Tranbarger v. Lincoln Life & Annuity Co. of N.Y.

• Decision Date: 29 March 2022
• Docket Number: 2:20-cv-00945
• Court: U.S. District Court — Southern District of Ohio
• Parties: VICKIE TRANBARGER, Plaintiff, v. LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK, Defendant.

VICKIE TRANBARGER, Plaintiff,
v.
LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK, Defendant.

No. 2:20-cv-00945

United States District Court, S.D. Ohio, Eastern Division

March 29, 2022

Deavers Magistrate Judge

OPINION & ORDER

ALGENON L. MARBLEY CHIEF UNITED STATES DISTRICT JUDGE

This matter is before the Court on the parties' cross Motions for Judgment on the Administrative Record. (ECF Nos. 25, 26). For the reasons set forth below, Defendant's Motion for Judgment on the Administrative Record (ECF No. 26) is GRANTED and Plaintiff's Motion (ECF No. 25) is DENIED.

I. BACKGROUND

A. Factual Background

Plaintiff Vickie Tranbarger worked as an Accounts Receivable Manager for David Feldman Worldwide, Inc. (“DFW”) until July 18, 2016. (ECF No. 14-3 at 54). She participated in DFW's long-term disability plan. (See Id. at 48-49). Defendant, Lincoln Life & Annuity Company of New York (“Lincoln”), serves as the administrator of the long-term disability plan for DFW employees. (Id.).

As Accounts Receivable Manager, Tranbarger oversaw, at least, portions of the accounts receivable function. Her specific responsibilities included keeping records of payments to the company; applying those payments; making calls when needed; working with collections agencies as necessary; reconciling the accounts receivable of different business lines; and assisting with

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loan reconciliation. (ECF No. 14-3 at 27). According to Defendant's occupational analysis, Tranbarger's work required her to direct, control, and oversee the “activities of others” as well as implement discretionary decision making. (Id. at 24).

According to Tranbarger, she was an otherwise healthy and active person until her gallbladder removal in late 2015. (See ECF No. 14-3 at 10; ECF No. 14-2 at 507) (“biking 5 days a week”). Upon awaking from that surgery, she suffered a panic attack and increasing anxiety. (Id.). Approximately a month and a half after surgery, she received a flu shot. (ECF No. 14-3 at 10). It was around this time she began experiencing issues with her sinuses and increased intensity of her insomnia and panic attacks. (Id.). She developed “flu-like symptoms” in December of that year in addition to her a worsening of her existing symptoms. (Id.). In January of 2016, Tranbarger experienced “pain [and] tingling in her back, shoulders and back of the legs.” (Id.). She noted, at that time she felt as if “her whole body was in cement as she was trying to go about her normal daily activities.” (Id.).

In February 2016, Tranbarger began seeing clinicians at the Mayo Clinic. (Id. at 55). There, clinicians prescribed Tranbarger Lexapro and hormone replacement therapy. (Id. at 17). Examination notes indicate that she had not been formally diagnosed with depression or anxiety. (Id.). Moreover, she had not been previously diagnosed with Fibromyalgia. (Id.). She revisited the Mayo Clinic in July that year, where she was seen by healthcare professionals in the Fibromyalgia & Chronic Fatigue Internal Medicine department. (Id.).

On July 21, 2016, Nurse McDermott diagnosed Tranbarger with Fibromyalgia and Chronic Fatigue Syndrome (“CFS”). (Id. at 20). McDermott recommended the Mayo Clinic's self-management program “which focuses on stress management, sleep hygiene, balanced lifestyle, moderation, energy conservation, and graded exercise.” (Id.). Yet, because Tranbarger's

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insurance did not cover the program, she “referred her for individual education at Mayo's Patient Education Center.” (Id.). Further, McDermott recommended medication, cognitive behavior therapy, and an “intensive physical and psychological rehabilitation program” through the Mayo Clinic. (Id. at 20-21). It is unclear whether Tranbarger's insurance covered that program. (See id.).

That same day and over the following week, Tranbarger saw three other healthcare professionals at the Mayo Clinic. (Id. at 8-22). After Nurse McDermott, she saw Nurse Stephanie Graham. (Id. at 10). Nurse Graham notes that Tranbarger complains of experiencing constant pain of varying intensity and severe fatigue. (Id.). Despite having issues sleeping, she reported “no difficulty with memory.” (Id. at 11). Nurse Graham noted that Tranbarger was currently “working from home in finance … [but] has had to take a temporary leave due to current symptoms.” (Id.). Moreover, Graham recorded that Tranbarger “describe[d] her current functional status as being very limited in being able to carry out activities of daily living.” (Id.).

