Sunday, April 1, 2007

Palm v. Wausau Benefits, Inc. (U.S.D.C. Maryland)(Not approved for publication)

Filed March 26, 2007—Opinion by Judge Andre Davis

Plaintiff Anthony Palm, a beneficiary under a group long term disability income policy sponsored by his former employer, sued under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001, et. seq., to challenge a denial of benefits.

The Court considered it undisputed that Palm suffered from numerous impairments, including chronic lumbalgia, acute chronic lumbosacral paravertebral muscle spasm, bilaterally, and degenerative dessication with dorsal disc bulging at L4 - 5, L5 - S1 and C5 - 6, that are, collectively, disabling. On the ultimate issue, however, of whether the evidence was sufficient to establish that Palm was "totally disabled" from working in "any occupation," the Court determined that a physician’s opinion that Palm cannot perform sedentary or light duty work was rather conclusory and wholly undercut by other evidence in the record, including surveillance videos of Palm engaged in physical activity inconsistent with his claims.

On cross-motions for summary judgment, the Court found that Palm failed to show by a preponderance of the evidence that he is "totally disabled" within the definition of the relevant policy. At best, the Court said, the evidence was in equipoise (and parenthetically added that it was not), but in any event Palm failed to satisfy his burden to show “total disability” under the Policy.

The opinion is available in PDF.

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