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Anxiety/Depressive Disorder and the 24 Month Cap-W.D. Va.

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  • Anxiety/Depressive Disorder and the 24 Month Cap-W.D. Va.

    In a Western Virginia case, the court examines the Plaintiff's claim for disability payments and whether his disability was caused or contributed by an anxiety or depressive disorder. With respect to the differing medical opinions produced in the case, the court found that:

    LINA was entitled to favor the opinions of Drs. Abraham, Banks, and Antonelli that Plaintiff was capable for working an 8-hour workday, especially in light of Dr. Diminick’s often sparse justifications for his conclusions and Plaintiff’s restrictions, which sometimes exceeded Diminick’s bailiwick as an orthopedist. Evans v. Eaton Corp. Long Term Disability Plan, 514 F.3d 315, 323–26 (4th Cir. 2008) (affirming ERISA disability denial under abuse of discretion standard with conflicting testimony from treating and reviewing physicians); Booth v. Wal-Mart Stores, Inc. Assocs. Health & Welfare Plan, 201 F.3d 335, 345 (4th Cir. 2000) (“it is not an abuse of discretion for a plan fiduciary to deny . . . benefits where conflicting medical reports were presented”). Moreover, LINA was neither required to accept or allowed to reject Plaintiff’s account of his pain out of hand, DuPerry v. Life Ins. Co. of N. Am., 632 F.3d 860, 874 (4th Cir. 2011), and the record reveals it abided by that principle.
    As far to what extent mental health played in the Plaintiff's disability, the court held:

    Even if LINA erred by finding Plaintiff not disabled under the any occupation standard, terminating benefits was justifiable under the Plan’s Mental Health Limitation, restricting benefits to 24 months for disabilities “caused by, or contributed to by . . . [a]nxiety disorders” or “[m]ental illness.” (AR63). Substantial evidence supports the conclusion that Plaintiff’s disability, for which he had already received over 24 months of benefits, was indeed contributed to by anxiety and depression.
    Evidence from both Plaintiff’s self-assessments and his doctors amply reflects that—for more than 24 months prior to the December 2014 termination of benefits—Plaintiff’s anxiety and depression “contributed to” his disability. As far back as August 2011, Plaintiff reported on a disability questionnaire that he is “depressed most of the time,” and listed “stress, depression” as among the reasons he could not work.
    The opinion is attached below.
    Attached Files