Rhonda Hawks v. PNC Financial Services Group Inc

CourtCourt of Appeals for the Third Circuit
DecidedAugust 6, 2024
Docket23-2636
StatusUnpublished

This text of Rhonda Hawks v. PNC Financial Services Group Inc (Rhonda Hawks v. PNC Financial Services Group Inc) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rhonda Hawks v. PNC Financial Services Group Inc, (3d Cir. 2024).

Opinion

NOT PRECEDENTIAL

UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT

_____________

No. 23-2636 _____________

RHONDA HAWKS

v.

PNC FINANCIAL SERVICES GROUP INC; PNC FINANCIAL SERVICES GROUP AND AFFILIATES LONG TERM DISABILITY PLAN, Appellants _____________________________________

On Appeal from the United States District Court for the Western District of Pennsylvania (District Court No. 2-21-cv-00612) District Judge: Hon. Lisa P. Lenihan ______________

Argued on July 10, 2024 ______________

Before: BIBAS, FREEMAN, RENDELL, Circuit Judges.

(Filed: August 6, 2024)

Samuel M. Schwartz-Fenwick (Argued) Julie M. Kamps Seyfarth Shaw 233 S Wacker Drive Suite 8000 Chicago, IL 60606

For the Appellants Michael D. Grabhorn (Argued) Andrew M. Grabhorn Grabhorn Law Office 2525 Nelson Miller Parkway Suite 107 Louisville, KY 40223

For the Appellee ______________

OPINION* ______________

RENDELL, Circuit Judge.

PNC Financial Services Group, Inc. and PNC Financial Services Group and

Affiliates Long Term Disability Plan (“PNC”) appeal from the District Court’s grant of

summary judgment in favor of Rhonda Hawks, an employee whose disability benefits

were terminated by the plan administrator, Lincoln Financial Group (“Lincoln”), in

November 2019. PNC urges that the District Court misapplied the applicable standard of

review, failed to consider the language of PNC’s Long Term Disability Plan (the “Plan”)

in assessing Hawks’s ability to perform the duties of her occupation, and considered

evidence that was never presented to Lincoln. We agree and will vacate and remand.

I

Rhonda Hawks was employed by PNC as a banking center manager. Hawks’s job

was summarized as follows:

Manages priorities through planning and execution to drive all aspects of branch performance, including individual

* This disposition is not an opinion of the full Court and pursuant to I.O.P. 5.7 does not constitute binding precedent.

2 expectations for outside business development. Builds a high performing team through the attraction, on-boarding, coaching and development of branch team members. Leads and impacts a broad range of eco-system partners in an omni channel environment. Drives revenue and loyalty through proactive interactions with clients.

App. 1526. Hawks was eligible for short-term disability and long-term disability

(“LTD”) benefits.

In April 2018, Hawks slipped and fell, fracturing her ankle, which required

surgery, so she stopped working. She applied for, and received, benefits under the Plan,

which was administered by Lincoln and funded by PNC’s general assets. Under the Plan,

for the first twenty-four months after LTD benefits begin, a participant is “disabled if

[her] disability makes [her] unable to perform the material or essential duties of [her] own

occupation as it is normally performed in the national economy.” App. 111.

Over the course of the next year-and-a-half, Hawks was seen by her surgeon, Dr.

Lewis, almost monthly, and her internist, Dr. Anderson. During this time, she had four

surgeries, extensive physical therapy, and was consistently listed by multiple healthcare

professionals as being severely limited in functional capacity and unable to perform her

current job duties and experienced constant pain. She did show some signs of

improvement in the Spring of 2019. See, e.g., App. 1086–87 (describing scans showing

her fractures had healed); App. 1152–54 (noting that Hawks reported subjective

improvement). PNC was paying benefits to Hawks during this time.

In August 2019, Lincoln obtained a vocational analysis by vocational expert

Michelle Reddinger. Reddinger reviewed PNC’s five-page description of Hawks’s role.

3 Reddinger also reviewed the training, education, and experience form submitted by

Hawks; however, Hawks had left the fields identifying the tasks and duties of her

position blank on the form. Reddinger then consulted the Dictionary of Occupational

Titles (“DOT”), Occupational Information Network (“O*Net”), Occupational Outlook

Handbook (“OOH”), and Economic Research Institute (“ERI”) to determine what

occupation in the national economy is most analogous to Hawks’s own occupation.

Reddinger concluded that Hawks’s own occupation as normally performed in the national

economy was substantially consistent with DOT occupation “Manager, Financial

Institution” and O*Net occupation “Financial Managers, Branch or Department.” App.

1081. Reddinger found that these two occupations are performed at the sedentary

physical demand level in the national economy. App. 1081–82.

In November 2019, Dr. Lewis filled out Lincoln’s Restriction Form and noted that

Hawks had capacity to perform “activities as tolerated.” App. 570–71. Unlike in prior

Restriction Forms, Dr. Lewis did not identify any specific restrictions or limitations for

Hawks. Dr. Lewis’s evaluation notes documented improvement in Hawks’s condition:

Hawks “is ambulating in normal shoes. She is very pleased. She reports the sharp

medial pain she had before surgery is gone.” App. 567. He further reported that Hawks

“looks quite good. She is very pleased with her current status/improvement.” App. 568.

Dr. Lewis noted that Hawks was “welcome to follow up with [him] as needed.” App.

568. However, there is no evidence in the record that Hawks ever sought further

treatment from Dr. Lewis.

4 That same month, Hawks’s internist, Ian Anderson, also submitted a Restrictions

Form. App. 629–30. Dr. Anderson checked a box indicating that Hawks had capacity

for full-time sedentary work, with the only restriction being “unable to stand/walk any

substantial length of time.” App. 629–30. Dr. Anderson’s office notes documented that

Hawks’s blood pressure was controlled, although her diabetes was not. In response to the

form’s inquiry about Hawks’s inability to return to work, Dr. Anderson noted “Specialty

follow-up. Unclear long term prognosis.” App. 629. Hawks did not submit other

treatment records from Dr. Anderson to Lincoln.

Lincoln then obtained an independent medical review of Hawks’s medical records

by Paul Stander, a board-certified internist. App. 587–89. Dr. Stander found, based on

the treating physicians’ notes, that Hawks had capacity for full-time sedentary work and

that she was limited to standing/walking for brief periods and occasionally lifting,

carrying, pushing, and pulling up to 10 pounds. App. 588. Dr. Stander did not himself

examine Hawks. He also found it unnecessary to contact Dr. Anderson because “the

documentation in the records and on the functional capacity form from [Dr. Anderson] is

clear.” App. 589.

In January 2020, Lincoln terminated Hawks’s LTD benefits because it found that

she no longer met the Plan’s definition of disability. Lincoln specifically found Hawks

had capacity to perform her own occupation as it is normally performed in the national

economy within the restrictions noted by her treating physicians. Lincoln relied on the

August 2019 occupational analysis in finding that Hawks’s own occupation, as performed

in the national economy, was sedentary. Lincoln also relied on Dr. Anderson’s

5 November 2019 Restriction Form supporting Hawks’s full-time sedentary work capacity

and Dr. Lewis’s November 2019 Restriction Form stating Hawks could perform activities

as tolerated with no prescribed restrictions or limitations, with no follow-up visits

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Rhonda Hawks v. PNC Financial Services Group Inc, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rhonda-hawks-v-pnc-financial-services-group-inc-ca3-2024.