Opinion

Olayinka Oye v. Hartford Life and Accident Insurance Company

  • 140 F.4th 833
Court
Court of Appeals for the Seventh Circuit
Filed
Jun 12, 2025
Status
Published
Author
Scudder
On the bench
Scudder
Cited by
9 cases
Authority
More cited than 64.1%

recognizing that plaintiff bears the burden of submitting records sufficient to demonstrate coverage, and that evidentiary gaps undermine the viability of a plaintiff’s ERISA claim

How later courts described this case

  • recognizing that plaintiff bears the burden of submitting records sufficient to demonstrate coverage, and that evidentiary gaps undermine the viability of a plaintiff’s ERISA claim
  • gaps in the record weigh against plaintiff

Written by the judges who cited it.

The opinion

In the

United States Court of Appeals

For the Seventh Circuit

____________________

No. 24-2925

OLAYINKA OYE,

Plaintiff-Appellant,

v.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY,

Defendant-Appellee.

____________________

Appeal from the United States District Court for the

Northern District of Illinois, Eastern Division.

No. 1:21-cv-03749 — Edmond E. Chang, Judge.

____________________

ARGUED MAY 29, 2025 — DECIDED JUNE 12, 2025

____________________

Before EASTERBROOK, BRENNAN, and SCUDDER, Circuit

Judges.

SCUDDER, Circuit Judge. Asserting that her fibromyalgia

prevented her from working, Olayinka Oye applied for bene-

fits through her employer’s long-term disability plan, admin-

istered by Hartford Life and Accident Insurance Company.

Hartford determined Oye was disabled, but later reevaluated

her condition, found her fit to work, and terminated benefit

payments. Oye reacted by filing this suit, seeking a federal

2 No. 24-2925

district court’s review of her benefits claim. In a detailed and

diligent opinion, the district court found that Oye’s fibrom-

yalgia, while limiting, did not render her disabled under

Hartford’s plan. We agree and affirm.

I

A

Olayinka Oye began working at PricewaterhouseCoopers

in 2005, earning many promotions and in time becoming a di-

rector. Her health took a turn in 2013, however. Suffering

from depression, anxiety, and post-traumatic stress disorder,

she took a leave of absence to seek treatment. And while Oye

briefly returned to work in 2016, she applied for disability

benefits through PwC’s Long Term Disability Plan a year

later, claiming that she suffered from fibromyalgia, a chronic

pain condition, which altogether prevented her from work-

ing.

As the Plan’s insurer and administrator, Hartford initially

denied Oye’s claim. But after Oye appealed the denial, Hart-

ford reversed course, found her disabled within the meaning

of the Plan, and awarded benefits through 2036.

Not long after Oye began receiving benefits, Hartford

changed course again. For reasons unclear from the record,

the insurer reevaluated Oye’s condition and disability claim

in 2020. Relying on the reports of several consultative doctors

who reviewed Oye’s medical records, Hartford terminated

her benefits, finding her no longer disabled.

When Hartford upheld its denial on appeal, Oye turned to

the courts. Invoking the Employee Retirement Income Secu-

rity Act, Oye filed suit in federal court in Chicago, seeking to

No. 24-2925 3

reinstate her long-term disability benefits under the Plan. See

29 U.S.C. § 1132(a)(1)(B) (ERISA’s private right of action).

B

The parties agreed to a “paper trial” pursuant to Federal

Rule of Civil Procedure 52(a), which allows the district court

to resolve the dispute without a formal trial by making find-

ings of fact and conclusions of law based on the administra-

tive record. See Fontaine v. Metro. Life Ins. Co., 800 F.3d 883,

885 (7th Cir. 2015) (observing that Rule 52(a) “is well-suited

to ERISA cases in which the court reviews a closed record”).

After outlining the history of Oye’s claim and cataloguing the

evidence for and against a finding of disability, the district

court found that Oye had failed to meet her burden of show-

ing that she was disabled within the meaning of the Plan.

