Cook v. Prudential Insurance Co. of America

494 F. App'x 599
CourtCourt of Appeals for the Sixth Circuit
DecidedAugust 16, 2012
Docket11-3364
StatusUnpublished
Cited by12 cases

This text of 494 F. App'x 599 (Cook v. Prudential Insurance Co. of America) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cook v. Prudential Insurance Co. of America, 494 F. App'x 599 (6th Cir. 2012).

Opinion

OPINION

KAREN NELSON MOORE, Circuit Judge.

Plaintiff-Appellant David Cook filed this civil lawsuit seeking judicial review of Defendant-Appellee Prudential Insurance Company of America’s (“Prudential”) decision to deny his application for long-term disability benefits. Although the parties raised two timeliness issues in the proceedings below, the district court decided the case on the merits, determining that Prudential’s decision was not arbitrary or capricious and granting Prudential’s motion for judgment on the administrative record. Because substantial evidence supports Prudential’s decision, we AFFIRM.

I. BACKGROUND

Cook began working as a telephone collector for Bank One in July 1991. Cook suffered polio as a child and had a long history of muscle weakness, which doctors believed was attributable at least in part to a condition known as post-polio syndrome. Cook also had a history of depression. Around 2000, Cook began experiencing other medical problems, including increased muscle and joint pain and edema, diabetes mellitus, and severe obstructive sleep apnea. Consistent with these diagnoses, Cook’s medical records support a substantial number of physician visits, therapy sessions, and referrals. In 2004, for example, a report from the Morrow County Hospital emergency department reflects increased edema in Cook’s lower extremities. In December of that year, medical records also indicated that Cook had reported experiencing dizziness, light-headedness, headaches, and falls. Around August of 2005, Cook began experiencing “increasing pain with ambulation,” Admin. Record (“A.R”) at 483 (Page ID # 582), and, on June 9, 2006, Cook was referred to Dr. Erick Arce, a neurologist, for further *601 evaluation. Around that time, Cook also began consulting with physicians concerning his sleep apnea, which one neurologist described as “profound.” Id. at 42B (Page ID # 472). In conjunction with these assessments, the record is replete with diagnostic tests and nerve-conduction studies, physician notes, and other documentation of Cook’s medical care.

Cook first took disability leave as a result of these issues in early 2004, and received short-term disability from Bank One through his return to work in July of that year. Cook, however, was forced to stop working entirely on October 28, 2004, due to continuing medical problems. Bank One resumed the short-term disability benefits, but notified Cook of its intent to stop making those payments in December 2004. 1

Cook applied for Social Security disability benefits in February 2005. In the application, Cook described his position as conducting computer-connected phone calls during which he reviewed customer accounts and sought payment on outstanding balances. Cook estimated that the job required approximately one hour of walking, a half hour of standing, and six-and-a-half hours of sitting per day. The application also included letters from two of Cook’s treating physicians. In one letter, neurologist Dr. J. Blake Kellum indicated that Cook had “a remote history of polio, which has severely affected his lower extremities” and opined that Cook was “disabled from the standpoint of any type of work that would involve the use of his lower extremities.” Id. at 474 (Page ID # 528). In the other letter, Dr. Paramvir Bains discussed Cook’s sleep apnea, post-polio syndrome, diabetes, and hyperlipide-mia, and stated that “compounded together,” the conditions “ma[d]e it extremely difficult for Mr. Cook to work fulltime at this time.” Id. at 489 (Page ID # 588). Dr. Bains noted Cook’s self-reported inability “to remain in a seated position for more than 30 minutes at a time, ambulate greater than 50' without stopping at least once, and limited strength to his upper and lower extremities,” and concluded that “Mr. Cook has significant medical conditions which limit his ability to be fully employed at this time or in the near future.” Id.

As part of the Social Security review, Cook also received medical evaluations from three other medical professionals, all of which were included in the materials submitted to Prudential. On April 25, 2005, Dr. William Schonberg, a psychologist, evaluated Cook’s mental status. Dr. Schonberg concluded that Cook’s “mood seemed mildly depressed,” that Cook’s “mental ability to maintain attention, concentration, persistence, and pace to perform simple repetitive tasks” was “mildly to moderately impaired,” and that Cook’s “mental ability to withstand the stress and pressures associated with day to day work activity” was also “moderately impaired.” Id. at 296-97 (Page ID #345-46). The report did not, however, recommend any restrictions on account of these findings.

The two other physicians conducted physical assessments. In the first assessment, dated July 8, 2005, Dr. Charles Der-row concluded that Cook was capable of performing sedentary work, including frequently lifting objects of less than ten pounds, standing or walking less than two hours per day, and sitting about six hours a day. The second assessment, dated February 7, 2006, resulted in a similar finding. Specifically, Dr. Gary Hinzman concluded that Cook was “capable [of] working at [a *602 sedentary] level” and that the evidence “[did] not support” Cook’s inability to lift or carry or Dr. Kellum’s statement that Cook was disabled. Id. at 350 (Page ID # 399).

A Functional Capacity Evaluation (“FCE”) conducted on February 20, 2007, conveyed a less optimistic picture. The FCE presented Cook’s self-reported tolerances, which indicated that Cook was able to sit for only thirty minutes at a time, stand for about five minutes at a time, and walk for ten to fifteen minutes at a time. Id. at 381 (Page ID # 430). Upon completion of the testing, the physical therapist determined that “[o]verall test findings, in combination with clinical observations, identify Mr. Cook’s subjective reports of pain and associated disability to be both reasonable and reliable.” Id. at 402 (Page ID #451). She further concluded that Cook’s “physical abilities did not match up with the critical physical demands of [his] position” and that Cook “would not be safe to return to this position at this time due to limited static/dynamic standing balance which decreases his safety during functional mobility, lifting, pushing, and pulling tasks.” Id. at 461 (Page ID # 510). These work-capacity assessments, however, were based on an erroneous classification of Cook’s job as involving the physical demands of “light” duty. M 2 Both Cook’s self-reported description of his position and the generic description used in Prudential’s denial letter, however, identify Cook’s position as “sedentary,” which is a less demanding classification.

On April 14, 2008, an administrative law judge (“ALJ”) determined that Cook had been disabled since October 28, 2004. Although the ALJ did not find Cook to have an impairment or combination of impairments that rendered him totally disabled, the ALJ determined that Cook’s “residual functional capacity [was] diminished to sedentary work ...

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494 F. App'x 599, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cook-v-prudential-insurance-co-of-america-ca6-2012.