On July 25, 2016, Tranbarger saw Dr. Ann Bell. Dr. Bell clarified that the sickness Tranbarger experienced in December was a sinus infection. (Id. at 15). Moreover, Dr. Bell affirmed the diagnosis of Chronic Fatigue Syndrome and additionally diagnosed Tranbarger with Temporomandibular joint dysfunction, nonobstructive deviated nasal septum, and Chronic rhinitis. (Id. at 16). Later that day, Tranbarger saw Dr. Nerissa Collins. (Id. at 8). Dr. Collins affirmed the diagnoses of CFS and Fibromyalgia and additionally diagnosed her with Postmenopausal bleeding. (Id. at 9). Regarding CFS, Collins noted that “Tranbarger would be a good candidate for a three-week pain rehab program.” (Id.). Further, she remarked that if she can't participate in that program, she recommended that Tranbarger find “a therapist locally who does CBT for anxiety and fibromyalgia.” (Id.). Finally, Collins recommended that Tranbarger consider physical

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therapy. (Id.). Importantly, no healthcare professional at the Mayo Clinic opined on Tranbarger's functional capacity.

A little over two months later, Tranbarger saw Dr. Charles Swift, her primary care physician for a “follow-up General adult exam.” (ECF No. 14-2 at 499). There, the attending nurse-Stephanie Fisher-noted that Tranbarger “felt well with minor complaints.” (Id.). Tranbarger also requested a prescription “water therapy.” (Id.). Dr. Swift documented his findings, noting the absence of “[b]ack [p]ain and [j]oint [p]ain” and describing Tranbarger's condition as normal for many tests. (See e.g., ECF No. 14-2 at 500) (“Chest and Lung Exam … Movements - Normal … Breath sounds - Normal.”). Dr. Swift noted that Tranbarger had “5/5 normal muscle strength - Left Upper Extremity, Left Lower Extremity, Right Upper Extremity and Right Lower Extremity.” (Id.). He noted that Tranbarger was “exercising and willing to try relaxant at night.” (Id.). Dr. Swift did not opine on Tranbarger's functional capacity. (See id.).

A few days later, on October 5, 2016, Tranbarger began seeing Mr. Chris Glenn and Sheldon Chisam for physical therapy. (ECF No. 14-2 at 476). As documented in her treatment plan, Tranbarger was supposed to attend physical therapy three times a week for nine to ten weeks. (Id. at 482). Planned treatment included “aquatic therapy, balance training, gait training, neuromuscular reeducation, patient education, and therapeutic exercises.” (Id.). Ultimately, however, Tranbarger would participate in physical therapy for a total of four sessions over two weeks, eventually opting to cancel any additional sessions.^[1] Although it is unclear why she stopped attending, ^[2] she does not appear to have participated in physical therapy after October 2016.

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(See ECF No. 14-3 at 475-487). On her initial visit, she had a fifty-five-minute session. (Id. at 482). There, Tranbarger reported “constant pain and fatigue.” (ECF No. 14-2 at 476). Despite her representations that day, Mr. Glenn rated her “rehabilitation potential” as “fair.” (Id.). Further, Glenn opined that Tranbarger had the following impairments and limitations: “ambulation deficits, coordination/proprioception deficits, endurance deficits, impaired sensation, range of motion deficits, strength deficits, [and] transfer deficits.” (Id.). Tranbarger represented that she has “many plans in place to address these issues including exercise, cupping, acupuncture and Tai Chi.” (Id. at 484).

Two days later, on October 7, 2016, Tranbarger had her second physical therapy session lasting forty-five minutes. (Id. at 480). There, she “report[ed] no pain today … [today] is a good day.” (Id.). Tranbarger completed the following warmup exercises: backward walking, forward walking, lateral walking for a total of five laps. (Id.). She then completed the following “lower extremity aquatic therapy” exercises: “heel raises, hip abduction/adduction, hip circles, hip flexion/extension, knee flexion/extension, squat, [and] toe raises, ” at least ten repetitions of each. (Id. at 487).

On October 10, 2016, three days later, she had her third physical therapy session. (Id. at 485). There, she noted that she experienced “a lot of soreness and pain after” the last visit. (Id.). That said, Tranbarger reported having “no pain” that day. (Id.) In addition to repeating the warmup routine and “lower extremity aquatic therapy” from the October 7 session (See Id. at 480), she biked for 5 minutes and completed the “upper extremity aquatic therapy grid, ” which consisted of rows, shoulder abduction/adduction, [and] shoulder horizontal abduction/adduction. (Id. at 481).

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On October 12, 2016, Tranbarger had her fourth and final physical therapy session that lasted forty-five minutes. (Id. at 479). She noted-again-that she was experiencing “no pain, ” just tiredness “after pool and on off days”. (Id.). For the fourth consecutive time in two weeks, was able to increase her exercise. (See id.). She completed her original warmup exercises and added in five minutes of marching. (Id.). For her “lower extremity aquatic therapy grid” she kept her original regimen and added the following exercises: forward step up and down for five repetitions and hip alphabet for one repetition. (Id. at 486). Just like in the third session, she also biked for five minutes and completed the exercises associated with the “upper extremity aquatic therapy grid.” (Id.).

On November 11, 2016, Tranbarger saw Dr. Swift, her...