Brown v. Federal Express Corp., 62 F. Supp. 3d 681

Background

Shelley Brown worked for Federal Express (FedEx) and applied for short-term disability (STD) benefits in Feb 2012 and later sought long-term disability (LTD) benefits under ERISA-governed plans administered by Aetna.
Brown's treating physicians diagnosed clinical Lyme disease and Hashimoto’s thyroiditis based on symptoms and mixed/limited lab results (two negative IgM Western Blot results under CDC standards, one lab-positive but CDC-negative result); three physicians found some disability, two independent reviewers (Aetna-retained doctors) found no objective findings supporting functional impairment.
Aetna denied STD benefits (May 24, 2012) and denied Brown’s administrative appeal (Feb 8, 2013), concluding there were insufficient "significant objective findings" per the STD plan language; LTD benefits were denied because LTD requires 26 weeks of STD benefits.
Brown also alleged Aetna improperly refused to allow IV antibiotic administration at work and sought a penalty under 29 U.S.C. § 1132(c) for failure to provide the LTD plan document without charging a copying fee.
The STD plan required objective anatomical/physiological/psychological abnormalities (observable apart from symptoms); burden of proof rested on the claimant. The court took judicial notice of CDC testing standards for Lyme disease.
The Court reviewed Aetna’s discretionary denials under the arbitrary-and-capricious standard and concluded Aetna’s denials of STD and LTD benefits were not arbitrary and capricious; no penalty under § 1132(c) was awarded.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Were Aetna's denials of STD benefits arbitrary and capricious?	Brown: treating physicians’ diagnoses and lab bands constitute "significant objective findings"; Aetna relied on a non-examining reviewer.	Aetna: lab testing was not positive under CDC two-step standard; objective evidence insufficient; plan requires abnormalities observable apart from symptoms.	Court: Denial upheld — Aetna reasonably relied on lack of objective findings and CDC standards.
Did the IV antibiotic regimen make Brown disabled or unworkable?	Brown: Aetna’s assertion that IV administration could be accommodated is conclusory and unsupported, so denial was arbitrary.	Aetna: Burden is on Brown to show objective evidence that IV regimen precludes work; Brown offered only an unsworn statement.	Court: Denial upheld — Brown failed to meet burden; record lacks objective findings showing IV regimen prevents work.
Was denial of LTD benefits arbitrary given STD denial?	Brown: LTD denial improper if underlying facts support disability.	Aetna: LTD entitlement requires 26 weeks of STD benefits; Brown did not receive them.	Court: Denial upheld — LTD properly denied because STD denial stands.
Is a statutory penalty under 29 U.S.C. § 1132(c) appropriate for withholding plan document?	Brown: Defendants failed to supply LTD plan upon request, warranting penalty.	Aetna: Charged a permissible copying fee; no bad faith; plaintiff did not pay; no prejudice.	Court: No penalty — copying charge reasonable, no bad faith or prejudice shown.

Key Cases Cited

Smith v. Fed. Express Corp. Long Term Disability Plan, 991 F. Supp. 2d 992 (W.D. Tenn. 2014) (explains arbitrary-and-capricious review of plan administrator’s denial supported by objective medical evidence)
McDonald v. Western-Southern Life Ins. Co., 347 F.3d 161 (6th Cir. 2003) (deference to plan administrators with discretionary authority)
Williams v. Int’l Paper Co., 227 F.3d 706 (6th Cir. 2000) (arbitrary-and-capricious is least demanding standard but requires reasoned explanation)
Kovach v. Zurich Am. Ins. Co., 587 F.3d 323 (6th Cir. 2009) (court must review quality and quantity of evidence under deferential standard)
Glenn v. Metropolitan Life Ins. Co., 461 F.3d 660 (6th Cir. 2006) (plan discretion limits review but is not a rubber stamp)
Moon v. Unum Provident Corp., 405 F.3d 373 (6th Cir. 2005) (reasonableness of administrator’s decision controls despite courts’ possible disagreement)
Elliott v. Metropolitan Life Ins. Co., 473 F.3d 613 (6th Cir. 2006) (conclusory medical/vocational opinions without supporting reasoning can render denial arbitrary)
Morrison v. Regions Fin. Corp., 941 F. Supp. 2d 892 (W.D. Tenn. 2013) (decision must be result of deliberate, principled reasoning supported by substantial evidence)
Devlin v. Empire Blue Cross and Blue Shield, 274 F.3d 76 (2d Cir. 2001) (factors for § 1132(c) penalties: bad faith, delay, number of requests, prejudice)