Bailey v. Retirement Board, Long Term Disability Program
294 P.3d 577
Utah Ct. App.2012Background
- Bailey petitions for review of the Utah State Retirement Board’s denial of ongoing permanent total disability benefits.
- Under the LT disability act, after 24 months total disability must be from objective physical impairment and precludes any reasonable gainful occupation, with the employee bearing the burden to prove disability.
- The Board found Bailey’s physical impairments were present but that a predominant psychological impairment prevented employment, not a qualifying physical disability.
- Evidence included treating physicians (physical limits) and consulting physicians (some no impairment) and social security findings.
- Bailey argued the Board erred in credibility and weighing evidence and urged treating-physician-rule-like approach; the court reviews for substantial evidence and proper findings, not de novo weighing.
- The court ultimately upheld the Board, concluding the findings were adequate and supported by substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Bailey showed a total physical disability supported by objective medical impairment | Bailey argues evidence of physical impairment supports disability | Board relied on predominance of psychological impairment | No; Board’s finding supported by substantial evidence |
| Whether the Board should adopt a treating physician rule | Bailey urges adopting treating-physician-rule like SSA | Board has not adopted such rule and lacks regulatory basis | Rejected; no adopting of treating-physician rule in Utah retirement disability context |
| Whether the Hearing Officer’s findings were adequately detailed for review | Bailey contends lack of explanation for Why certain doctors’ opinions were not persuasive | Findings stated persuasiveness of Stadler/Rondina and primary role of psychological impairment | Adequate; findings sufficiently detailed for meaningful review |
Key Cases Cited
- Martinez v. Media-Paymaster Plus/Church of Jesus Christ of Latter-day Saints, 164 P.3d 384 (Utah 2007) (substantial evidence standard and burden on employee; cited for framework)
- Grace Drilling Co. v. Board of Review of the Indus. Comm’n, 776 P.2d 63 (Utah Ct. App. 1989) (reviewing board credibility and weighing of evidence; deference to agency)
- Nyrehn v. Industrial Comm’n, 800 P.2d 330 (Utah Ct. App. 1990) (requirements of detailed findings for meaningful review)
- Adams v. Board of Review of the Indus. Comm’n, 821 P.2d 1 (Utah Ct. App. 1991) (necessity of adequate findings and review standards)
- Rushton v. Gelco Express, 732 P.2d 109 (Utah 1986) (limitations on adopting broad treating-physician rule in workers’ comp context)
- Black & Decker Disability Plan v. Nord, 538 U.S. 822 (Supreme Court 2003) (SSA treating physician rule referenced in argument but not adopted)