Opinion

UNITED STATES DISTRICT COURT

CENTRAL DISTRICT OF CALIFORNIA

Laura Cyr, an individual, 2:23-cv-06286-DSF-RAO

Plaintiff,

Findings of Fact and Conclusions

v. of Law After Bench Trial on

Administrative Record

Reliance Standard Life Insurance

Company, an Illinois corporation,

and Susan Strickler, an

individual,

Defendants.

This is an action for benefits under the Employee Retirement

Income Security Act of 1974 (ERISA), 29 U.S.C. § 1001 et seq. Plaintiff

Laura Cyr contends she is entitled to long-term disability benefits

under the terms of the long-term disability policy Defendant Reliance

Standard Life Insurance Company (RSL) issued to her former

employer, Channel Technologies, Inc. (CTI). A bench trial on the

administrative record was held on March 31, 2026. After consideration

of the parties’ trial briefs, oral arguments, and the evidence in the

Administrative Record (AR),1 the Court makes the following Findings

of Fact and Conclusions of Law.

1 The Court refers to pages from the Administrative Record as “AR __.” RSL

has also filed separate documents it asserts are part of the “old” or “original”

claim (OC) file. Dkt. 124 (Defs.’ Notice of Lodging of the Administrative R.)

at 1. The pages of the OC, as filed, are numbered consecutively following the

page numbers in the AR. The parties do not dispute that the documents

I. Findings of Fact

A. The Long-Term Disability Plan

1. Cyr was employed by CTI until she ceased working in 2000. AR

376, 1875. CTI established an ERISA-governed plan (the Plan)

that provided long-term disability (LTD) benefits to eligible

employees through a group insurance policy issued by RSL. AR

1-29, 284-287. RSL is the named claims administrator for

benefits under the LTD plan. AR 17.

2. The Plan provides that RSL “will pay a monthly benefit if an

insured: (1) is Totally Disabled as the result of a Sickness or

Injury covered by this policy; (2) is under the regular care of a

Physician; (3) has completed the Elimination Period; and (4)

submits satisfactory proof of Total Disability to [RSL].” AR 21.

3. Total disability means that, “as a result of an Injury or Sickness,”

during the period a monthly benefit is payable, the insured

“cannot perform the material duties of his/her regular

occupation.” AR 12.

a. An insured who is “Partially Disabled” is considered

“Totally Disabled.” Id. Partial Disability means that, “as a

result of an Injury or Sickness an Insured is capable of

performing the material duties of his/her occupation on a

part-time basis or some of the material duties on a full-time

basis.” Id.

b. Sickness is defined as “illness or disease causing Total

Disability which begins while insurance coverage is in

effect for the Insured.” Id. “Injury” means “bodily injury

resulting directly from an accident, independent of all other

causes.” AR 11.

contained in the OC are part of the AR, and they both cite the OC as such in

their briefing. Therefore, the Court cites pages from the OC using the same

format as it does pages in the AR.

4. The policy provides that benefits will stop on “the date the

Insured ceases to be totally disabled.” AR 22.

B. Cyr’s Employment

5. Until 2000, Cyr was employed as Vice President of

Administration at a subsidiary of CTI. AR 376, 1875.

6. Cyr reported to the President of the company, and her job duties

included “management of all the various departments with

special emphasis on formulating of financial plans and policies,

and providing overall direction for accounting and budget

functions.” AR 1875.

7. As part of an occupational assessment for Cyr’s job, RSL obtained

a generic occupational description for a Vice President. AR 1958.

The occupational description states that a Vice President’s role

includes, among other things, “[p]lan[ning], direct[ing], and

coordinat[ing] operational activities at the highest level[.]” Id.

RSL classified Cyr’s regular occupation as Vice President of

Administration as “sedentary.” AR 1961. According to the

insurer’s Occupational Requirements document for a Vice

President, Cyr’s sedentary work required occasionally lifting up

to 10 pounds. Id.

8. Cyr’s position required both cognitive function and sedentary

capacity. See AR 1875; 1958-61.

9. Cyr’s job description and RSL’s occupational description indicate

that the material duties of Cyr’s occupation included: (1)

managing various departments; (2) formulating plans and

policies; (3) directing accounting functions; (4) directing budget

functions; (5) planning, directing, and coordinating operational

activities; (6) formulating and administering company policies;

and (7) developing long-range goals and objectives. AR 1875; AR

1958-61.

10. According to the occupational description employed by RSL, the

physical demands of Cyr’s occupation included occasionally lifting

up to 10 pounds, frequently talking and hearing, occasionally

reaching, handling, and fingering. AR 1961.

C. Cyr’s Medical Conditions and Initial LTD Claim

11. After separating from her employment in 2000, Cyr submitted a

disability claim based on a back condition stemming from a

previous automobile accident. AR 2002-03, 2012. RSL approved

Cyr’s claim and began paying disability benefits in 2001. AR

2397.

12. During the time RSL was paying benefits to Cyr, she asserted

additional grounds for disability, with diagnoses including, but

not limited to: cervical disc disease, AR 2165; multiple sclerosis

(MS), AR 3151; complex regional pain syndrome/reflex

sympathetic dystrophy, AR 468; seizure disorder, AR 2634;

strokes, AR 904; other orthopedic complications, AR 956; and

traumatic brain injury (TBI), AR 561, 974.

