Mozdziers v. Aetna – Video Surveillance Supports LTD Claim Denial

Mozdzierz sought long-term disability (LTD) benefits from Aetna under an ERISA-governed plan, but the court upheld Aetna’s denial, finding it did not abuse its discretion. The case is worth noting for the court’s discussion of video surveillance as investigatory evidence in long-term disability claims.

Use of Video Surveillance in a Long-Term Disability Claim

In Mozdzierz, the Plaintiff demonstrated poor performance on the functional capability evaluation, and there was significant evidence – both from his treating physicians and Defendant’s independent medical reviewers – suggesting that Plaintiff may be exaggerating his condition. Because of this, Aetna obtained video surveillance of the claimant doing some pretty heavy duty yard work. The court found that such surveillance is significant support for denying a plaintiff’s claim:

As mentioned above, Defendant’s decision finds significant support in the surveillance video itself. The video depicts activity levels inconsistent with a claim of total disability. Surveillance is a legitimate investigatory tool used by plan administrators. Russell v. Paul Revere Life Ins. Co., 288 F.3d 78, 81 (3d Cir. 2002). Courts are reluctant to find a benefits termination to be arbitrary and capricious where a surveillance video “indicates that a claimant’s physical limitations do not match either his own description of his limitation or the opinions of his treating physicians.” Eppley, 789 F. Supp. 2d at 573. The surveillance video of Plaintiff shows him performing strenuous activities in his yard, including raking, digging, and mending a fence. He is seen bending, kneeling, walking, and lifting without any problems.

Although not dispositive of the question of whether or not he is capable of performing the sedentary occupation of computer programmer, the video does not support his claims of total disability and of an inability to sit and drive longer than ten minutes. The surveillance video is part of a record that, when viewed as a whole, calls into serious question Plaintiff’s claims. Nothing contained in the Administrative Record, or in the initial termination letter or subsequent appeal denial letters, suggest that Defendant relied upon the surveillance video alone in terminating Plaintiff’s disability benefits. The surveillance video did, however, provide Defendant with additional proof to conclude Plaintiff did not meet the definition of “totally disabled” under the Plan, when viewed along with all of the available medical information.

Get Help with Your Long-Term Disability Denial

If Aetna or any other insurer has denied a claim for long-term disability benefits — including one involving video surveillance evidence — it is imperative to consult an attorney before handling an appeal alone. Anyone with questions about how surveillance affects a claim can contact the firm or call (888) 321-8131 for a free case evaluation.

Here is a PDF copy of the decision: Mozdzierz v. Aetna