Miller v. United Welfare Fund, 72 F.3d 1066, 1075 (2nd Cir. 1995).
Furthermore, Delta did not ask Dr. Petti or Dr. Maser what they meant when they
said Ms. Wolf was capable of performing some type of work. This could mean that Ms.
Wolf was only capable of performing tasks needed to be self-sufficient, it does not mean
that she is capable of performing the duties of some occupation. It was unreasonable for
Delta to assume that Ms. Wolf was not disabled and unreasonable for Delta to forgo any
further inquiry. Its decision to terminate benefits cannot be upheld.
“Lacking necessary – and easily obtainable – information, Aetna made its decision blindfolded.
... Had Aetna requested the needed information and offered a rational reason for its denial, it world be entitled to substantial deference. But to deny the claim without explanation and without obtaining relevant information is an abuse of discretion.”
Booton v. Lockheed Medical Benefit Plan, 110 F.3d 1461, 1463-64 (9th Cir. 1997).
Not only did Delta fail to acquire all available information, but it did not even
consider all the information it did have in its possession.
“[T]he administrative Committee’s function was to evaluate the various reports in tandem and render a determination as to Paramore’s ability to engage ‘in any occupation whatsoever for compensation or profit, including part –time work’.”
Paramore, 129 F.3d at 1452.
Delta received Dr. Wender’s report which concluded that Ms. Wolf remained
totally disabled. Delta did not address this opinion40 or refute it in any way.
“There is nothing in the decision itself to indicate that the Administrative Committee in fact examined the record in its entirety. No mention is made of the supplemental medical opinions, Mr. Todorowski’s report, or the favorable decision of the Social Security Administration, finding Plaintiff completely disabled, within the meaning of the Social Security Act, as of
Other than to state that it was received after the original denial in this case occurred.