Yu Wang v. Metropolitan Life Insurance Company

CourtCourt of Appeals for the Eleventh Circuit
DecidedJuly 7, 2026
Docket25-11527
StatusUnpublished

This text of Yu Wang v. Metropolitan Life Insurance Company (Yu Wang v. Metropolitan Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Yu Wang v. Metropolitan Life Insurance Company, (11th Cir. 2026).

Opinion

USCA11 Case: 25-11527 Document: 33-1 Date Filed: 07/07/2026 Page: 1 of 21

NOT FOR PUBLICATION

In the United States Court of Appeals For the Eleventh Circuit ____________________ No. 25-11527 Non-Argument Calendar ____________________

YU WANG, Plaintiff-Appellant, versus

METROPOLITAN LIFE INSURANCE COMPANY, Defendant-Appellee. ____________________ Appeal from the United States District Court for the Northern District of Georgia D.C. Docket No. 1:24-cv-01124-SCJ ____________________

Before ROSENBAUM, JILL PRYOR, and BRANCH, Circuit Judges. PER CURIAM: Yu Wang, proceeding pro se, appeals the district court’s judg- ment in favor of Metropolitan Life Insurance Company (“Met- Life”) on his complaint under the Employee Retirement Income USCA11 Case: 25-11527 Document: 33-1 Date Filed: 07/07/2026 Page: 2 of 21

2 Opinion of the Court 25-11527

Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. After careful review of the record and the parties’ briefs, we affirm. I. Wang was employed by General Electric (“GE”) as an Engi- neering Technical Leader. As a salaried GE employee, Wang was covered by a benefits plan insured by Metlife (“Plan”), which pro- vided long-term disability (“LTD”) benefits in cases of “total disa- bility.” The Plan states that MetLife will pay a monthly LTD benefit “as long as [participants] are absent due to Total Disability,” among other requirements. The Plan defines “total disability” to mean that an employee is under the care of a physician or Psy- chologist, if necessary, for any treatment of his disa- bility, and (A) because of illness or injury, is unable to engage in any gainful occupation for which he is rea- sonably fitted by education, training or experience; or (B) (i) is within the first 12 months of absence because of disability . . . and (ii) is unable, because of illness or injury, to perform any and every duty of his occupa- tion held prior to his date of disability, lay off or leave of absence or to perform any occupation made avail- able by the Company if medically appropriate. To obtain benefits under the Plan, a claimant must submit “proof of claim.” The Plan states that “[t]he Carrier will make all decisions on claims and has reserved the right to examine medically USCA11 Case: 25-11527 Document: 33-1 Date Filed: 07/07/2026 Page: 3 of 21

25-11527 Opinion of the Court 3

an individual for whom claim is made at any time during the period of disability.” And according to the Plan, “the management and control of the operation and administration of claim procedures under the Plan, including the review and payment or denial of claims and the provision of full and fair review of claim denial pur- suant to [ERISA § 503], shall be vested in the Carrier.” Since the Plan was insured, MetLife was designated as the “Carrier” under the Plan. A. Wang ceased working for GE near the end of October 2022, after experiencing frequent symptoms of shortness of breath, chest pain, and arrythmia. In August 2023, Wang applied for long-term disability benefits under the Plan, stating that he was unable to work because of a stress-related heart condition and chest pain and tightness. A third-party administrator for the Plan, Sedgwick Claims Management Services, Inc., contacted Wang’s treatment providers and requested additional medical records. Wang’s primary care physician, Dr. Robert Donohue, completed a provider medical statement in August 2023, in which he opined that Wang had been incapacitated by chest pain, dyspnea, and palpitations since Octo- ber 31, 2022, and could not return to work until August 11, 2024, citing Wang’s diagnosis of “premature ventricular contractions” (“PVCs”). Wang’s medical records show that he sought treatment for his symptoms from cardiologist Dr. Robert Joy in 2020 and then USCA11 Case: 25-11527 Document: 33-1 Date Filed: 07/07/2026 Page: 4 of 21