13. From 2001 to 2021, RSL continued to find Cyr met the definition

of total disability. For example, during a 2014 review, RSL

acknowledged Cyr’s MS and seizure disorder diagnoses and found

that a “[l]ack of consistent work function [was] supported.” AR

2874.

14. RSL cites Cyr’s “increasingly complex and evolving medical

complaints” and “the continued certification of disability by her

primary care physician, Dr. Barbara Hrach” as its grounds for

continuing to pay her claim. Dkt. 129 (Defs.’ Br.) at 6.

15. Cyr’s claim was eventually transferred to RSL’s Extended

Duration Unit. See AR 218, 263. To verify continued disability

and establish entitlement to ongoing benefits, Cyr was required

to provide updated documentation on an annual basis. AR 218.

16. In February 2021, RSL requested updated records from Cyr and

her health providers, covering a period starting January 1, 2019

up to the date of the request. AR 280-81. RSL received updated

records from many of Cyr’s providers. AR 226-228, 243-244.

17. Cyr’s psychiatrist Dr. Early and therapist Neil Friedman did not

provide records for RSL’s review. See AR 150, 281-83, 681.

Friedman explained in a letter to RSL that he was not treating

Cyr’s neurological issues directly, and that her neurologist and

physicians were the appropriate authorities to assess her

working ability. AR 681.

18. During the time covered by the February 2021 records requests,

multiple doctors documented Cyr’s condition and symptoms and

provided medical records to RSL, including: (1) her California-

based primary care physician since 1999, Dr. Barbara Hrach, AR

2012; (2) her neurosurgeon Dr. Richard Chung, AR 2844; (3) her

treating physician in Colorado since 2016, Dr. Kelley Glancey,

and Dr. Glancey’s colleagues at Byers Peak Family Medicine, AR

489, 531; (4) her neurologist since 2019, Dr. Michael Gibbs, AR

490; (5) her orthopedist since 2019, Dr. Premjit Deol, AR 606-607;

and (6) Dr. Michael Pifer of Ortho Surgical Practice in Santa

Barbara, AR 581-590. Cyr also submitted self-reported

information. AR 489.

19. In 2019, Cyr was involved in an accident where a golf cart rolled

over her, resulting in multiple fractures requiring surgery for her

pelvis and arm. AR 615, 637-41. In progress notes, Dr. Deol

noted that Cyr experienced “persisting numbness in her fingers

after surgery” and “intermittent paresthesias of her left lateral

upper leg.” AR 620-23. Dr. Deol diagnosed Cyr with left leg

paresthesias and numbness of her right hand, AR 612-14, which

Dr. Deol noted was worsening during a December 2019 visit, AR

610. Still, Dr. Deol included in his notes that Cyr was doing

“remarkably well” and “ha[d] been doing some hiking and even

just this weekend skied for about 5 hours.” Id.

20. Dr. Glancey and her colleagues at Byers Peak Family Medicine

reported that Cyr experienced continuing pain and seizure

activity. See AR 536-37, 542, 1175. Cyr saw Dr. Glancey or one

of her colleagues nearly monthly during the reporting period. See

528-80.2 Throughout their reports, her providers consistently

noted headaches and pain in her arm. See id. While some

reports note improvements in pain levels—AR 538-40, 550, 566-

70—her providers consistently note headaches and left arm pain

that were at times “significant,” “severe,” or worsening—AR 544-

48, 570, 576. Dr. Glancey noted in 2019 that Cyr “ha[d]n’t been

able to read well.” AR 576.

21. Records from Dr. Gibbs in 2020 indicate a confirmed diagnosis of

non-epileptic seizures, though he noted her EEG was normal.

AR 511. However, Dr. Gibbs questioned whether Cyr’s MRI

images supported an MS diagnosis, writing in a letter to Dr.

Hrach that he “suspect[ed] [MS] was a wrong diagnosis made

many years ago.” AR 508.

22. In 2020, Cyr’s primary care physician, Dr. Hrach, submitted an

updated attending physician’s statement (APS). AR 468-79. The

form listed diagnoses of cervical disc disease, MS, complex

regional pain syndrome, and seizure disorder as the bases for

Cyr’s disability claim. AR 468. She reported symptoms including

headaches and arm pain. Id. Dr. Hrach checked boxes indicating

that Cyr had “retrogressed” and should “cease work.” AR 469,

982. Dr. Hrach described restrictions imposed on Cyr as “no

driving, lifting,” or “prolonged standing.” AR 469. In 2020, Dr.

Hrach indicated that Cyr could not “resume some/all work duties

while continuing treatment.” Id. Dr. Hrach’s notes also stated

that Cyr could sit for 10 hours, stand for four hours, and walk

daily. AR 472. She indicated that Cyr could occasionally lift up

to one pound and occasionally carry less than or equal to 10

pounds. Id. Dr. Hrach noted that Cyr had no psychiatric

impairment, visual impairment, or hearing impairment. AR 470-

71.

23. In an Activities of Daily Living Questionnaire dated February 21,

2021, Cyr reported that her medical conditions caused cognitive

2 There is a gap between October 2019 and February 2020. See AR 531-33.

impairments affecting communication, short-term memory,

comprehension, and reading. AR 489. The form also indicated

she was taking several medications daily, including Keppra,

gabapentin, carbamazepine, baclofen, and fentanyl. Id. She

reported activities including sewing sometimes, golfing

sometimes, skiing sometimes, and participating in pool therapy.

