noting that plaintiff submitted a “considerable amount of objective medical evidence in support of his physical disability [and] functional limitations” including multiple recent MRIs and a functional capacity examination (“FCE”)
How later courts described this case
- noting that plaintiff submitted a “considerable amount of objective medical evidence in support of his physical disability [and] functional limitations” including multiple recent MRIs and a functional capacity examination (“FCE”)
- upholding a plan administrator’s denial of claim based on lack of objective evidence
- “When, as here, the language of the plan grants discretion to an administrator to interpret the plan and determine eligibility for benefits, a court will reverse an administrator’s decision only for abuse of discretion.”
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF LOUISIANA
HOWARD SCHMILL CIVIL ACTION
VERSUS NO. 21-1470
METROPOLITAN LIFE INSURANCE SECTION M (3)
COMPANY
FINDINGS OF FACT & CONCLUSIONS OF LAW
Plaintiff Howard Schmill brought this action against defendant Metropolitan Life
Insurance Company (“MetLife”) seeking long-term disability (“LTD”) benefits under a plan
sponsored by his former employer Turner Industries Group, LLC (“Turner”).1 It is undisputed that
the LTD plan is governed by the Employment Retirement Income Security Act of 1974
(“ERISA”), 29 U.S.C. §§ 1001-1461.2 On February 1, 2022, this Court granted the parties’ joint
motion to submit the case for decision based on the administrative record and their written
submissions, without the need for a civil trial.3 Having considered the administrative record, the
parties’ memoranda, and the applicable law, the Court finds that there was substantial evidence in
the administrative record to support MetLife’s LTD benefits denial decision.4 Consequently,
1 R. Doc. 1.
2 R. Docs. 1; 14.
3 R. Doc. 16. When an ERISA case is submitted to the district court for decision based on the parties’
memoranda and the administrative record, it is “essentially a bench trial ‘on the papers’ with the District Court acting
as the finder of fact.” Muller v. First Unum Life Ins. Co., 341 F.3d 119, 124 (2d Cir. 2003); Batchelor v. Life Ins. Co.
of N. Am., 504 F. Supp. 3d 607, 610 n.2 (S.D. Tex. 2020) (“Courts have noted that a trial on the papers under Rule
52(a) is effective in the ERISA context because courts may resolve factual disputes and issue legal findings without
the parties resorting to cross motions for summary judgment.”). Rule 52(a) of the Federal Rules of Civil Procedure,
which governs actions tried on the facts without a jury, states that the district court “must find the facts specially and
state its conclusions of law separately.” A district court’s findings are sufficient under Rule 52 if they provide “a clear
understanding of the analytical process by which the ultimate findings were reached.” Valley v. Rapides Par. Sch.
Bd., 118 F.3d 1047, 1053-54 (5th Cir. 1997) (quotation omitted). “Rule 52(a) does not require that the district court
set out findings on all factual questions that arise in a case.” Id. at 1054.
4 Pursuant to Rule 52, the Court sets out its findings of fact and conclusions of law herein. To the extent a
finding of fact constitutes a conclusion of law, the Court adopts it as such, and vice versa.
Schmill is not entitled to further LTD benefits, and judgment should be entered in favor of MetLife
dismissing with prejudice all of Schmill’s claims.
FINDINGS OF FACT
I. Jurisdiction and Venue
1. Pursuant to 28 U.S.C. § 1331, this Court has jurisdiction over the claims asserted
in the complaint, because they arise under federal law, specifically, ERISA, which provides federal
courts with jurisdiction to review benefits determinations made by fiduciaries or plan
administrators. Estate of Bratton v. Nat’l Union Fire Ins. Co. of Pittsburgh, PA, 215 F.3d 516,
520-21 (5th Cir. 2000) (citing 29 U.S.C. § 1132(a)(1)(B)).
2. Venue is appropriate in the Eastern District of Louisiana under 28 U.S.C. § 1391.
II. The Parties
3. Schmill, an adult citizen of Louisiana, worked as a foreman at Turner and was
eligible to participate in its employee welfare benefit plan titled Short Term Disability and Long
Term Disability Coverage for Hourly Employees (the “Plan”).5
4. MetLife administers the Plan for Turner.6
III. The Plan
5. The Plan provides that LTD benefits for disability due to mental or nervous
disorders or diseases; neuromuscular, musculoskeletal, or soft tissue disorders; and chronic fatigue
syndrome and related conditions are subject to a lifetime maximum equal to the lesser of (1) 12
months or (2) the maximum benefit period.7
5 R. Doc. 1 at 1-2.
6 Id. at 3. The Fifth Circuit has held that the plan administrator is a proper party defendant in an ERISA
action. LifeCare Mgmt. Servs. LLC v. Ins. Mgmt. Adm’rs Inc., 703 F.3d 835, 845 (5th Cir. 2013).
