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N.D. Cal and M.D. Fla.

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  • N.D. Cal and M.D. Fla.

    Attached are two recent cases out of California and Florida respectively. The California case deals with attorney's fees, and illustrates the current trend for California courts.

    The second, from Florida, illustrates the arbitrary and capricious standard:

    Although McCook has provided evidence that Aetna could have awarded her long term disability benefits, she has failed to establish that Aetna’s denial of benefits was arbitrary and capricious. As long as Aetna has demonstrated a reasonable basis for its decision to deny benefits, “it must be upheld as not being arbitrary or capricious, even if there is evidence that would support a contrary decision.” White v. Coca-Cola Co., 542 F.3d 848, 856 (11th Cir. 2008) (citation omitted). Here, despite McCook’s arguments that Aetna failed to properly consider her occupation at Bank of America as a Foreclosure Specialist II, Aetna was entitled to rely on the Dictionary of Occupational Titles (“DOT”) to determine how McCook’s occupation was normally performed in the national economy. See Cook v. Standard Ins. Co., No. 6:08-cv-759- Orl-35DAB, 2010 WL 807443, *9-10 (M.D. Fla. Mar. 4, 2010) (stating that defendant “was entitled to rely on the DOT’s classification exclusively” for its “own occupation” determination, where the plan allowed defendant to “look at the way the occupation is generally performed in the national economy”). The Court agrees with the findings of the Magistrate Judge which conclude that “[t]he additional duties and demands described by Plaintiff appear to be products of her particular work setting at [Bank of America], not her occupation as generally performed in the national economy.” (Doc30 at 45). While McCook may have considered her job at Bank of America stressful, that does not mean that she could not perform her occupation elsewhere. See Landman v. Paul Revere Life Ins. Co., 337 F. Supp. 2d 283, 297 (D. Mass. 2004) (“However, the record does not support a conclusion that [the plaintiff’s] inability to handle the stress at one firm meant that she could not perform her occupation as a legal secretary elsewhere.”). In addition, to the extent McCook argues that Aetna improperly favored its own medical experts over her treating physicians, the Eleventh Circuit has found that “[p]lan administrators need not accord extra respect to the opinions of a claimant’s treating physicians.” Blankenship v. Metro. Life Ins. Co., 644 F.3d 1350, 1356 (11th Cir. 2011). “Even where [McCook’s] own doctors offered different medical opinions than [Aetna’s] independent doctors, the plan administrator may give different weight to those opinions without acting arbitrarily and capriciously.” Id.
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