AR 495. She noted that she spent 40 minutes on a computer once

monthly. Id.

D. RSL Terminates Benefits; Cyr Appeals

24. In a letter dated June 4, 2021 (Initial Denial Letter), RSL

notified Cyr that her LTD benefits would be terminated. AR 284-

85. RSL wrote that it had “reviewed all of the information in

[Cyr’s] claim file,” and found that she no longer met the definition

of Total Disability under the policy. Id. The letter stated:

A staff Medical Specialist reviewed all of the

available information on file. The staff Medical

Specialist noted that Dr. Deol noted a follow-up visit

dated 12/4/2019 that states in part “She has actually

been doing remarkably well and has reported that

she has been doing some hiking and even just this

weekend skied for about 5 hours. She says she gets a

little bit of soreness, but not enough to stop her from

being active.” In addition, records from Family

Medicine note that your chronic pain is unchanged

but you were feeling good overall and seizures were

due to medication. The Attending Physician

Statement signed by Dr. Hrach on March 13, 2020

states that you are capable of sitting for 10 hours at a

time, with walking and standing for 1 hour at a time.

Based on the totality of information, the staff Medical

Specialist concluded that you are capable of

sedentary work activity.

. . .

As your pre-disability occupation is sedentary, you

are no longer precluded from performing the material

duties from regular occupation. Therefore, you no

longer meet the above mentioned definition of Total

Disability.

AR 285.

25. The letter did not address Cyr’s cognitive abilities. See AR

284-85.

26. Over the year following RSL’s termination of her claim,

Cyr, her doctors, and her attorneys provided additional

information to support reinstatement of her benefits.

27. Immediately after RSL terminated her claim, Cyr

submitted, or caused to be submitted, letters from her

physicians, attending physician statements, progress notes,

clinical notes, and other medical records to show she

remained entitled to LTD benefits. See AR 238-42.

28. On May 31, 2022, after Cyr retained counsel, her attorneys

submitted an ERISA appeal that included legal argument

and updated attending physician statements, letters from

Cyr’s doctors, and progress notes. AR 1146-85.

29. In a letter dated June 8, 2021, Dr. Hrach offered her

medical opinion and asked that RSL reconsider denial of

Cyr’s LTD benefits. AR 774. Dr Hrach acknowledged that

she had previously stated Cyr could sit for 10 hours a day,

but that after discussing the matter with Cyr “it is

apparent that she is not able to sit for any length of time.”

Id. Dr. Hrach stated that Cyr “suffers from chronic neck

pain, has reflux sympathetic dystrophy in her arm, has

chronic back and pelvic pain, and is on high doses of

fentanyl chronically to control her pain.” Id. Dr. Hrach

opined that Cyr was unable to perform her job duties, and

that her physical and mental conditions were worse than at

the onset of her disability. Id. In an APS form dated June

22, 2021, Dr. Hrach listed the same diagnoses as in 2020

but added the symptom of “difficulty concentrating.” AR

980. She again indicated that Cyr had “retrogressed” and

should “cease work” with similar restrictions on driving,

lifting, and standing. AR 982. For psychiatric impairment,

Dr. Hrach checked a box to indicate that Cyr was “able to

engage in only limited stressful situations and engage only

in limited interpersonal relations” due to her medications

and seizures. AR 984.

30. After RSL terminated her benefits, Cyr saw Dr. Deol for an

appointment on June 9, 2021. AR 949-51. In his notes, Dr.

Deol wrote that Cyr “[brought] to our attention that our

previous note had indicated she had skied for five hours”

but that “[u]nfortunately, that was a mistake on my part

and I misdocumented that she was active for five hours

over the course of the month, but not able to ski for five

hours continuously.” AR 950. He opined that she was

“pretty limited,” having “trouble even with sedentary

activities,” and was “permanently disabled.” Id.

31. The record also contains an updated APS form completed

by Dr. Glancey, dated July 19, 2021. AR 1720-25. It

indicates that Cyr was last examined on July 8, 2021, that

she has cervical disc disease, MS, RSD, headache

symptoms, acute pain, and seizures, that she can sit for a

maximum of 45 minutes in a day, and that the level of

functional impairment is to “cease work.” AR 1720.

32. Additionally, Cyr submitted an updated APS form from Dr.

Gibbs dated June 9, 2021. AR 1728-35. It lists diagnoses

of MS and seizures, and symptoms including memory loss,

speech difficulty, and left arm and leg pain. AR 1728. Dr.

Gibbs indicated Cyr’s progress was “unchanged” and circled

that she should “cease work.” AR 1730.

E. The Burns Report

33. In response to Cyr’s appeal, RSL commissioned a peer review

through a third-party vendor, who selected Dr. Norman Burns to

review Cyr’s records. AR 1233-39.

34. Dr. Burns conducted a paper review and summarized his findings

in a report (the Burns Report) in which he responded to eight

review questions covering topics including Cyr’s medical

conditions, prognosis, continuing impairment, and work capacity.

See AR 1271-73.