7 R. Doc. 17 at 56.
6. The mental or nervous disorder disease limitation excepts disability for bipolar
disorder.8
7. “Mental or nervous disorder or disease” is defined as “a medical condition which
meets the diagnostic criteria set forth in the most recent edition of the Diagnostic And Statistical
Manual Of Mental Disorders as of the date of [the claimant’s] Disability.”9
8. The neuromuscular, musculoskeletal, or soft tissue disorder limitation includes
“any disease or disorder of the spine or extremities and their surrounding soft tissue; including
sprains and strains of joints and adjacent muscles, unless the Disability has objective evidence of
… Radiculopathies.”10
9. “Radiculopathies” is defined as “disease of the peripheral nerve roots supported by
objective clinical findings of nerve pathology.”11
IV. Schmill’s LTD Claim
10. On February 21, 2019, Schmill injured his right shoulder while playing catch with
his son, which resulted in surgery.12
11. MetLife paid short-term disability benefits to Schmill from March 8, 2019, through
March 23, 2019.13
12. MetLife approved Schmill’s LTD benefits claim related to the shoulder injury and
surgery for the period of May 24, 2019, to May 23, 2020.14
8 Id.
9 Id.
10 Id.
11 Id.
12 R. Doc. 21 at 6.
13 R. Doc. 20 at 6.
14 Id.
13. On October 1, 2019, MetLife informed Schmill that his LTD benefits would expire
on May 23, 2020, unless he provided medical information to support continued disability covered
by the Plan.15
14. MetLife requested additional medical information from Schmill on November 21,
2019, December 20, 2019, January 14, 2020, and February 13, 2020.16
15. On March 23, 2020, MetLife informed Schmill that he was receiving LTD benefits
associated with a neuromuscular-musculoskeletal or soft tissue disorder (i.e., the shoulder injury
and surgery) that is subject to the 12-month lifetime maximum. MetLife also informed Schmill
that the medical information received regarding his reported bipolar disorder did “not support a
psychiatric impairment of a severity to prevent you from returning to work” or impair normal daily
activity. MetLife noted that “[t]he documented infrequency of following for psychiatric conditions
are not consistent with a frequency and intensity expected in a severe, functionally debilitating,
psychiatric condition.”17
16. On April 23, 2020, MetLife informed Schmill that he had to meet the definition of
disability as of May 23, 2020, to be eligible to continue receiving LTD benefits.18
17. On May 11, 2020, MetLife again notified Schmill that his LTD benefits would
cease on May 23, 2020. MetLife recounted that on October 9, 2019, Schmill informed MeLife,
that he had bipolar disorder. MetLife reviewed the notes from Schmill’s healthcare providers
regarding his bipolar diagnosis, including a behavioral health initial functional assessment
completed by Hayley Folse, PMHNP, Schmill’s primary mental health provider. MetLife’s
psychiatric clinical specialist opined that Schmill’s medical records did not establish that he