4 Opinion of the Court 25-11527

again in 2022. In 2020, a “Holter monitor showed rare PVCs.” Wang also had a “coronary CT scan showing a calcium score of 0 and a stress test that was normal.” Then, in October 2022, Wang reported “increasing skipped heartbeat symptoms.” Dr. Joy put Wang on a two-day Holter monitor, which showed “less than 1% PVCs.” In December 2022, Dr. Joy performed an echocardiogram and exercise stress test, which were normal apart from “arrythmia” consisting of “rare PVCs.” Dr. Joy noted that the PVCs “seem[ed] to be provoked by physical exertion such as hiking.” Overall, Dr. Joy assessed that Wang had a “relatively benign condition,” with no evidence of heart disease or risk of cardiac arrest. In June 2023, Wang had an annual physical examination with Dr. Devender Reddy, a primary-care physician, after moving from New York to Georgia. Dr. Reddy’s notes do not show any abnormal findings, apart from the fact that Wang scored at the low end of the moderate range on a depression-screening question- naire. Apart from these records, in December 2022, Dr. Donohue wrote a letter at Wang’s request, and using language Wang sup- plied, stating that Wang had “experienced episodes of elevated stresses with panic attack like symptoms in the past 2 years,” and that, as a result, Dr. Donohue had prescribed the use of an emo- tional support animal. Wang had requested the letter so he could bring his dog with him for holiday travel. On September 7, 2023, Sedgwick issued a denial letter to Wang, stating that he did not meet the Plan’s definition of “total USCA11 Case: 25-11527 Document: 33-1 Date Filed: 07/07/2026 Page: 5 of 21

25-11527 Opinion of the Court 5

disability.” The letter summarized Dr. Joy’s testing and findings, noting that the echocardiogram and cardiac exercise stress-test findings were largely normal, and that Dr. Joy had assessed a rela- tively benign condition. The letter further noted that Dr. Reddy’s physical findings were “within normal limits” and that no assess- ment or treatment plan was documented. Based on these records, the letter stated, “we are unable to consider you totally disabled as defined by the Plan as of 10/31/2022-present.” B. The Plan allowed for up to two appeals of a denied claim. Wang submitted his first appeal in September 2023, claiming he had been told not to work by both Dr. Donohue and cardiologist Dr. Vineet Dua. Sedgwick forwarded the claim to MetLife for re- view. Treatment records show that Dr. Dua diagnosed Wang with “[s]ymptomatic PVCs” and palpitations in September 2023. Dr. Dua told Wang to “hold off on work for now” given his reports that he was so symptomatic that he had to leave his job, and he referred Wang to Dr. Michael Riley, an electrophysiologist. Wang then saw Dr. Riley, who noted that the prior testing was largely normal except for rare PVCs. Dr. Riley found that the PVCs did not appear to be related to Wang’s complaints of chest pain. Dr. Riley ordered a seven-day Holter monitor and a low-dose trial of diltiazem, and he directed Wang to follow up in four to six weeks. In support of his appeal, Wang also submitted a letter from Dr. Dua dated October 3, 2023. In the letter, Dr. Dua wrote that USCA11 Case: 25-11527 Document: 33-1 Date Filed: 07/07/2026 Page: 6 of 21

6 Opinion of the Court 25-11527

Wang could not work at that time because he was having sympto- matic PVCs and chest pain. Dr. Dua stated that Wang should be excused for two weeks to evaluate diagnostic testing, but that his date of return was unknown. MetLife referred Wang’s claim to a third-party vendor for a cardiology peer review. To that end, Dr. Craig Napolitano, M.D., board certified in cardiology and internal medicine, reviewed Wang’s medical records, spoke with both Dr. Donohue and Dr. Dua, wrote letters to each doctor summarizing their conversations, and then submitted a report to MetLife. Dr. Napolitano’s letter to Dr.

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Yu Wang v. Metropolitan Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/yu-wang-v-metropolitan-life-insurance-company-ca11-2026.