35. Responding to the review question asking him to address medical

conditions impacting Cyr’s status, Dr. Burns wrote:

Based on the provided medical records, the claimant

has neurologic diagnoses consisting of epileptic and

non-epileptic seizures and possible multiple sclerosis.

Documentation provided indicates seizures are well

controlled with occasional non-epileptic events

related to stress and pain. Her multiple sclerosis has

been stable for years with unchanged MRIs. An

ongoing neurologic impairment from 6/10/2021 and

continuing is not supported.

AR 1271.

36. Responding to the review question asking if there is “medical

data to substantiate the presence of complaints as of 6/10/2021

going forward,” Dr. Burns responded:

The medical records indicate chronic and diffuse

multi focal pain in the neck, back, and arms. There

are extensive treatment notes from pain management

and orthopedic surgeons. Ongoing neurologic

complaints of intermittent seizures are documented,

though are non-epileptic and occur every few months.

A neurologic impairment is not supported.

AR 1271.

37. Another review question asked if Cyr “has work capacity on a full

time consistent basis as of 6/10/2021 going forward,” prompting

Dr. Burns to state his opinion based on the definition of a

sedentary occupation. AR 1272. Sedentary was defined as:

Exerting up to 10 pounds of force occasionally and/or

a negligible amount of force frequently to lift, carry,

push, pull, or otherwise move objects, including the

human body. Sedentary work involves sitting most of

the time, but may involve walking or standing for

brief periods of time. . . . Jobs are sedentary if

walking and standing are required only occasionally

and all other sedentary criteria are met.

Id. Dr. Burns responded, “From a neurologic perspective

the claimant is considered to have full time work capacity.”

Id.

38. Dr. Burns was not asked to consider the cognitive demands

of Cyr’s occupation, nor did he address her material duties.

See AR 1271-72. He addressed only whether she had

sedentary capacity. AR 1272.

39. RSL sent the Burns Report to Cyr’s counsel in a letter

dated June 28, 2022. AR 1266. Cyr was given until July

19, 2022, to respond to the report with additional

information. Id.

40. On July 19, 2022, Cyr’s attorneys responded to RSL,

submitting a letter from Dr. Hrach and documentation

from other physicians treating Cyr. AR 1418-20. In her

letter, Dr. Hrach expressed disagreement with findings in

the Burns Report. AR 1464. Of Cyr’s condition, she wrote:

[Cyr] has been a patient in my Internal Medicine

practice for over 20 years. Over these years I have

observed her physical condition deteriorate. She

suffers from chronic cervical radicular pain, chronic

migraines and a complex regional pain syndrome

involving the left upper extremity. She has been on

high doses of narcotics for many years to control this

pain as well as trials of various neuroleptics,

triptans, CGRP inhibitors, muscle relaxers and anti-

inflammatory medications. Despite these, she

continues to suffer from intractable pain and the

inability to mobilize her neck or left arm. She has

had multiple fractures including a recent pelvic

fracture that resulted in bilateral SI joint instability

requiring bilateral SI joint fusion surgeries last year.

She also has been diagnosed with multiple sclerosis

and seizure disorder and is on chronic medication for

these conditions. She contacted me just last week

describing a recent increase in seizure activity and

flair [sic] up of the CRPS symptoms in her left arm.

Id.

41. Dr. Hrach also noted the Burns Report excluded certain

conditions, including Cyr’s “complex regional pain

syndrome, migraine headaches, cervical fusion with chronic

radicular pain or pelvic fracture and SI joint instability

diagnoses.” AR 1464. She stated that Dr. Burns’

statements—that (1) Cyr’s seizure disorder was well

controlled, (2) she had no upper extremity impairment, and

(3) had full time work capacity—were false and

contradicted Dr. Hrach’s previous documentation. Id. Dr.

Hrach reiterated Cyr was “unable to sit for any length of

time.” Id. Dr. Hrach added that Cyr’s medications

“directly affect her cognitive function.” AR 1465.

42. Cyr submitted an APS from Dr. Glancey, as part of the July

19, 2022 submission, which recited Cyr’s various diagnoses,

stated she “can sit for a maximum of 45 minutes in a day,”

and noted the level of functional impairment was to “cease

work.” AR 1467. The APS provided that Cyr’s progress

remained “unchanged.” Id.

43. As part of the July 19, 2022 submission, Cyr also submitted

an APS dated June 9, 2021 and progress notes from her

neurologist, Dr. Gibbs. AR 1728-1735. Dr. Gibbs cited

current symptoms from Cyr’s diagnoses, including seizures,

memory loss, speech difficulty, and pain in her left arm and

leg. AR 1728. Dr. Gibbs also stated in the APS that Cyr

could sit for 45 minutes at a time up to a total of one hour

per day, that her functional impairment is to “cease work”

and that her progress was “unchanged.” AR 1730.

Updated records from Dr. Gibbs indicated that, during

2021 and 2022, Cyr experienced episodes of loss of

awareness noted by her family, migraines, an exacerbation

of her reflex sympathetic dystrophy, and functional speech

disorder. AR 1739-45.

44. Dr. Burns did not change his findings after the new

information was submitted, writing that the “additional

records [did] not alter [his] opinion.” AR 1802-03.

