Schneider, Janet M. v. Sentry Group Long Te

CourtCourt of Appeals for the Seventh Circuit
DecidedSeptember 7, 2005
Docket04-2689
StatusPublished

This text of Schneider, Janet M. v. Sentry Group Long Te (Schneider, Janet M. v. Sentry Group Long Te) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schneider, Janet M. v. Sentry Group Long Te, (7th Cir. 2005).

Opinion

In the United States Court of Appeals For the Seventh Circuit ____________

No. 04-2689 JANET M. SCHNEIDER, Plaintiff-Appellant, v.

SENTRY GROUP LONG TERM DISABILITY PLAN, SENTRY GROUP SUPPLEMENTAL DISABILITY INSURANCE PLAN, and SENTRY LIFE INSURANCE COMPANY, Defendants-Appellees. ____________ Appeal from the United States District Court for the Western District of Wisconsin. No. 03 C 721—John C. Shabaz, Judge. ____________ ARGUED MAY 12, 2005—DECIDED SEPTEMBER 7, 2005 ____________

Before RIPPLE, ROVNER and SYKES, Circuit Judges. RIPPLE, Circuit Judge. Janet M. Schneider claimed that defendants Sentry Life Insurance Company (“Sentry Life”), Sentry Group Long Term Disability Plan and Sentry Group Supplemental Disability Insurance Plan (collectively, “Sentry”) violated the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq., when her disability benefits were terminated. The district court 2 No. 04-2689

granted Sentry’s motion for summary judgment. For the reasons set forth in the following opinion, we reverse the judgment of the district court and remand the case for further proceedings consistent with this opinion.

I BACKGROUND A. Facts Ms. Schneider began working for Sentry Life in 1974. She held various positions at Sentry Life, ultimately reaching the position of “Director, Underwriting Services, National Accounts.” R.2 at 4. As an employee of Sentry Life, Ms. Schneider participated in the defendant plans, Sentry Group Long Term Disability Plan and Sentry Group Supplemental Disability Plan (collectively, “the Plan”). The Plan is an employer-sponsored disability plan within the meaning of ERISA. 29 U.S.C. § 1002. Ms. Schneider began treatment for depression in 1995, and, in 1999, she came under the care of psychiatrist Dr. Paul Samo. Dr. Samo diagnosed Ms. Schneider with recur- rent major depressive disorder. Beginning in October 2001, her depression prevented Ms. Schneider from performing the duties of her job at Sentry Life. Accordingly, Dr. Samo excused her from work beginning on or about October 29, 2001. At this time, Ms. Schneider notified Sentry that she was disabled under the terms of the Plan. Initially, Ms. Schneider continued to receive her wages under the “Healthy Return Plan,” a wage continuation plan that Sentry Life provided to its employees covering absence from work due to illness or injury. R.18 at 2. The Healthy Return Plan is not implicated in this action. No. 04-2689 3

Prior to obtaining approval for her claim for disability benefits under the Plan, Ms. Schneider underwent an independent psychiatric medical evaluation (“IME”). Dr. Bruce Heyl, who conducted Ms. Schneider’s IME, evaluated Ms. Schneider and reviewed Dr. Samo’s records. Dr. Heyl concluded that Ms. Schneider “ha[d] suffered major depres- sive illness . . . that in the past and currently disables her from performing the substantial duties of her regular occupation.” R.12, Tab 4 at 2. In his report detailing the IME, Dr. Heyl also advised Sentry that Ms. Schneider was “currently improving in her clinical depression.” Id. He predicted that “her short and long term prognosis . . . for complete recovery” was “good” and anticipated that she would be able to return to work in June 2002. Id. Dr. Heyl also noted that, because a personality conflict with a supervisor at work was contributing to her illness, “[r]esolution of this relationship conflict would facilitate her return to employment.” Id. at 3. In May 2002, Sentry informed Ms. Schneider that her claim for disability benefits had been approved and she began receiving benefits under the Plan. In June 2002, Sentry notified Ms. Schneider that her disability had been verified until July 31, 2002, and that the company would require periodic updates regarding her medical condition from her treating physician. On July 31, Dr. Samo recommended extending Ms. Schneider’s disability leave through September 14, 2002, and Dr. Heyl agreed that her leave should be extended until September 2002. Dr. Samo also recommended extensions of Ms. Schneider’s disability leave in September and October 2002. In November 2002, Dr. Samo recommended that Sentry treat Ms. Schneider as “permanently restricted” from work due to her depression. R.12, Tab 9 at 1. In a subse- quent letter to Sentry supporting the permanent restriction 4 No. 04-2689

