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Significant Reliance on Surveillance is Not an Abuse of Discretion – W.D. Tn.

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  • Significant Reliance on Surveillance is Not an Abuse of Discretion – W.D. Tn.

    Significant Reliance on Surveillance is Not an Abuse of Discretion – W.D. Tn.

    Attached is a case out of the Western District of Tennessee, Eaton v. Reliance Standard Life Insurance Company. In this case, plaintiff seeks continued ERISA governed long term disability benefits under the “any occupation” standard. Defendant denied plaintiff’s claim based, in part, on surveillance that was performed on him. Plaintiff appealed, exhausted administrative remedies, and filed suit. Plaintiff argued that defendant improperly relied on the surveillance when denying his claim. The court disagreed.

    In addressing Plaintiff’s concern that Defendant improperly relied on surveillance footage, the Court finds that Defendant did not base its decision to terminate Plaintiff’s LTD benefits solely on the surveillance footage. While it is undeniable that the video footage played a role, perhaps a significant role, in Defendant’s decision, it was not improper. Defendant noticed a discrepancy between Plaintiff’s 2015 Activities of Daily Living Form and Dr. Rizk’s Independent Medical Evaluation, which prompted Defendant to request surveillance. After reviewing the surveillance footage and the updated medical documentation sent by Dr. Webb and Dr. Pierce in 2015 and 2016, Defendant determined that Plaintiff was capable of at least light functioning. (AR0416.) In doing so, Defendant relied on the surveillance videos combined with the medical records.

    Additionally, unlike the surveillance videos at issue in Wagner v. American United Life Insurance Company, No. 17-4072, 2018 WL 2065076, at *2 (6th Cir. May 3, 2018), which only “captured [the plaintiff] for 20 minutes over a two-hour period, and only for a few minutes at a time,” the surveillance videos of Plaintiff here lasted significantly longer and showed Plaintiff partaking in activities for hours at a time. Also both the doctors and the plaintiff in Wagner readily admitted that the plaintiff’s pain “would come and go,” so the sporadic surveillance video ultimately revealed no inconsistencies. Id. Here, Plaintiff has repeatedly stated over the years that his pain is constant and deliberating.

    As late as his 2015 Activities of Daily Living form, Plaintiff claimed that he could not bend because of back pain, could not walk any length of time, could not sit for more than one to two hours, and could not drive more than a couple times a week for no more than 40 to 50 miles. (AR1115, AR1116, AR1118, AR1088.) In the same form, Plaintiff claimed that he could barely walk, that he dragged his left leg, and could only perform small household activities that do not require bending. (AR1104, AR1105.) The surveillance footage contradicted all of this information. Plus, it contradicted his subjective complaints made to Dr. Webb in November 2015 that there are no relieving factors for his pain because the pain is so severe and that he walks with a limp. (AR1184.)

    For example, one surveillance video showed Defendant attending a MidSouth Jeep Club meeting, a club for which he is the Secretary. (AR1204.) He drove himself and his wife to the meeting. (Id.) After the meeting, he and his wife arrived at a restaurant and remained there for around two hours. (AR1204–06.) While at the restaurant, the video shows Defendant standing for extended periods of time, walking, raising his arms to take photos of the group, and smoking a cigarette. (Id.)

    The April 2016 surveillance footage also revealed more than minor inconsistencies. On one day, the surveillance footage showed Defendant leaning down to load drinks into a cooler in his trailer. (AR1207.) Defendant continued to walk to and from his house to his Jeep to load pillows, blankets, and other objects. (AR1209.) This footage shows Plaintiff repeatedly bending over. Defendant drove himself and his wife for about four hours until they reached their destination in Alabama. (AR1211.) Although the investigator did not follow Defendant into the woods, the footage showed Defendant, along with the rest of the group, driving to the off-road trails.2 (AR1214.)

    It is clear to the Court that the video surveillance did in fact reveal inconsistencies between what Plaintiff reported about his health and what he could do. The March and April 2016 videos show Plaintiff easily moving about with no physical indications of pain. There is no footage of Plaintiff limping or barely being able to walk. It stands to reason that, if Plaintiff were, in fact, totally disabled, a surveillance video taken over a long span of time would show Plaintiff in the constant and deliberating pain that he alleges. Here, it did not. Defendant’s reliance on such overwhelming contradictory surveillance footage is not arbitrary and capricious.

    Lastly, the Court disagrees with Plaintiff that the surveillance footage is not “damaging” and does not “contradict [Plaintiff’s] assertion that he is disabled as to any type of employment.” As explained above, the Court, after viewing the surveillance footage and reading the investigative report, finds that the videos contradict Plaintiff’s assertions.
    Attached Files