15 R. Doc. 17-2 at 134-36.
16 Id. at 17-18, 60-61; R. Doc. 17-1 at 365-66, 398-99.
17 R. Doc. 17-1 at 299-301.
18 Id. at 248-49.
suffered from disabling bipolar disorder because he demonstrated improvement in his condition
and denied “[m]ore serious and severe psychiatric symptomatology more reliably associated with
psychiatric dysfunction.”19
18. On January 6, 2021, Schmill timely appealed MetLife’s denial of his LTD benefits
claim asserting that he was mentally and physically disabled from all gainful employment due to
multilevel cervical spine degenerative disc disease, radiculopathy with bilateral upper extremity
radicular symptoms, chronic right shoulder pain, type-2 diabetes, bipolar disorder, and obsessive-
compulsive disorder. Schmill argued that his LTD benefits were not limited to 12 months because
he had objective evidence of radiculopathy, particularly, a statement from his orthopedist, Scott
Buhler, MD, that Schmill had bilateral upper extremity radicular symptoms and radiculopathy,
along with MRI evidence of disc bulges, most significantly at the C4-5 and C5-6 levels. As to his
bipolar disorder, Schmill cited a November 16, 2020 questionnaire completed by Folse stating that
Schmill was unable to work due to mental health issues. Schmill also submitted a personal
statement and a statement from his wife.20
19. On July 16, 2021, MetLife informed Schmill that it had completed its review of his
appeal and had:
determined that [it was] unable to approve benefits on [Schmill’s] claim beyond
May 23, 2020 because Mr. Schmill’s disabling conditions fall under the Mental or
Nervous Disorder or Disease and Neuromuscular, musculoskeletal or soft tissue
disorder limited benefit condition provision, for which Mr. Schmill has received
the maximum benefits allowed per the Plan, which is [12] months,21 with no
additional benefits payable due to his diagnosis of depression, anxiety, rotator cuff
tear and disc bulge. Based on Mr. Schmill’s diagnosis of diabetes mellitus, this is
a non-impairing condition and no restrictions or limitations are supported.22
19 Id. at 242-44.
20 R. Doc. 17 at 851-70.
21 The letter recited 24 months, which the parties agree was a typographical error.
22 R. Doc. 17 at 616.
20. MetLife’s July 16, 2021 letter explained the history of Schmill’s short- and long-
term disability benefits claims, along with the steps it took in reviewing the denial of Schmill’s
LTD benefits claim during the appeal process. MetLife confirmed that it reviewed all information
regarding Schmill’s claim “including everything received prior to the initial decision as well as the
information submitted on appeal,” and had the entire file reviewed by three independent physician
consultants (“IPCs”) who were board certified in either psychiatry, family medicine, or orthopedic
surgery.23
21. The psychiatry-certified IPC, Elbert Greer Richardson, MD, opined that, although
Schmill’s medical records indicate he was diagnosed with bipolar disorder and he self-reported
mania, “there is no clear and convincing evidence to support this diagnosis,” and there is “no
evidence of independent assessment of psychological (or cognitive) functioning to clarify
diagnostic impressions and treatment implications.”24 Further, Dr. Richardson opined that,
although Schmill reported psychiatric symptoms that would limit him to part-time work, the
documentation on file does not support a finding of psychiatric impairment – that is, symptoms of
depression, anxiety, and ongoing poor frustration tolerance and personality pathology severe
enough – as “would totally and indefinitely preclude all work activity.”25 Moreover, there is no
documented evidence of “psychiatric treatment of a frequency or an intensity consistent with the
presence of totally debilitating psychopathology,” such as “referral to a higher level of psychiatric
care,” nor are there any “indicators of psychiatric severity that would warrant total occupational
restrictions.”26 Further, there was no “clear and convincing evidence to support” the bipolar
diagnosis because “manic episodes are not seen in serial exams and especially not seen during
23 Id.
24 Id. at 839.
25 Id. at 837-38.
26 Id. at 838.
visits where the claimant reports he is in a manic episode (thought process, speech, insight and
judgment are unremarkable throughout for bonafide manic symptoms).”27
22. The family medicine-certified IPC, Mahdy Flores, DO, opined that, considering
both the subjective and clinical information, Schmill did not have a medical condition or
combination of conditions of such severity to warrant the placement of restrictions or limitations
on his activities after May 24, 2020.28 Dr. Flores noted that Schmill’s type-2 diabetes mellitus is
controlled with medication, which “does not translate into restrictions or limitations.”29
23. The orthopedic surgery-certified IPC, Michael Chen, MD, opined that Schmill’s
file did not have “objective evidence of radiculopathy” on or around May 23, 2020, explaining:
The [American Medical Association] Guides define radiculopathy as a “significant
alteration in the function of a nerve root or nerve roots and is usually caused by
pressure on one or several nerve roots.” The most important clinical components
required to support the diagnosis of a compressive radiculopathy include: [p]ain,
numbness, and/or paresthesias in a dermatomal distribution; [a]n imaging study
documenting correlating concordant nerve root pathology; and [a]ssociated clinical
findings such as loss of relevant reflexes, muscle weakness and/or atrophy of
appropriate muscle groups, loss of sensation in the corresponding dermatome(s).30
Further, Dr. Chen stated that the disc bulges reported on Schmill’s referral MRI are not indicative
of radiculopathy, and there was no cervical MRI report in the file, making it impossible to establish
a radiculopathy diagnosis.31 After reviewing additional information provided by Schmill’s treating
orthopedist, Dr. Chen maintained his opinion that there was “no evidence upon the cervical MRI
to support the diagnosis of cervical radiculopathy,” and “there remains no evidence of neural
