In Rebecca McCook v. Aetna Life Insurance Company, the U.S. District Court for the Middle District of Florida accepted the Report and Recommendation (R & R) of the Magistrate Judge and determined that Plaintiff McCook was not entitled to disability benefits. The Court held that “Although McCook has provided evidence that Aetna could have awarded her long term disability benefits, she has failed to establish that Aetna’s denial was arbitrary and capricious.”

Standard for Determining if Denial was Arbitrary and Capricious

Relying on Eleventh Circuit precedent, the Florida Court concluded that, “As long as Aetna has demonstrated a reasonable basis for its decision to deny benefits, ‘it must be upheld as not being arbitrary and capricious, even if there is evidence that would support a contrary decision.’”

Aetna’s Decision that Plaintiff Could Perform the Duties of Her Own Occupation was not Arbitrary and Capricious

Plaintiff argued that Aetna erred by relying on the Dictionary of Occupational Titles (DODT) in determining she was not disabled from performing her own occupation. Instead, she asserted that it should have considered her actual job duties as a Foreclosure Specialist II for Bank of America. The Court disagreed and concluded that “While McCook may have considered her job at Bank of America stressful, that does not mean that she could not perform her occupation elsewhere.” Thus, Aetna’s decision to deny her LTD benefits on this basis was not arbitrary and capricious.

Aetna’s Decision to Rely on its Own Experts Over Opinions of Treating Physicians was Not Arbitrary and Capricious

Again, relying on precedent, the Court held that Aetna “need not accord extra respect to the opinions of a claimant’s own treating physicians.” Even when treating physicians disagree with the medical opinions of a plan administrator’s independent doctors, “the plan administrator may give different weight to those opinions without acting arbitrarily and capriciously.”

Taking into account that Aetna had a conflict of interest by being both the Plan Administrator and payer of benefits, the Court accepted the R & Rs and concluded that Plaintiff was not entitled to LTD benefits.

This case was not handled by our office, but we think it may be helpful to claimant’s who are challenging the R & Rs of a Magistrate Judge on appeal to the District Court Judge. If you have questions about this case, or any matter concerning your disability claim, contact one of our disability attorneys at Dell & Schaefer for a free consultation.