45. On July 22, 2022, Cyr submitted a letter (the Gibbs Letter)

signed by her neurologist Dr. Gibbs. AR 1794-96. The

letter stated that Cyr had ongoing “disabling impairments”

of reflex sympathetic dystrophy, “non-responsiveness/loss of

awareness,” migraine headaches, and functional speech

disorder, and opined that “[n]one of these impairments is

well controlled and all preclude Ms. Cyr from performing

the material duties of her regular occupation.” Id.

Additionally, the letter stated that Cyr’s medications

impaired her ability to work. AR 1795. Dr. Gibbs opined

that Cyr was “unable to perform the material duties of her

regular occupation.” Id.

46. The Gibbs Letter was drafted by Cyr’s attorneys and signed

by Dr. Gibbs without changes. Compare Dkt. 129-1

(Bernacchi Decl.) ¶ 12, Ex. 5, with AR 1794-96. As part of

the tort action related to this case, Dr. Gibbs testified in a

deposition that he “[did not] have any independent

recollection of writing [the Gibbs Letter], but, clearly, [he]

signed it.” Dkt. 141-5 (Gibbs. Dep.) 76:4-6.

F. RSL Denies Cyr’s Appeal

47. In a letter dated July 26, 2022 (Final Denial), RSL informed Cyr

it was upholding the termination of her LTD benefits. AR 303-

09. In the Final Denial, RSL stated it had “concluded that the

information does not substantiate a medical condition at a level

of severity, precluding Ms. Cyr from performing the full-time

material duties of a sedentary occupation beyond June 10, 2021.”

AR 303. RSL referenced the occupational assessment for Cyr’s

position as Vice President of Administration, concluding that her

“occupation was best classified at a sedentary physical exertion

level.” AR 304. RSL stated that it had, accordingly, “utilized the

vocational evidence combined with the medical records . . . to

determine if [Cyr] qualified for LTD for a ‘Total Disability’ from

her sedentary level Regular Occupation.” AR 304-05.

48. In the Final Denial, RSL summarized medical documentation

from January 1, 2021 to the date of the letter. AR 305. It wrote

that Cyr had “ceased working due to a history of multiple

sclerosis, chronic neck and back pain.” Id. It stated that the

following diagnoses had been made or documented during that

period by Cyr’s various physicians:

 Chronic pain due to trauma

 Complex regional pain syndrome

 Long term drug therapy

 Multiple sclerosis

 Seizure disorder

 Sacroiliitis

 Underweight

 Non-epileptic convulsion

 Choreiform movements

 Reflex sympathetic dystrophy

 Trigeminal neuralgia of the left side of face

 Migraine headache

 Chronic ulnar nerve paresthesias

AR 305-08. RSL then summarized its findings of Cyr’s medical

documentation, writing:

In reviewing the medical documentation, the level of

impairment specific to Ms. Cyr’s history of multiple

sclerosis, neck and back pain was not consistent with

an inability to perform sedentary work function.

Specifically, a CTA of the Head/Neck conducted May

10, 2021, revealed no evidence of acute infarct or

large vessel occlusion. In addition, following the joint

fusion conducted May 10, 2021, a Neurology

evaluation dated May 11, 2021, with Dr. Jones noted

intermittent deficits in strength and sensation with

no specific consistent localized neurological deficits.

While we also acknowledge multiple Neurology

evaluations with Dr. Gibbs from April 2, 2021,

through April 13, 2022, noting complaints of

migraine headaches, there is no indication of an

impairment precluding Ms. Cyr’s ability to perform

the material duties of her regular occupation.

AR 307.

49. RSL stated that it was “not disputing that Ms. Cyr may

have symptoms associated with a history of multiple

sclerosis, chronic neck and back pain” but that its “position

is that the level of severity associated with these

symptoms, do not preclude her from sedentary work

function.” AR 308. RSL then cited the opinion of Dr.

Burns as confirmation of its findings. Id. RSL wrote that it

had concluded Cyr was not Totally Disabled and therefore

not entitled to LTD benefits. Id.

50. In its Final Denial, RSL did not make any statements or

determinations about Cyr’s cognitive function or the

cognitive demands of her regular occupation. See AR 303-

09.

II. Conclusions of Law

After considering the parties’ oral arguments and trial briefs, the

Court draws the following conclusions of law:

1. Any conclusion under this category that is a finding of fact is also

adopted as a finding of fact.

2. This matter is properly before the Court pursuant to Federal

Rule of Civil Procedure 52. Rule 52 provides that “[i]n an action

tried on the facts without a jury or with an advisory jury, the

Court must find the facts specially and state its conclusions of

law separately.” Fed. R. Civ. P. 52(a)(1). This case is governed

by ERISA because it involves an employee welfare benefit plan

within the meaning of that statute.

3. The Court reviews the denial of benefits de novo. Dkt. 120.

Pursuant to its de novo review, the Court has “examine[d] the

administrative record without deference to [RSL’s] conclusions to

determine whether [RSL] erred in denying benefits.” Collier v.

Lincoln Life Assurance Co. of Bos., 53 F.4th 1180, 1182 (9th Cir.

2022).

4. The Court is not required to accord special deference to the

opinions of treating physicians based on their status as treating

physicians. Black & Decker Disability Plan v. Nord, 538 U.S.