foraminal narrowing or encroachment on an existing or transiting nerve root.”32
27 Id. at 839.
28 Id. at 798.
29 Id. at 798-99.
30 Id. at 804.
31 Id.
32 Id. at 617.
24. MetLife’s July 16, 2021 denial letter noted that the three IPC reports authored by
Drs. Richardson, Flores, and Chen were sent to Schmill’s attorney in March 2021, so that Schmill’s
treating physicians would have an opportunity to comment. After Schmill’s attorney requested
and received several extensions, Dr. Buhler penned a June 9, 2021 letter indicating that Schmill
continues to have pain and that further evaluation and treatment by pain management and
rheumatology may benefit Schmill. Upon review of this information, Dr. Chen indicated that it
did not change his mind concerning Schmill’s claimed radiculopathy. Similarly, additional
information provided to Dr. Flores did not suggest to him that Schmill had any medical condition
of such severity to warrant restrictions or limitations based on his type-2 diabetes mellitus.33
25. On June 29, 2011, MetLife sent these IPC addendum reports to Schmill’s attorney
and gave Schmill’s physicians until July 9, 2021, to comment. MetLife did not receive any
comments or additional information.34
26. MetLife’s July 16, 2021 denial letter concluded that after reviewing all of the
evidence, including the IPC reports, the medical evidence did not support disability due to bipolar
disorder or type-2 diabetes mellitus, and lacked objective evidence of radiculopathy.35
27. As of July 16, 2021, Schmill exhausted his administrative remedies.36
28. On August 3, 2021, Schmill filed this action against MetLife alleging that
MetLife’s arbitrary and capricious denial of his LTD benefits claim violated section 502(a)(1)(B)
of ERISA (codified at 29 U.S.C. § 1132(a)(1)(B)). Schmill seeks a declaration of his continued
33 Id.at 617-18.
34 Id. at 618.
35 Id.
36 R. Doc. 1 at 3.
eligibility for LTD benefits under the Plan, payment of retroactive LTD benefits owed to him under
the Plan, prejudgment interest, attorney’s fees, and costs.37
CONCLUSIONS OF LAW
I. Standard of Review
1. The Fifth Circuit has stated the following standard of review for a challenge to an
ERISA benefits decision:
When an ERISA plan lawfully delegates discretionary authority to the plan
administrator, a court reviewing the denial of a claim is limited to assessing whether
the administrator abused that discretion. For plans that do not have valid delegation
clauses, the Supreme Court has held that “a denial of benefits challenged under §
1132(a)(1)(B) is to be reviewed under a de novo standard.”
Ariana M. v. Humana Health Plan of Tex., Inc., 884 F.3d 246, 247 (5th Cir. 2018) (quoting
Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989)).
2. The Plan delegates discretionary authority to MetLife as the plan administrator:
In carrying out their respective responsibilities under the Plan, the Plan
administrator and other Plan fiduciaries shall have discretionary authority to
interpret the terms of the Plan and to determine eligibility for and entitlement to
Plan benefits in accordance with the terms of the Plan. Any interpretation or
determination made pursuant to such discretionary authority shall be given full
force and effect, unless it can be shown that the interpretation or determination was
arbitrary and capricious.38
3. Neither side argues that the delegation of authority is unlawful, and the Court is not
aware of any reason to think so. Therefore, the abuse-of-discretion standard of review applies.
See High v. E-Sys. Inc., 459 F.3d 573, 576 (5th Cir. 2006) (“When, as here, the language of the
plan grants discretion to an administrator to interpret the plan and determine eligibility for benefits,
a court will reverse an administrator’s decision only for abuse of discretion.”).
37 Id. at 4-5.
38 R. Doc. 17 at 73.
4. Under the abuse-of discretion standard of review, a district court may consider only
the evidence that was available to the plan administrator in determining whether the administrator
abused its discretion in making its factual determinations on a plaintiff’s benefits claim. So. Farm
Bureau Life Ins. Co., v. Moore, 993 F.2d 98, 102 (5th Cir. 1993). In this case, that evidence is the
administrative record, which was filed into the court record. See R. Doc. 17.
5. The district court may not substitute its judgment for that of the plan administrator
and must uphold the plan administrator’s decision if it is supported by substantial evidence.