recommendation, Dr. Samo noted that Ms. Schneider had not continued to improve as quickly as he initially had hoped she would and that she had experienced “a setback in her progress.” R.12, Tab 10 at 1. In order to determine Ms. Schneider’s condition, Sentry contracted with a company called PsyBar to conduct an additional IME with respect to Ms. Schneider. The IME was conducted by Dr. Michael J. Spierer, a psychologist, on February 25, 2003. In February 2003, Dr. Samo wrote a letter (the “February letter”) to Sentry describing Ms. Schneider’s condition. Dr. Samo stated that Ms. Schneider’s recurrent major depressive disorder was “currently mild.” R.12, Tab 12 at 1. He also opined that “it would be unwise for her to return to her prior job,” because “[i]f she were to do that it would be likely that the depression would worsen.” Id. Instead, Dr. Samo explained, “[o]ur goals would be for her to find alternate employment.” Id. In March 2003, Dr. Spierer authored a report detailing the results of Ms. Schneider’s IME. Dr. Spierer’s nine and one-half page report surveyed Ms. Schneider’s medical history and reviewed the findings of Dr. Samo and Dr. Heyl. Ultimately, Dr. Spierer concluded that Ms. Schneider was “capable of returning to work” as of the date of the report. R.12, Tab 13 at 9. Dr. Spierer also indicated that Ms. Schnei- der did not require “any special accommodations . . . in order to be able to return to work,” but he noted that, if Ms. Schneider were to work under the supervisor with whom she had a personality conflict, she “very likely would experience interpersonal conflict with him.” Id. Sentry sent a copy of Dr. Spierer’s IME report to Dr. Samo to determine whether he agreed with the findings in the report. In a letter to Sentry (the “March 24 letter”), Dr. Samo No. 04-2689 5

responded: I agree that Janet Schneider is now ready to return to work. She has made slow, gradual improvements in her condition with time. Before this point, however, I would have worried about her returning to work. Mrs. Schnei- der is interested in discussing possibilities at this time. She would be most interested in becoming an independ- ent consultant to Sentry Insurance. This may provide her with the flexible [sic] that she desires. Please contact Mrs. Schneider to discuss possible job opportunities at this time. 1 R.12, Tab 15 at 1. On April 23, 2003, Sentry sent a letter (the “April 23 letter”) to Ms. Schneider explaining that it had reviewed her claim and had determined that her long-term benefits should be terminated. The letter read, in relevant part: Based on the February 25, 2003 Independent Medical Exam report and Dr. Samo’s letter dated March 24, 2003 you have recovered and can return to work. As a result

1 Dr. Samo also sent a letter to Karen Roll, a registered nurse hired by Sentry to keep track of Ms. Schneider’s claims, on June 3, 2003. In the letter, Dr. Samo stated that Ms. Schneider “has been advised not to return to her previous position as this was too stressful for her and would likely worsen her depres- sion again.” R.12, Tab 23 at 1. He also indicated that he “would not advise her to return to full-time work status in any position.” Id. at 2. It is not clear whether this letter was a part of Sentry’s final decision regarding Ms. Schneider’s appeal of the denial of her benefits. In any event, the evidence of Dr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
Schneider, Janet M. v. Sentry Group Long Te, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schneider-janet-m-v-sentry-group-long-te-ca7-2005.