822, 834 (2003). Instead, opinions must “be accorded whatever

weight they merit.” Jebian v. Hewlett-Packard Co. Emp. Benefits

Org. Income Prot. Plan, 349 F.3d 1098, 1109 n.8 (9th Cir. 2003).

However, a court may give greater weight to a treating

physician’s opinion where it is evident a particular physician has

had a “greater opportunity to know and observe the patient than

a physician retained by the plan administrator” who conducts a

file review. Id. (citation omitted).

5. “[B]ecause the relevant provisions [of the LTD policy] focus on

[Cyr’s] ability to perform the acts necessary to carry out her

[regular] occupation, whether [Cyr] is ‘disabled’ must be

measured by her functional capacity as compared to the duties of

her [regular] occupation.” Brown v. Unum Life Ins. Co. of Am.,

356 F. Supp. 3d 949, 964 (C.D. Cal. 2019).

6. It is Cyr’s burden to prove “by a preponderance of the evidence

that [she] was disabled under the terms of the plan.” Armani v.

Nw. Mut. Life Ins. Co., 840 F.3d 1159, 1163 (9th Cir. 2016). To

meet that burden, she must show not only “the mere existence of

an impairment,” but that the “impairment is disabling.”

Matthews v. Shalala, 10 F.3d 678, 680 (9th Cir. 1993) (citation

omitted).

7. The relevant issue before the Court on de novo review is whether

the Cyr’s “symptoms rose to the level of total disability” as

defined in the policy. Muniz v. Amec Cost. Mgmt., Inc., 623 F.3d

1290, 1296 (9th Cir. 2010). To that end, “[r]easoned assessments

of what [Cyr] can and cannot do are given greater weight than

mere statements of medical diagnoses.” Brown, 356 F. Supp. 3d

at 964.

8. The Court has considered “only the rationales [RSL] relied on in

denying benefits and [has not] adopt[ed] new rationales that the

claimant had no opportunity to respond to during the

administrative process.” Collier, 53 F.4th at 1182.

A. Extra-Record Evidence, Supplements, Request for

Judicial Notice

9. Both parties have submitted evidence not included in the

administrative record as filed.

10. On de novo review, the Court may exercise its discretion to

consider evidence outside the administrative record “only when

circumstances clearly establish that additional evidence

is necessary to conduct an adequate de novo review of the benefit

decision.” Opeta v. Nw. Airlines Pension Plan for Cont. Emps.,

484 F.3d 1211, 1217 (9th Cir. 2007) (quoting Mongeluzo v. Baxter

Travenol Long Term Disability Benefit Plan, 46 F.3d 938, 944

(9th Cir. 1995)). In Opeta, the Ninth Circuit adopted a non-

exhaustive list of circumstances where evidence beyond the

administrative record could be necessary, including:

claims that require consideration of complex medical

questions or issues regarding the credibility of

medical experts; the availability of very limited

administrative review procedures with little or no

evidentiary record; the necessity of evidence

regarding interpretation of the terms of the plan

rather than specific historical facts; instances where

the payor and the administrator are the same entity

and the court is concerned about impartiality; claims

which would have been insurance contract claims

prior to ERISA; and circumstances in which there is

additional evidence that the claimant could not have

presented in the administrative process.

Id. (quoting Quesinberry v. Life Ins. Co. of N. Am., 987 F.2d

1017, 1027 (4th Cir. 1993) (en banc)).

11. RSL has submitted extra-record evidence attached to the

Bernacchi Declaration. Dkt. 129-1. Of that evidence, the Court

admits only the draft letter sent from Cyr’s counsel to Dr. Gibbs

for his signature, attached to the Bernacchi Declaration as

Exhibit 5, dkt. 129-10. The document is necessary to conduct an

adequate de novo review because, as explained in the conclusions

below, the Gibbs Letter’s provenance affects its credibility and,

therefore, the persuasive weight assigned to it.

12. The Court declines to admit any other evidence submitted by

RSL because it is not necessary to conduct an adequate de novo

review.

13. Cyr has submitted: (1) evidence to rebut the extra-record

evidence submitted by RSL, dkt. 141, and (2) a supplement to the

administrative record, dkt. 133, consisting of documents she

argues should have been included in the administrative record

filed by RSL.

14. Of Cyr’s extra-record evidence, the Court admits a portion of Dr.

Gibbs’ deposition transcript, dkt. 141-5 (Gibbs Dep. Tr) at 76:4-6,

because it directly responds to RSL’s admitted extra-record

evidence meant to show that Cyr’s counsel wrote the letter

submitted by Dr. Gibbs.

15. The remainder of the deposition transcript and Cyr’s remaining

rebuttal evidence attached to dkt. 141 are not admitted.

16. Cyr also submitted a supplement to the administrative record.

Dkt. 133. The documents included fall into three main

categories: (1) documents subpoenaed from MES Peer Review

Services, which hired Dr. Burns (MES Documents), (2) emails

between counsel and RSL (Emails), and (3) excerpts from RSL’s

Claims Manual.

17. The MES Documents and Emails are already included in the

administrative record, and the Court finds it unnecessary to

supplement the record with those documents.