Chapman v. Prudential Life Ins. Co. of Am., 267 F. Supp. 2d 569, 577 (E.D. La. 2003) (citations
omitted). In this context, “[s]ubstantial evidence is more than a scintilla, less than a preponderance,
and is such relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Ellis v. Liberty Life Assur. Co. of Bos., 394 F.3d 262, 273 (5th Cir. 2004) (quotation
omitted). “The law requires only that substantial evidence support a plan fiduciary’s decisions,
including those to deny or to terminate benefits, not that substantial evidence (or, for that matter,
even a preponderance) exists to support the employee’s claim of disability.” Id. (emphasis in
original). “If the plan fiduciary’s decision is supported by substantial evidence and is not arbitrary
and capricious, it must prevail.” Id. On the other hand, the plan administrator’s decision is
arbitrary if it lacks “a rational connection between the known facts and the decision or between
the found facts and the evidence.” Corry v. Liberty Life Assur. Co. of Bos., 499 F.3d 389, 398 (5th
Cir. 2007) (quotation omitted).
II. Review of MetLife’s Decision
6. MetLife’s decision to limit Schmill’s LTD benefits to 12 months is supported by
substantial evidence found in the administrative record.
7. It is undisputed that MetLife originally approved Schmill’s LTD benefits for his
shoulder injury and subsequent surgery, which injury is a neuromuscular, musculoskeletal, or soft
tissue disorder for which LTD benefits are limited to 12 months.
8. MetLife informed Schmill on numerous occasions that his LTD benefits would
cease on May 23, 2020, unless he was able to satisfy the Plan’s definition of disability in a way
not subject to the lifetime maximum benefits limitation. Schmill attempted to do so by claiming
he had radiculopathy and bipolar disorder. MetLife repeatedly requested supporting
documentation for these claimed conditions.
9. Schmill contends that he submitted sufficient evidence of radiculopathy, including
(1) medical notes dated August 21, 2019, which reflect that he had decreased sensation in both
legs and hands, along with numbness and tingling in his legs; (2) Dr. Buhler’s December 11, 2020
note that Schmill had bilateral upper extremity radicular symptoms and radiculopathy; and (3) Dr.
Buhler’s May 4, 2020 note that Schmill had upper extremity tingling and numbness. Schmill
argues that these notes should be sufficient to prove radiculopathy because the Plan did not specify
that medical imaging confirming radiculopathy was necessary, nor did the Plan define
radiculopathy as a narrowing or encroachment on an existing or transiting nerve root.39
10. MetLife considered Schmill’s entire file, including the evidence of radiculopathy
he cites, and it reasonably found that there was no objective evidence of radiculopathy as required
by the unambiguous terms of the Plan. The Plan expressly defines “radiculopathies” as “disease
of the peripheral nerve roots supported by objective clinical findings of nerve pathology.”40
“Objective evidence” includes medical imaging such MRIs and x-rays. See Trahan v. Metro. Life
Ins. Co., 2016 WL 8252651, at *11 (W.D. La. Nov. 29, 2016), adopted, 2017 WL 561339 (W.D.
39 R. Doc. 21 at 19-20.
40 R. Doc. 17 at 56.
La. Feb. 9, 2017); see also Schully v. Cont’l Cas. Co., 634 F. Supp. 2d 663, 682-83 (E.D. La. 2009)
(noting that plaintiff submitted a “considerable amount of objective medical evidence in support
of his physical disability [and] functional limitations” including multiple recent MRIs and a
functional capacity examination (“FCE”)), aff’d, 380 F. App’x 437, 439 (5th Cir. 2010).
11. Schmill has not pointed to any objective evidence of his claimed radiculopathy in
the administrative record. Dr. Chen noted that there were no imaging studies indicative of
radiculopathy (i.e., documenting nerve root pathology) in the record, and MetLife gave Schmill
the opportunity to provide some, which he did not. Dr. Chen considered but dismissed Dr. Buhler’s
observations, to which Schmill points, for two principal reasons: first, Dr. Buhler’s observations
were based on Schmill’s subjective reports of pain, as opposed to objective evidence like imaging
studies; and second, the disc bulges revealed by the one MRI are not indicative of radiculopathy,
and no imaging reflected the requisite nerve root pathology. Courts “consistently recognize that
an insistence on objective evidence of restrictions and limitations is not arbitrary and capricious.”