While observing that Oye’s fibromyalgia no doubt caused

pain and limited her abilities, the district court determined

that the record evidence, when assessed in its totality, did not

support a finding that her condition was so disabling as to

render her unable to continue her work at PwC. Most persua-

sive, the district court reasoned, was that three of Hartford’s

medical reviewers concluded in detailed consultative reports

that Oye’s medical records and physical exams did not sup-

port her claim of complete disability. These reports, the court

explained, belied the brief and conclusory letters from Oye’s

treating physicians, which described Oye’s condition as to-

tally disabling.

The district court also granted judgment in Hartford’s fa-

vor on another, independent ground. Under the Plan, Oye

only qualified for additional disability benefits if she demon-

strated that her disability arose from solely physical, rather

4 No. 24-2925

than mental, conditions. Because the record suggested that

Oye’s mental health contributed significantly to her limita-

tions, the district court concluded that she failed to establish

entitlement to additional benefits under the Plan.

Oye now appeals.

II

A

Because the plan did not give Hartford discretion over el-

igibility determinations, ERISA obligated the district court to

review the administrative record and “come to an independ-

ent decision on both the legal and factual issues that form the

basis of the claim.” Diaz v. Prudential Ins. Co. of Am., 499 F.3d

640, 643 (7th Cir. 2007); see Firestone Tire & Rubber Co., 489 U.S.

101, 115 (1989) (explaining that “a denial of benefits chal-

lenged under § 1132(a)(1)(B) is to be reviewed under a de novo

standard unless the benefit plan gives the administrator or fi-

duciary discretionary authority to determine eligibility for

benefits or to construe the terms of the plan”). Put differently,

unlike disability proceedings in the Social Security context

and unless the plan provides otherwise, a district court con-

sidering ERISA-based disability claims owes no deference to

the plan administrator’s decision. See Diaz, 499 F.3d at 643.

Oye recognizes this standard in her brief on appeal. But in

many places she suggests the district court owed deference to

Hartford’s prior determination that she was disabled. Indeed,

Oye labors to undermine the district court’s conclusion by

pointing out deficiencies in Hartford’s handling of her claim.

For example, she faults the district court for disregarding her

claim history, insisting that the court should have given

weight to the fact that Hartford had previously approved her

No. 24-2925 5

claim based on the reports of her treating physicians—the

same physicians the district court found unpersuasive.

The district court approached its review exactly the right

way, owing no deference to Hartford’s prior decisions. See

Dorris v. Unum Life Ins. Co. of Am., 949 F.3d 297, 304 (7th Cir.

2020) (describing an ERISA plan administrator’s prior deci-

sions as “irrelevant” once a covered employee seeks federal

court review). In short, the district court committed no error

by affording no weight to Hartford’s prior finding that Oye

was disabled. The prior administrative finding had no preclu-

sive effect on the district court’s own independent review of

the record.

B

That brings us to the merits of the district court’s decision,

with our review being only for clear error. See Hess v. Hartford

Life & Acc. Ins. Co., 274 F.3d 456, 461 (7th Cir. 2001). Unless the

district court’s factual findings leave us “with the definite and

firm conviction that a mistake has been made,” we must af-

firm. Marantz v. Permanente Med. Grp., Inc. Long Term Disability

Plan, 687 F.3d 320, 336–37 (7th Cir. 2012).

Under Hartford’s Plan, Oye had to show that her fibrom-

yalgia prevented her from performing the essential duties of

a business manager and consultant. As the applicant seeking

benefits, she bore the burden of proving entitlement to those

benefits, and “any gaps in the record cut against her claim.”

Dorris, 949 F.3d at 304.

We see no clear error in the district court’s finding that

Oye failed to meet her burden. The court described in detail

its reasons for awarding certain evidence more weight. Most

important, the court articulated why it found the letters from

6 No. 24-2925

Oye’s treating physicians unpersuasive, emphasizing that

they did not explain why Oye’s medical conditions would

cause serious functional limitations and seemed otherwise in-

consistent with the same physicians’ clinical notes. The re-

ports from Hartford’s consultative doctors, in contrast, tied

each of their conclusions to portions of Oye’s medical records.

