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Killen v. Reliance Standard Life Insurance Co.

United States Court of Appeals, Fifth Circuit

January 8, 2015

JUDY B. KILLEN, Plaintiff-Appellant,
v.
RELIANCE STANDARD LIFE INSURANCE COMPANY, Defendant-Appellee

Page 304

Appeal from the United States District Court for the Northern District of Texas.

For JUDY B. KILLEN, Plaintiff - Appellant: Harold Houston Pigg, Law Offices of Harold H. Pigg, Lubbock, TX.

For RELIANCE STANDARD LIFE INSURANCE COMPANY, Defendant - Appellee: Joshua Bachrach, Esq., Wilson, Elser, Moskowitz, Edelman & Dicker, L.L.P., Philadelphia, PA; Claire Winniford Parsons, Wilson, Elser, Moskowitz, Edelman & Dicker, L.L.P., Houston, TX.

Before STEWART, Chief Judge, OWEN, Circuit Judge, and MORGAN, District Judge.[*]

OPINION

Page 305

CARL E. STEWART, Chief Judge:

Plaintiff-Appellant Judy Killen (" Killen" ) worked as an ultrasound technician for Covenant Health Systems (" Covenant" ) beginning in 2002. She ceased working in March 2009 due to neck, shoulder, and upper back pain. She was awarded 24 months of benefits from Covenant's long-term disability insurance plan, which Defendant-Appellee Reliance Standard Life Insurance Company (" Reliance Standard" ) administered. After three internal decisions by Reliance Standard rejecting Killen's request for extended long-term disability benefits, she brought suit in federal court. The district court held that Reliance Standard did not abuse its discretion in finding that Killen could perform sedentary work, and granted summary judgment to Reliance Standard. For the reasons discussed herein, we AFFIRM.

I. Factual and Procedural Background

Killen worked for Covenant from 2002 until March 2009, when she claimed that neck, shoulder and upper back pain made it too difficult for her to continue. Reliance Standard administered Covenant's long-term disability plan (the " Plan" )--which is governed by the Employee Retirement Income Security Act of 1974 (" ERISA" ), 29 U.S.C. § 1001 et seq.--and also paid benefits under the Plan if it found an employee disabled.

Killen collected benefits from June 2009 to June 2011. During this time, Killen separately qualified for Social Security disability benefits. To continue receiving benefits under the Plan after two years, a claimant must be " totally disabled" such that she is incapable of performing the material duties of any occupation for which she is qualified by way of education, training, or experience. Under the contract, an insured is totally disabled if " due to an Injury or Sickness he or she is capable of only performing the material duties on a part-time basis or part of the material duties on a Full-time basis."

At the outset, Killen's primary care physician--Dr. Steven Crow (" Dr. Crow" )--treated her. Dr. Crow treated Killen on over twenty separate occasions over the next four years and addressed a variety of maladies she experienced beginning in late 2008. In August 2010, Killen seriously injured her right shoulder by exacerbating an apparently pre-existing tear in the rotator cuff. Dr. Crow found in September 2010 that Killen " had severe pain in the shoulder since that time," and that she was experiencing " [s]hooting pain towards her neck." Shortly thereafter, Dr. Crow referred her to Dr. Kevin Crawford (" Dr. Crawford" ), an orthopedic surgeon who determined in October 2010 that Killen had a " high-grade full-thickness rotator cuff tear" in her right shoulder. The tear was further corroborated by a radiologist's report. In a follow-up appointment in January 2011, however, Dr. Crawford found that Killen's " function is good, even though she has some discomfort."

Page 306

In May 2011, Reliance Standard's internal vocational staff--evaluating the reports outlined above after Killen requested continued benefits--performed a residual employability analysis and listed five sedentary occupations appropriate for Killen. Consequently, Reliance Standard determined that, while Killen could no longer work as an ultrasound technician, she " appear[ed] capable of ...


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