Adams v. UNUM Life Ins. Co. of Am., 2005 WL 2030840, at *32 (S.D. Tex. Aug. 23, 2005); see
also Vercher v. Alexander & Alexander Inc., 379 F.3d 222, 230-31 (5th Cir. 2004) (upholding a
plan administrator’s denial of claim based on lack of objective evidence); Richardson v. Metro.
Life Ins. Co., 2014 WL 1050758, at *11 (E.D. La. Mar. 14, 2014) (holding that MetLife did not
abuse its discretion in denying benefits where claimant did not provide results of an FCE or other
tests that would confirm his subjective reports of pain or otherwise support the restrictions listed
by his treating doctor). Thus, MetLife’s conclusion that Schmill was not entitled to continued
LTD benefits because the administrative record lacked objective evidence of radiculopathy was
not arbitrary and capricious. Said another way, Metlife’s determination was certainly supported
by substantial evidence – that is, more than a scintilla – in the administrative record.
12. With respect to his bipolar disorder, Schmill argues that MetLife abused its
discretion by ignoring the opinions of Folse, his treating nurse practitioner, and instead relying on
its psychiatric IPC, Dr. Richardson.41
13. MetLife clearly considered Folse’s opinions but found them wanting. Dr.
Richardson acknowledged that Schmill was reportedly diagnosed with bipolar disorder, but he
found that there was no evidence of disabling bipolar disorder. Under the Plan, a mental or nervous
disorder or disease must meet “the diagnostic criteria set forth in the most recent edition of the
Diagnostic And Statistical Manual Of Mental Disorders [“DSM”] as of the date” of the claimant’s
disability.42 For a bipolar disorder diagnosis, the DSM-5 requires a manic episode – that is, an
elevated, expansive, or irritable mood – lasting for at least one week and present most of the day,
nearly every day, and including at least three of the following symptoms representing a significant
change from usual behavior: inflated self-esteem or grandiosity; decreased need for sleep;
increased talkativeness; racing thoughts; distracted easily; increase in goal-directed activity or
psychomotor agitation; and engaging in activities that hold the potential for painful consequences,
such as unrestrained buying sprees.43 Dr. Richardson found that there was no evidence of manic
episodes in Schmill’s medical file, including Folse’s notes, other than Schmill’s own reports of
them. Because Schmill’s documented symptoms did not meet the DSM-5 definition of bipolar
disorder, MetLife’s decision to deny continuing LTD benefits based on a reported bipolar disorder
diagnosis was not arbitrary and capricious. Bottom line, again, MetLife’s decision was certainly
supported by substantial evidence – that is, more than a scintilla – in the administrative record.
41 R. Doc. 21 at 22-25.
42 R. Doc. 17 at 56. The most recent edition is the DSM-5.
43 Jessica Truschel, Bipolar Definition and DSM-5 Diagnostic Criteria, PSYCOM (Sept. 29, 2020),
https://www.psycom.net/bipolar-definition-dsm-5.
14. Finally, Schmill argues that MetLife abused its discretion by failing to consider the
compounding effects of all of his mental and physical conditions.44 This argument misses the
mark. Schmill’s original LTD benefits claim related to his shoulder injury, which was subject to
the 12-month lifetime maximum for neuromuscular disorders. MetLife consistently informed
Schmill of this limitation period and the requirement that benefits could only continue after the
limitation period if he otherwise satisfied the Plan’s definition of disability. Schmill tried to do so
by submitting information to MetLife in support of his claims of radiculopathy and bipolar
disorder. After a full review of the administrative record and giving Schmill multiple opportunities
to supplement the record, MetLife found those claims insufficient. Moreover, Dr. Flores reviewed
Schmill’s entire file and found that the subjective and clinical evidence does not suggest that
Schmill suffers from a medical condition or combination of conditions of such severity to warrant
the placement of restrictions or limitations on his activities beyond May 24, 2020. Thus, MetLife’s
decision was supported by substantial evidence and thus was not arbitrary and capricious.
CONCLUSION
Accordingly, for the foregoing reasons,
IT IS ORDERED that Schmill is not entitled to further LTD benefits.45
IT IS FURTHER ORDERED that judgment be entered in favor of MetLife and against
Schmill dismissing with prejudice all of Schmill’s claims against MetLife.
New Orleans, Louisiana, this 11th day of July, 2022.
________________________________
BARRY W. ASHE
UNITED STATES DISTRICT JUDGE
44 R. Doc. 21 at 23-24.
45 Because Schmill is not entitled to further LTD benefits, the Court need not address his claim for attorney’s
fees and costs.