Holden v. Unum Life Insurance Company of America
| Decision Date | 08 July 2021 |
| Docket Number | 20-6318 |
| Parties | LISA HOLDEN, Plaintiff-Appellant, v. UNUM LIFE INSURANCE COMPANY OF AMERICA, Defendant-Appellee. |
| Court | U.S. Court of Appeals — Sixth Circuit |
In this case for long-term disability benefits brought under the Employee Retirement Income Security Act ("ERISA") 29 U.S.C. § 1101 et seq., Plaintiff-Appellant Lisa Holden appeals the denial of long-term disability benefits under her plan with her former employer, Williams & Connolly, LLP and its administrator, Defendant-Appellee Unum Life Insurance Company of America. For the foregoing reasons, we affirm.
Lisa Holden worked as an assistant controller at Williams & Connolly, LLP in Washington, DC from 1997 to 2005, at which time she was promoted to Deputy Director of Finance. In that new position, Holden was in charge of all tax reporting for the firm and oversaw six pension plans, the firm's financial reporting, and accounts payable. Holden reported that she had "chronic stress" while working at Williams & Connolly, and that the "workload [was] so much." Given the "low head count" in the accounting department, Holden claims that she and others in accounting had to "pick up all the slack," and as a result, she worked excessive hours. She claims one boss told her she should wait to have another child, given the number of hours she worked.
The hours and workload were not the only problem. Holden reported that despite the nearly two decades she dedicated to the firm, "they did not show any dedication to her." She described her time at the firm as "traumatic" and explained that she experienced bullying, abuse, and harassment including sexual harassment from the firm's executive director in the early 2000s. Holden reported to HR issues in the accounting department which largely appear to be based on Holden's interaction with two other employees.[1] For example, Holden claims that the two employees met with her boss in a "secret meeting" after which Holden was passed up for a promotion. At one point in 2013, Williams & Connolly had a consultant come in, and that consultant reported that she "could see all the vitriol and anger" that the two other employees displayed toward Holden and noted "what a bad environment" it was for Holden.[2] Holden maintained that she "worked incredibly hard" but that others at the firm "denigrated her by telling her the only reason they liked her was because she worked so hard." She claimed she was "alienated completely," and that her superiors "yanked out all of her authority" without any concomitant decrease in responsibility. Holden felt she was withdrawing from others in her life when "these years of abuse at work started to kick in."
After reporting the above, Holden told Unum that "all of these little things" came together and led her to leave work. She left because she was "feeling sick and anxiety-ridden" and because she felt her employer did not want her that and that it was "time to go." She reported to Unum that she spent her time "thinking about all of the abuse at work and trying to process it," feeling that she had nowhere to go. On August 12, 2015, Holden contacted her primary care physician, Dr. Lucy Chang, who suggested Holden leave work. Holden's last day at Williams & Connolly was August 14.[3]
Two days before her departure, Holden applied for short-term disability benefits with Unum. In speaking with Unum, Holden reported anxiety, tearfulness, nightmares, tremors, an inability to focus, insomnia, fatigue, social withdrawal, a sense of impending doom, and poor appetite. Holden also explained to Unum that she "thinks it's primarily the work situation . . . most of her hours are spent at the office."[4] Holden then obtained evaluations and treatment from two treating physicians-Dr. Chang and Dr. Fischer-whose evaluations and conclusions formed the basis of Unum's initial long-term disability denial.
Holden's primary-care physician, Dr. Chang, first examined Holden on August 24, 2015. She described Holden as presenting with a diagnosis of stress-related anxiety and as feeling "very stressed from work." Holden reported having nightmares and feeling anxious "because of altercations at work." Dr. Chang reported that Holden was "feeling somewhat better" but still had a low mood, persistent sadness, forgetfulness, anger, hypervigilance, and a feeling of victimization. She also noted that Holden was recently "passed up for a long expected promotion[.]" In her attending physician statement provided to Unum, Dr. Chang diagnosed Holden as suffering from "anxiety and situational depression."
