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11th Cir. – Pro Se Appeal Denied

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  • 11th Cir. – Pro Se Appeal Denied

    Here’s a new case out of the Eleventh Circuit, David Carr v. John Hancock Life Insurance Company (USA). There is really not much interesting about this case. The court first finds that the administrative record was closed and that the District Court properly did not consider outside evidence.

    While not explicitly stated, it is clear from the district court’s order that it did not take the information regarding Carr’s April 2015 claim into account when making its determination. This was correct because “[r]eview of the plan administrator’s denial of benefits is limited to consideration of the material available to the administrator at the time it made its decision.” Blankenship, 644 F.3d at 1354. The only information that may be properly taken into account when assessing Carr’s current claim is the information that John Hancock had as of October 2, 2014, when it informed Carr of its final denial of his claim and closed the matter. The new claim, filed in April 2015, falls outside of this window and neither we nor the district court may properly consider it.
    The court finds that the defendant’s decision to deny benefits was correct.

    Carr’s argument that John Hancock wrongly discounted his own doctors’ opinions is unavailing. Carr does not indicate on appeal which medical records or physician opinions would sufficiently rebut this evidence. While the record contains two “Certification[s] of Chronically Ill Individual” from Dr. Subramanian and Dr. Sadler, these Certifications are in conflict with the July 2013 on-site assessment, the weekly notes, and the ICP bills, all of which indicate that Carr did not require substantial assistance with any more than one ADL from May to mid-August 2013. And Dr. Subramanian’s Certification is in direct conflict with his own notes from a visit just one month prior to the Certification. Thus, John Hancock could, in its discretion, afford this evidence little weight. See Blankenship, 644 F.3d at 1356 (explaining that plan administrators “may give different weight to [certain doctors’] opinions without acting arbitrarily and capriciously” and “need not accord extra respect to the opinions of the claimant’s treating physicians,” especially where other evidence in the record could have led the plan administrator to “doubt” the proffered opinions).
    The court further determines that even if the decision was not correct it was not unreasonable. About the most I can take out of this case is that it’s generally a pretty bad idea for a plaintiff to fire their attorneys and proceed pro se. That being said, the opinion is attached below.
    Attached Files