLife, pursuant to the <a href=\"https:\/\/www.nickortizlaw.com\/ltd-faq\/what-is-erisa-and-what-does-it-have-to-do-with-my-ltd-claim\/\">Employee Retirement Income Security Act of 1974 (\u201cERISA\u201d)<\/a>, 29 U.S.C. \u00a7\u00a7 1001 et seq., seeking review of MetLife\u2019s decision to discontinue Black\u2019s long-term disability benefits as of December 15, 2014. The parties filed cross-motions for judgment based on the Administrative Record.<\/p>\n\n\n\n<p><strong>Other important factors:&nbsp;&nbsp;<\/strong>In a call with MetLife, the claimant\u2019s physical therapist opined she could perform sedentary occupations (desk jobs), even with her impairments.<\/p>\n\n\n\n<p><strong>Key Physician Opinions: <\/strong>Based on the Internet Data Investigation Report, MetLife obtained an updated clinical opinion from MetLife Senior Medical Director David S. Peters, M.D. Dr. Peters opined on the claimant\u2019s restrictions and limitations as follows:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n[T]here are significant cervical spine MRI findings and mildly decreased shoulder [range of motion]. Dr. Salamon has documented knee crepitation. Social media sites revealed her to be active and, in my opinion, restricted fulltime (8 hours daily) primarily seated work should be possible while continuing evaluation and treatment of her conditions. In my opinion, she should not be required to climb ladders and standing\/walking should be limited to 20 minutes per hour and to a daily total of 2.5 hours. She should not be required to work at or above shoulder level on the affected side. Lifting\/carrying\/pushing\/pulling should be limited to 10 pounds or less occasionally. She should be able to shift positions when seated and have 2-3 minute \u201cstand and stretch\u201d periods at least every hour in addition to standard morning, afternoon and lunch breaks. There is no detailed description of elbow, hand or wrist impairments and constant handling, feeling, fine fingering and grasping should be possible.<\/p>\n<\/blockquote>\n\n\n\n<p>After her benefits were terminated, the claimant appealed. In connection with the appeal, MetLife referred Black\u2019s claim file to Robert H. Bolt, M.D., an \u201cindependent physician consultant\u201d (IPC) board-certified in orthopedic surgery, for his opinion on Black\u2019s restrictions and limitations. Dr. Bolt issued an initial report and two supplemental reports.<\/p>\n\n\n\n<p>On April 29, 2015, Dr. Bolt issued his second supplemental report based on new information from MetLife regarding the course requirements for the claimant\u2019s graduate studies. Dr. Bolt stated:<br>This [new information] does change my opinion. It states fairly clearly what is required of Ms. Black and, since she is getting a 4.0 GPA, she must be following those requirements. From this description, it appears that Mrs. Black can sit unlimited in an 8 hour day. She should be able to change positions as needed to standing and stretching for 5 to 10 minutes. As far as standing and walking is concerned, I feel that she does have some limitations and could stand and walk no more than 2 hour [sic] cumulatively in an 8 hour day but total work time could add up to 8 hours. I reviewed the Diary Notes hoping to find a recent conversation with Ms. Black where she described exactly what she does for her classes but that did not appear to be available. Also missing from the record are clinical reports from Dr. Neuschwander [sic] and Dr. Salamon\u2019s response to my report which is still pending.<\/p>\n\n\n\n<p><strong>Issues: <\/strong>\u201cThe administrative record in this case leaves no doubt that the 2008 accident exacerbated preexisting conditions that Black had in her knees, right shoulder, and neck and that these injuries caused her pain which precluded her from performing the duties of her position at Visteon. There is also no question that Black continued to suffer from the pain and effects of her injuries over the next several years. The question for this Court, however, is whether Black\u2019s functional capacity showed improvement to the point that she was able to perform the duties of a sedentary occupation at the time MetLife terminated her benefits.\u201d<\/p>\n\n\n\n<p><strong>Holdings: <\/strong>\u201cThe evidence MetLife received in 2014, and in 2015 after Black appealed MetLife\u2019s initial denial, showed that Black\u2019s physical condition had in fact improved sufficiently to allow her to perform sedentary work.\u201d<\/p>\n\n\n\n<p><strong>Noteworthy court comments: <\/strong>\u201cThe Policy required Black to submit proof, satisfactory to MetLife, that she continued to be disabled not just from performing the duties of her prior occupation with Visteon, but \u201cany gainful occupation for which [she was] reasonably qualified taking into account [her] training, education, and experience.\u201d Pursuant to this provision, Black had the burden of proving that she continued to be disabled; MetLife was not obligated to prove that Black was not disabled.\u201d<\/p>\n\n\n\n<p>\u201cBlack argues that MetLife\u2019s reliance on the attendance requirements of the Benedictine doctoral program\u2014full days at least one weekend per month\u2014and Black\u2019s trip to Dubai as part of that program to conclude that Black is not disabled from performing full-time work is \u201cabsurd\u201d because the number of days Black spent attending class (approximately 56 per year) is much less than the approximately 250 days per year that Black would be required to spend at full-time employment. While Black is correct that her attendance at the doctoral program cannot be equated to full-time work, her class attendance (as well as the out-of-class work she did toward completion of that program) is still material to whether she was disabled. First, her participation in the program, including travel to Illinois and attendance of classes at least one weekend per month, shows that she was not as limited as she claimed. For example, in her January 15, 2015, letter to MetLife, Black said that she could not \u201cbe up for more than a few hours and must rest . . . [and was] in constant pain.\u201d The fact that Black was able to travel several hours and sit through daylong classes shows that Black was not as limited as she claimed. Second, the fact that Black was able to earn and maintain a 4.0 GPA in a doctoral program\u2014certainly no easy feat\u2014undermines Dr. Neuenschwander\u2019s opinion that Black suffered from \u2018extreme fatigue, easy fatigability [sic], brain dysfunction (consistent with traumatic brain injury) and PTSD symptoms.\u2019\u201d<\/p>\n\n\n\n<p><strong>Summary: <\/strong>The Court denied the plaintiff\u2019s motion, granted MetLife\u2019s motion, and affirmed MetLife\u2019s decision to discontinue benefits.<\/p>\n\n\n\n<p><strong>Disclaimer:<\/strong> The Ortiz Law Firm did not handle this claim. It is merely summarized here to provide claimants with a better understanding of how Federal Courts handle long-term disability insurance claims.<\/p>\n\n\n\n<p>Here is a copy of the decision in PDF: <a href=\"https:\/\/www.nickortizlaw.com\/wp-content\/uploads\/2020\/04\/Black-v.-MetLife-W.D.-Mich-Mar-21-2017.pdf\">Black v. MetLife<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this case, the court found that the evidence MetLife received in 2014, and in 2015 after Black appealed MetLife\u2019s initial denial, showed that Black\u2019s physical condition had in fact improved sufficiently to allow her to perform sedentary work<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[258],"class_list":{"0":"post-7458","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-case-summary-blog","7":"tag-metlife","8":"entry"},"_links":{"self":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/7458"}],"collection":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/comments?post=7458"}],"version-history":[{"count":0,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/7458\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/media?parent=7458"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/categories?post=7458"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/tags?post=7458"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}