{"id":7449,"date":"2020-04-06T14:40:37","date_gmt":"2020-04-06T19:40:37","guid":{"rendered":"https:\/\/www.nickortizlaw.com\/?p=7449"},"modified":"2024-01-04T17:40:49","modified_gmt":"2024-01-04T22:40:49","slug":"bowman-v-reliance-standard-court-rules-denial-not-arbitrary-capricious","status":"publish","type":"post","link":"https:\/\/www.nickortizlaw.com\/bowman-v-reliance-standard-court-rules-denial-not-arbitrary-capricious\/","title":{"rendered":"Bowman v. Reliance Standard – Court Rules Denial Not Arbitrary & Capricious"},"content":{"rendered":"
Anthony Bowman (\u201cBowman\u201d) was employed as a Maintenance Mechanic which required the ability to do heavy lifting between fifty and sixty pounds. Injuries throughout his life caused him to have a number of surgeries and resulted in chronic neck<\/a> and back pain<\/a>. Bowman also had issues with a sleep disorder<\/a> and pain medication, which led to problems with concentrating and performing sedentary tasks. As a result of his injuries, Bowman applied for long term disability benefits with Reliance Standard Life Insurance Co.\u00a0(\u201cReliance\u201d)<\/a>.<\/p>\n Reliance approved the disability application because Bowman could not perform his duties as a Maintenance Mechanic. Subsequently, he was also approved for disability benefits by the Social Security Administration. After a two-year period of paying benefits, Reliance\u2019s policy required a re-evaluation of the long-term disability benefits. The definition of total disability after the two years required that the claimant be unable to perform any job duties, not simply his previous job\u2019s duties.<\/p>\n At this time, Reliance provided Bowman with a questionnaire and contacted his three physicians: Dr. Cordover, Dr. Connolly, and Dr. DeBerry. Dr. Cordover suggested that Bowman could \u201cperform[] full-time work\u201d with few limitations, but had concerns about \u201crepetitive bending, squatting, stopping, etc.\u201d In addition, a specific part of the questionnaire asked whether Bowman\u2019s medications caused: \u201c(1) no significant effect, (2) some limitations, (3) severe and limiting side effects, or (4) total restriction and inability to function productively.\u201d Dr. Cordover cited that the medications that Bowman was taking caused \u201csevere and limiting side effects.\u201d<\/p>\n Dr. DeBarry stated that \u201c[i]t has been determined that [Bowman] is disabled . . . and in my opinion has not improved over the past 2-3 years.\u201d He did, however, \u201cdefer all functional capacity evaluations and further prognosis to [Bowman\u2019s] back specialist Dr. Cordover.\u201d Dr. Connolly, Bowman\u2019s doctor who treated him for idiopathic hypersomnia and obstructive sleep apnea, was also contacted but provided no comments on Bowman\u2019s disability level.<\/p>\n Reliance then decided that while Bowman did have a disability, he was not totally disabled under their definition because he was not unable to work in any capacity. Therefore, Reliance denied Bowman\u2019s claim. Bowman then appealed, and in the meantime, Reliance received information from Dr. Cordover citing Bowman\u2019s \u201cprogressing\u201d neck symptoms, but also citing \u201cno change in [Bowman\u2019s] restrictions or forms that [Dr. Cordover] ha[d] filled out previously.\u201d Reliance then sought to obtain evaluations from a Dr. Denver and Dr. Goldstein, both independent medical examiners<\/a>.<\/p>\n Dr. Denver reviewed Bowman\u2019s medical files and eventually opined that Bowman was able to perform full-time work with light physical demand, as long as he could change positions every forty minutes. He cited that Bowman\u2019s \u201ccurrent medications . . . do not contribute to any significant limiting physical or cognitive deficits\u201d and that he \u201creports hydrocodone worsens insomnia and dulls his senses[,] but the documentation fails to substantiate significant impairment in cognition or physical function resulting from hydrocodone use.\u201d<\/p>\n