Throughout the fall of 2015, Holden visited a psychiatrist, Dr. David Fischer. On August 20, 2015, Holden first reported to Dr. Fischer that she thinks she has "complex PTSD." Fischer's chart notes that Holden has In that initial evaluation, Dr. Fischer noted that Holden's thought process was within normal limits and that she presented as "organized[, ] [g]oal [d]irected, [c]oherent, [and] [l]ucid." He also noted the absence of any obsessions or phobias. He did note that PTSD was present, given an "[a]busive relationship at work." He then implemented a treatment plan including psychoeducation, psychotherapy, and psychiatric medication. In an FMLA certification form on August 26, 2015, Dr. Fischer noted that Holden was "presently incapacitated" and that her condition would render her "unable to perform work of any kind." On September 5, in a separate response to a questionnaire from Unum, this one for her short-term disability claim, Dr. Fischer responded to a question asking whether Holden's "condition [was] due to sickness involving the patient's employment" in the affirmative, saying that her condition was due to "stress related to work."
On September 24, 2015, Holden reported to Dr. Fischer that she was improving, "[f]eeling less depressed, and "[had] ambivalent feelings about her job." Dr. Fischer noted that the "[p]sychosocial stressors [were] manageable[.]" He also wrote that Holden displayed logical, realistic thinking with no noted abnormalities present. Holden's "judgment concerning everyday activities and social situations [was] intact" and she "[was] developing the ability to accurately perceive and recognize the consequences of her behavior." He did, however, describe her depressed mood, insomnia, poor appetite, and poor concentration.
On September 30, Dr. Fischer noted that Holden's psychosocial stressors-"manageable" a week before-were now "overwhelming." Her symptoms included anxiety, depression, sadness, and low energy. On October 7, Holden reported "feeling a little better" although she was not sure if she was ready to return to work. Her psychosocial stressors remained "overwhelming."[5] On October 13, she reported largely the same-feeling better but with overwhelming stressors-but Dr. Fischer did note that it had "become apparent that work does not want her to return." On October 19, she again reported feeling a little better and had more energy, and her psychosocial stressors were back to "manageable." She did, however, report poor focus and concentration and "ruminat[ed] about treatment at work."
On October 22, Dr. Fischer responded to a Unum questionnaire about Holden's condition. He diagnosed her with "Major Depression Single Episode" and PTSD. He explained that Holden "has poor concentration and [an] inability to focus-anxious-not thinking in a goal directed manner." When asked whether Holden's condition was "caused by, contributed by, or exacerbated by [her] employment," Holden answered in the affirmative, explaining that Holden "feels that she was in an abusive relationship at work[.]" He continued, explaining that Holden had become depressed with low self-esteem and "[f]eels she has been displaced by others at work." He described Holden as unable to plan and organize information and as unable to "function at her current work situation due to poor memory and poor concentration and a lack of support from management." Dr. Fischer also answered that Holden would not-"at this time"-be able to perform the same occupation with a different employer. Dr. Fischer did not write anything in the subsequent question asking for an explanation of his rationale for answering this question in the negative.
On October 26, Dr. Fischer noted that Holden "[c]ontinues to ruminate about her treatment at work." Her focus and concentration remained poor, but she was now sleeping and eating well. That same day, Dr. Fischer completed a form from Unum in which he wrote that Holden feels "emotionally numb" and that he does not think that Holden would be able to perform the demands of her occupation with a different employer at that time. When asked to explain why Holden would not be able to work for a different employer Dr. Fischer wrote that He also wrote that Holden "cannot function at her current work situation" due to poor memory, poor concentration, and "lack of support from management." On November 5, Dr. Fischer's charts note that Holden was "still having difficulties concentrating and organizing her thoughts" and was "still puzzled about what has occurred at...
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