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Crediting Reviewing Physician’s Opinion RE: Side Effects of Prescriptions...

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  • Crediting Reviewing Physician’s Opinion RE: Side Effects of Prescriptions...

    Crediting Reviewing Physician’s Opinion RE: Side Effects of Prescriptions Not an Abuse of Discretion – M.D. Al.

    Attached is a case out of the Middle District of Alabama, Bowman v. Reliance Standard Life Insurance Company. The case involves a claim for ERISA governed long term disability benefits. Defendant denied plaintiff’s claim asserting that he was not disabled under the “any occupation” standard of disability. Plaintiff’s treating physician stated that while he could work with some limitations, his prescription medications caused him “severe and limiting side effects.” Defendant’s reviewing physician stated the opposite, that his physicians did not cause any significant issues. The court found that defendant did not abuse its discretion in crediting its physician over plaintiff’s physician regarding medication side effects.

    [quote]
    Third, Bowman claims Reliance’s decision was arbitrary and capricious because Reliance allegedly did not take into account the effects of his medications. Bowman claims they “affect his ability to perform work functions, drive to and from work, [and] to stay awake during the work day.” (Doc. 13 at 12). Bowman attempts to bolster his claim by citing Adams v. Prudential Insurance Company of America, where the court found it arbitrary and capricious to terminate a person’s benefits where the reports of the treating physicians ignored the person’s medications. 280 F. Supp. 2d 731, 741 (N.D. Ohio 2003).

    But here, the treating physicians did discuss the effect of Bowman’s medications. Specifically, Dr. Denver noted that Bowman’s current medications “do not contribute to any significant limiting physical or cognitive deficits.” (Doc. 12-3 at 56). So despite Bowman’s claims to the contrary, Reliance did take the effect of his medications into account. Even if the other doctors’ reports found that Bowman’s medications prevented him from working, Reliance acted rationally in crediting the most recent opinion, that being Dr. Denver’s. See Till, 182 F. Supp. 3d at 1273 (“[I]t is not arbitrary and capricious to deny a disability claim ‘on the basis of conflicting, reliable evidence.’”). Thus, Reliance did not act unreasonably.
    [quote]

    The case has been appealed.
    Attached Files
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