18. The parties disagree about whether the Claims Manual excerpts

are properly part of the administrative record or extra-record

evidence. Cyr relies on 29 C.F.R. § 2560.503-1(m)(8)(iv) to argue

the information is relevant and properly included in the AR

because it “constitutes a statement of policy or guidance with

respect to the plan,” but she omits an important part of the

subsection that continues “concerning the denied treatment

option or benefit for the claimant’s diagnosis.” Compare Dkt. 133

at 1-2, with 29 C.F.R. § 2560.503-1(m)(8)(iv). In any event, the

Court does not find it necessary to rely on the excerpts from

RSL’s Claims Manual and declines to supplement the record with

that document.

19. RSL requests judicial notice of a section of the California Health

and Safety Code referenced in its briefing and oral argument.

Dkt. 153. Cyr objects. Dkt. 155. The Court does not find it

necessary to rely on the cited statute and denies the request for

judicial notice. Accordingly, RSL’s request to strike Cyr’s

objections, dkt. 156, is denied as moot.

B. Cyr’s Occupation

20. Prior to the onset of her medical difficulties, Cyr worked full time

at CTI as a Vice President. AR 376. Cyr’s regular occupation is a

sedentary one that requires regular cognitive engagement. See

AR 1875, 1958-61.

21. RSL argues that Cyr “offered no evidence [during the

administrative process] that [she] could not perform the

occupation of a company vice-president.” Dkt. 137 (Defs.’ Resp.

Br. at 9); see Tr. of Oral Arg. 44:23-25, 50:16-25. Cyr asserts that

she experiences symptoms affecting her cognitive function

including seizures, memory loss, speech disorder, loss of

awareness, migraines, and medication side effects. Dkt. 132 (Pl.’s

Br.) at 22-26. She further argues that these issues were raised in

the administrative process. Tr. of Oral Arg. 54:14-23.

22. The Court finds Cyr adequately raised the issue of her cognitive

function during her ERISA appeal in documentation and letters

from Dr. Hrach, Dr. Glancey, and Dr. Gibbs. See AR 531-79, 788-

89, 1047-49, 1464-65, 1741-50.

23. RSL’s emphasis, in its briefing and oral argument, on the absence

of records from Dr. Early and Neil Friedman is unpersuasive.

Defs.’ Br. at 7-8. Multiple physicians offered opinions about Cyr’s

cognitive impairments such that the question of her cognitive

functioning was before RSL regardless of whether records from

those providers were produced.

24. Therefore, if Cyr establishes by a preponderance of the evidence

that her medical conditions have rendered her substantively

cognitively impaired, then she cannot perform the material

duties of her regular occupation and is disabled under the policy.

25. Additionally, Cyr is disabled under the terms of the policy if she

proves that, more likely than not, as a result of her medical

conditions, she is unable to perform the physical requirements of

a sedentary position, including sitting most of the time, with

walking or standing for brief periods, or occasionally lifting up to

10 pounds.

C. Cyr’s Medical Condition

26. Viewing the record in its totality, the Court finds Cyr has met her

burden of proving entitlement to benefits under the LTD Plan.

27. Though the Court is not obligated to give special deference to the

opinions of Cyr’s treating physicians, Black & Decker, 538 U.S. at

834, “courts generally give greater weight to doctors who have

actually examined the claimant versus those who only review the

file, especially when they are employed by the insurer[.]”

Backman v. Unum Life Ins. Co. of Am., 191 F.Supp. 3d 1053,

1066 (N.D. Cal. 2016) (collecting cases). While an insurer need

not provide in-person medical evaluations of its claimants, the

Court finds Drs. Hrach, Glancey, Gibbs, and Deol’s in-person

evaluations and observations—especially those provided before

RSL terminated benefits—more persuasive than the paper

review conducted by RSL’s Dr. Burns. See Salomaa v. Honda

Long Term Disability Plan, 642 F.3d 666, 676 (9th Cir. 2011)

(finding medical opinions rendered following in-person

examination more persuasive than contrary opinions from an

administrator’s paper-only review); Montour v. Hartford Life &

Acc. Ins. Co., 588 F.3d 623, 634 (9th Cir. 2009) (finding that a

“pure paper” review “raise[s] questions about the thoroughness

and accuracy of the benefits determination”).

28. Cyr consulted numerous doctors across specialties and

disciplines, including primary care, neurology, and orthopedics.

Doctors assessing her working capacity found she was unable to

work due to her symptoms. In particular, Cyr’s primary care

physicians who saw Cyr most frequently and consistently—Dr.

Hrach and Dr. Glancey—noted symptoms of headaches and

seizures for years and did not waver in their recommendation

that she cease work. It does appear that the medical opinions

provided by Dr. Hrach, Dr. Deol, Dr. Glancey, and Dr. Gibbs after

RSL terminated benefits contain changes—characterized as

corrections—to previous documentation of Cyr’s medical

conditions. But those opinions are consistent overall with the

opinions of Cyr’s medical providers prior to RSL’s termination of

benefits. Further, the post-denial opinions submitted during the

appeal process are consistent with each other, indicating

independent agreement among Cyr’s doctors regarding her

limitations and disability.

29. The Court, however, assigns less weight to the letter signed by

Dr. Gibbs and submitted by Cyr’s counsel on July 22, 2022. AR

1794-96. RSL has presented extra-record evidence that the letter

was drafted by Cyr’s counsel and signed by Dr. Gibbs without

changes. See Bernacchi Decl., Ex. 5. The Court does not

question whether Dr. Gibbs agrees with the letter’s contents.

