On March 24, 2020, after a bench trial in a 46-page opinion, Eastern District of California federal court Judge Troy Nunley ruled in favor of McKennon Law Group PC’s client in her ERISA lawsuit against her long-term disability insurer MetLife, who had denied her claim for long-term disability benefits. She had worked for Kaiser Permanente in a sedentary position in its HR department and obtained the MetLife disability coverage through her employer. Judge Nunley pointed out many weaknesses in MetLife’s denial decision, including the fact that it relied almost entirely on the reports of its own hired medical consultants who “only performed paper reviews of Plaintiff’s medical records and neither observed nor treated Plaintiff personally.” Nor did MetLife’s medical consultants, he reasoned, speak with any of her treating physicians (who had decided she was disabled after examining her in person for years). Judge Nunley afforded one of MetLife’s consultants, nurse Bachner, “with less weight as she is not a physician.”
He harshly criticized MetLife’s doctor consultant because his opinions were “not well-supported” and conclusory: “Dr. Hinrichs simply summarized the medical records he reviewed and then made a conclusion” without explaining which specific medical records supported his conclusion. Judge Nunley also determined that MetLife’s doctor “disregarded Plaintiff’s subjective reports of pain and only focused on what he deemed to be ‘objective’” evidence of disability, violating Ninth Circuit case law. As “Plaintiff correctly points out, it would be an abuse of discretion for the Court to fail to consider Plaintiff’s subjective account of pain. Kibel v. Aetna Life Ins. Co., 725 F. App’x 475, 477 (9th Cir. 2018) (citing Demer v. IBM Corp. LTD Plan, 835 F.3d 893, 904–07 (9th Cir. 2016)).”
The firm had several strategic battle victories along the way that contributed to winning the war for our client. We prevailed on a motion for partial summary judgment, where the Court ruled that the standard of review at trial would be de novo. We augmented the administrative record with the client’s favorable Social Security disability finding. Judge Nunley found that our client was totally disabled from performing the material duties of her own sedentary occupation because her physicians concluded, based on several in-person exams, that she had severe low back and heel pain that prevented her from sitting for more than two hours per workday or from standing on her own, which well-reasoned opinions the Court found much more credible than MetLife’s “paper reviewers.”
The Court entered judgment in our client’s favor requiring MetLife to reverse its disability insurance claim denial and pay our client all her benefits for the Policy’s “own occupation” period, plus prejudgment interest for the last seven years. This decision will allow our client to collect all her substantial attorneys’ fees and costs she incurred aggressively fighting MetLife for the last five years.
