Seventh Circuit Affirms Unum’s Termination of Long-Term Disability Benefits Based Substantially on Paper Reviews

In Feeney v. Unum Life Insurance Company of America, No. 20-1685, 2021 WL 5102780 (7th Cir. Nov. 3, 2021), Plaintiff-Appellant Arthur Feeney appealed the district court’s grant of Unum Life Insurance Company of America’s (“Unum”) motion for judgment on the pleadings on his ERISA Section 502(a)(1)(B) claim for denied long-term disability benefits. Feeney’s disability was supported by his family physician and a vocational consultant who opined that Feeney’s physical and cognitive impairments were too severe for him to work. Unum terminated Feeney’s benefits based on medical evidence it commissioned, including a report by an independent medical evaluator who found no reason Feeney could not return to full-time sedentary work, a neuropsychologist report which showed his cognitive abilities to be within normal limits, and the opinions of four independent medical consultants who reviewed Feeney’s medical records and concluded that he could return to work. At the district court, Feeney argued that Unum had an obligation to supplement his claims record with two recent decisions from the Department of Veterans Affairs and the Social Security Administration which granted him disability benefits. The district court granted Unum’s motion, finding that it was not arbitrary and capricious for Unum to terminate Feeney’s long-term disability benefits.

On appeal, the Seventh Circuit affirmed the district court’s decision. First, it found that Feeney did not introduce any evidence which would show that Unum’s review of his claim was tainted by a structural conflict of interest. The court explained that “Unum ameliorated any conflict by retaining numerous independent medical consultants to review his claim, thereby putting ‘distance between the conflict and the decision.’” Second, there is no treating physician rule in the ERISA context and Unum did not arbitrarily refuse to credit Feeney’s treating doctor’s opinion. Unum found her opinions to be inconsistent with her own treatment notes and the findings of other doctors. Third, Unum did not have to consider the VA and SSA awards or other notes Feeney did not submit to Unum before it made a final decision. The court explained that these are not part of the administrative record and Feeney waived any argument that Unum should have considered these documents because he did not challenge the contents of the administrative record at the district court. Lastly, the court found that it was not improper for Unum to rely on a paper review of his claim because there is no presumption in ERISA against paper reviews. Feeney did not provide any evidence showing that the reviewing doctors were not objective.