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Tuesday, July 31, 2012

Ind. Decisions - 7th Circuit decides one Indiana case today

In Aschermann v. Aetna Life (SD Ind., McKinney), a 13-page opinion, Chief Judge Easterbrook writes:

Carol Aschermann suffers from degenerating discs and spondylolisthesis. She had lumbar fusion operations in 2002 and 2004. Dmitry Arbuck, her pain-management specialist, believes that only the development of new medical procedures could alleviate her residual pain. * * *

Until 2003 Aschermann worked for AstraZeneca Pharmaceuticals as a sales representative. * * * Back pain left her unable to perform its duties. Between 2003 and 2009 she received disability payments under AstraZeneca’s disability plan, a welfare-benefit plan governed by the Employee Retirement Income Security Act (ERISA). Terms of the disability plan are contained in a group insurance policy issued by Lumbermens Mutual Casualty Company. For two years from the onset of a disability, the plan provides benefits to a participant who can’t do her old job. After that, the question becomes whether she can perform any job in the economy as a whole. Lumbermens stopped paying disability benefits to Aschermann in fall 2009, concluding that she could do sedentary work.

The district court held that, to upset this decision, Aschermann must establish that it is arbitrary and capricious. 2010 U.S. Dist. LEXIS 121841 (S.D. Ind. Nov. 12, 2010). After reviewing the documents that she submitted to Aetna Life Insurance Co., which administers the group plan on behalf of Lumbermens, the court held that the decision to end her disability benefits was neither arbitrary nor capricious, and it entered summary judgment in defendants’ favor. 2011 U.S. Dist. LEXIS 149785 (S.D. Ind. Dec. 30, 2011). Aschermann does not deny that her education (she has a B.S. in psychology and a master’s degree in social work) and experience suit her for many desk-bound positions, but she contends that Aetna erred in finding that she is able to perform any of them. Dr. Arbuck believes that she cannot work more than four hours a day. Aetna concedes that, if that is so, she is entitled to disability benefits. * * *


Posted by Marcia Oddi on July 31, 2012 04:22 PM
Posted to Ind. (7th Cir.) Decisions