Nowhere in the Plan does it require, mention or refer to objective evidence as
being necessary to establish entitlement to disability benefits.
Ms. Wolf, through her attorney, appealed the decision denying benefits and
submitted an additional report from Dr. Maser which clarified his previous statements to
Delta9 regarding Ms. Wolf’s ability to work. The letter stated, in part:
“At this particular time she will remain on temporary total disability. I am going to see her for reevaluation in July 1995. Until that time, I’ve recommended she do very minimal activities other than those she can do around the house.”
Delta did not immediately reinstate Ms. Wolf’s benefits in contrast to its actions
to terminate benefits when it received adverse information regarding total disability.
Instead, Delta scheduled Ms. Wolf’s claim for “review10.” In support of her appeal, Ms.
Wolf, through her attorney, submitted an additional report11 from Alphonso Petti, M.D. in
which he opined:
“Status post spinal surgery instrumentation and bone grafting for which she has a 15% impairment of the body and degenerative disc disease of the cervical spine.”
Dr. Maser examined Ms. Wolf and authored a report dated July 6, 199512. This
report consisted of several opinions and conclusions regarding Ms. Wolf’s disability
“She presented today and in actuality is worse off now than she has been in the past . . . I don’t think that we’re going to note any more improvement . . . As a result of this I think she has reached maximum medical improvement . . . [M]y personal feeling at this time is that she will
The May 10, 1995 appeal with the April 28, 1995 attachment from Dr. Maser is attached as composite
10 11 12 13
. The June 1, 1995 letter is attached as
The July 6, 1995 letter with attachment from Dr. Petti is attached as composite
Dr. Maser’s July 6, 1995 letter and report is attached as
Dr. Maser also stated that he intended to have a functional capacity evaluation performed on Ms. Wolf as
well as a