Rowe v. United Of Omaha – Failure To Apply For Social Security Disability Not Relevant

United of Omaha denied Rowe’s long-term disability (LTD) claim for chronic back pain and insomnia, and a Magistrate Judge recommended remand after finding the denial didn’t survive arbitrary-and-capricious review — largely because United of Omaha never made clear which medical opinions it credited or why. United of Omaha objected on two main grounds, arguing the wrong standard of review applied and that Rowe’s failure to apply for Social Security disability benefits should have counted against her; the district court rejected both objections and adopted the recommendation to remand.

Procedural History: This case was before the District Court on the Report and Recommendation (“R&R”) issued by a United States Magistrate Judge. In the R&R, the Magistrate Judge recommended that the plaintiff’s Motion for Judgment on the Record be granted in part and that the defendant’s Motion for Judgment on the Administrative Record be denied. The Defendant filed an objection to the R&R, and the plaintiff responded.

Issues: In the R&R, the Magistrate Judge found that the defendant’s decision to deny benefits does not withstand the arbitrary and capricious standard of review and recommended that the case be remanded for further consideration. Defendant raises four objections to the R&R. The two most interesting objections were those where the defendant objected to (1) the application of the arbitrary and capricious standard of review and (2) the determination that the plaintiff’s failure to apply for Social Security benefits is irrelevant.

Holdings: (1) “Therefore, while Judge Shirley may not have directly cited to McClain, he cited other Sixth Circuit case law that makes the same point—that arbitrary and capricious review is highly deferential and that an administrator’s decision will be upheld ‘if it is the result of a deliberate, principled reasoning process and if it is supported by substantial evidence.’” The Court continued, “defendant’s argument that Judge Shirley was incorrect to base his decision on the fact that defendant did not clearly articulate in its denials which medical opinions it credited and to what extent is not well taken.”

(2) “While a disability determination made by the SSA is relevant, defendant has not cited, and the Court is not aware of, any authority for the proposition that a failure to apply for benefits is similarly relevant. Furthermore, in the R&R, Judge Shirley declined to consider that the plaintiff failed to apply for Social Security benefits in part because the defendant ‘did not consider the plaintiff’s alleged failure to file for Social Security benefits at the administrative level’.”

Here is a PDF copy of the decision: Rowe v. United of Omaha