That the district court gave no weight to one Hartford con-

sultant who opined, with little explanation, that Oye had no

limitations only reinforces that the court carefully considered

the substance of each medical opinion as part of finding Oye

was not disabled.

Oye disagrees, contending that the district court erred by

crediting the consultative reports of doctors who had never

examined her over reports from her treating physicians. But

it is not our role, as a court of review, to reweigh the evidence

and decide for ourselves which doctors supplied the most

credible opinions. See Scanlon v. Life Ins. Co. of N. Am., 81 F.4th

672, 681 (7th Cir. 2023); see also Black & Decker Disability Plan

v. Nord, 538 U.S. 822, 823 (2003) (“Nothing in

ERISA … suggests that plan administrators must accord spe-

cial deference to the opinions of treating physicians.”). The

district court explained at length why it credited the more rea-

soned reports. The law required no more.

In the final analysis, then, we have a record that supports

two reasonable views of the evidence: one that Oye is disa-

bled within the meaning of the Plan, and another that she is

not. This observation ends our inquiry, for the Supreme Court

has emphasized that “[w]here there are two permissible

views of the evidence, the factfinder’s choice between them

cannot be clearly erroneous.” Anderson v. City of Bessemer City,

No. 24-2925 7

470 U.S. 564, 574 (1985); see also United States v. Contreras, 820

F.3d 255, 263 (7th Cir. 2016).

C

One final point warrants underscoring. Oye challenges the

district court’s failure to discuss what she sees as a relevant

piece of evidence: a 2017 consultative doctor’s report, solicited

by Hartford, which concluded that Oye’s fibromyalgia ren-

dered her completely disabled. Indeed, in portions of her

brief, Oye seems to suggest the district court committed clear

error by failing to discuss this particular report in its opinion.

Not so in our view.

The district court’s decision to forgo discussion of the 2017

consultative report makes sound sense. In 2016 Hartford so-

licited opinions about Oye’s condition from two different doc-

tors. One opined that Oye was completely disabled, and the

other disagreed. Hartford relied on these reports when mak-

ing its initial determination that Oye was disabled. But when

it reevaluated Oye’s disability status in 2020, Hartford solic-

ited new consultative reviews. Those more recent reviews ob-

served that Oye’s condition had improved since 2017. Un-

doubtedly realizing the comparative value of the newer re-

views, the district court reasonably focused its discussion on

the 2020 reports, while declining to discuss either of the two

reports from 2017.

In any event, the district court had no legal obligation to

discuss each piece of evidence in the record. Rule 52(a) re-

quires only that the district court “find the facts specially and

state its conclusions of law separately.” Fed. R. Civ. P. 52(a);

see Xodus v. Wackenhut Corp., 619 F.3d 683, 686 (7th Cir. 2010)

(explaining that, under Rule 52(a), a district court “need not

8 No. 24-2925

address each piece of evidence,” and is only required to “in-

clude sufficient subsidiary facts so that we can clearly under-

stand the steps by which it reached its ultimate conclusion”);

see also Amerline Corp. v. Cosmo Plastics Co., 407 F.2d 666, 669

(7th Cir. 1969) (“The court was not required under Rule 52,

Fed. R. Civ. P., to make findings on all facts presented.”).

We have emphasized this precise point in the analogous

Social Security setting, and we do so here in applying Rule

52(a): “[d]istrict courts and magistrates shoulder no obliga-

tion whatsoever to conform their opinions to any particular

template or to produce decisions of any particular length.”

Morales v. O'Malley, 103 F.4th 469, 472 (7th Cir. 2024). What

matters is that the district court provided reasoning adequate

to permit “meaningful appellate review,” see, e.g., Andre v.

Bendix Corp., 774 F.2d 786, 801 (7th Cir. 1985), and that its ul-

timate decision is “plausible in light of the record viewed in

its entirety,” Buechel v. United States, 746 F.3d 753, 756 (7th Cir.

2014) (quoting Fyrnetics (Hong Kong) Ltd. v. Quantum Grp.,

Inc., 293 F.3d 1023, 1028 (7th Cir. 2002)).

Because the district court’s decision easily satisfies these

standards, we AFFIRM.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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