There is no evidence that it doesn’t, and it contains his signature.

But the Court is not left with the same degree of assurance that

the letter reflects Dr. Gibbs’ independent medical judgment—

rather than counsel’s advocacy—as Dr. Gibbs’ other

documentation, such as clinical notes or APS forms.

30. By assessing Cyr’s capacity to perform only the duties of a

sedentary job rather than her specific duties, including non-

physical duties, RSL and its doctors failed to fully apply the

standard of disability articulated in the policy, which required

RSL to consider whether the Cyr could perform the “material

duties of [her] regular occupation.” AR 12 (emphasis added).

31. The record shows that RSL and Dr. Burns relied on a generic

occupational description for a Vice President to then determine

that Cyr’s position was “sedentary.” RSL then determined, based

on Cyr’s medical records and the Burns Report, that Cyr could

perform the material duties of a “sedentary” occupation.

32. While Cyr’s regular occupation did require a sedentary level of

exertion, her material duties were broader, including, among

other things: (1) managing various departments, (2) formulating

plans and policies, (3) directing accounting functions, (4) directing

budget functions, (5) planning, directing, and coordinating

operational activities, (6) formulating and administering

company policies, and (7) developing long-range goals and

objectives. See AR 1875, 1958-61.

33. Cyr has shown by a preponderance of the evidence that she was

unable to perform the material duties of her regular occupation.3

34. Cyr’s medical records support that she suffered from several

symptoms impairing her cognitive function, including seizures,

dizziness, memory loss, speech difficulty, loss of awareness,

migraines, and medication side effects. AR 468, 489, 531, 534,

536, 542, 544, 1184, 1717, 1728-35, 1745, 1751-53.

3 Under the definitions in the policy, Cyr is totally disabled even if “capable of

performing the material duties of [her] occupation on a part-time basis or

some of the material duties on a full-time basis.” AR 12. In other words, if

she is unable to perform one or more material duties full-time, she is totally

disabled.

35. The Court agrees with Cyr that these conditions rendered her

unable to meet the cognitive demands of her regular occupation.

For example, memory loss and speech difficulty affect the

material duties of managing various departments and planning,

directing, and coordinating operational activities. Loss of

awareness impairs her ability to do nearly all work functions

demanding a high level of cognition. Given the scope of cognitive

symptoms and consistency with which Cyr’s doctors noted those

symptoms, the Court concludes it is more likely than not that Cyr

was unable to perform the material duties of her regular

occupation on a full-time basis due to cognitive impairments.

36. Cyr has also established by a preponderance of the evidence that

she was unable to perform one or more of the material duties of a

sedentary occupation.

37. Cyr’s doctors regularly reported that Cyr suffered from severe

pain. See AR 544-48, 570, 576, 1053. It is widely accepted that

“disabling pain cannot always be measured objectively.” Saffon v.

Wells Fargo & Co, 522 F.3d 863, 873 n.3 (9th Cir. 2008). And

although it is true that self-reported symptoms are not

necessarily determinative, particularly when contradicted by

objective evidence, the record does not adequately establish the

unreliability of Cyr or her treating physicians.

38. Further, in both pre- and post-denial APS forms, Dr. Hrach

indicated Cyr could only occasionally lift up to one pound, see AR

472, 987, less than the occasional exertion of up to 10 pounds of

force occasionally required for a sedentary occupation,

39. Cyr’s claim is supported by RSL’s payment of benefits, which

required its own finding that Cyr met the definition of total

disability, over two decades.

40. In its briefing, RSL specifically cites Dr. Hrach’s reports as the

basis for finding Cyr was totally disabled. Defs.’ Br. at 6. But Dr.

Hrach’s position did not change, and she continued to verify Cyr’s

disability through the termination of benefits and appeal. She

certified in 2020 that Cyr’s condition had “retrogressed” and that

she should “cease work.” AR 469, 982. In a letter submitted after

RSL terminated benefits, Dr. Hrach explained that Cyr “is in

worse physical condition now than she was at the onset of her

disability.” AR 1717-18.

41. Further, the documentation RSL cites to justify its decision to

terminate Cyr’s benefits—two reports from Cyr’s physicians and

Cyr’s self-reported activities, see Defs.’ Br. at 9-10, 23, 29—does

not establish that Cyr no longer had an ongoing disability. In

those reports, Cyr’s physicians stated that she was skiing and

hiking, and Cyr reported sewing sometimes, golfing sometimes,

skiing sometimes, and participating in pool therapy. Yet, RSL

has never explained how Cyr’s recreational activities mean she is

not disabled under the terms of the policy, particularly

considering that Cyr’s job description requires sedentary

capacity—not physical exertion. That Cyr may have skied and

hiked for several hours in a day—which she denies—does not

indicate her ability to perform the material duties of her

occupation. See Kaminski v. UNUM Life Ins. Co. of Am., 517 F.

Supp. 3d 825, 864 (D. Minn. 2021) (finding evidence of family

trips was not indicative of the claimant’s ability to work a full-

time sedentary job); see also Demer v. IBM Corp. LTD Plan, 835

F.3d 893, 906 (9th Cir. 2016) (finding claimant’s self-reported

activities of daily living that “indicated some ability to engage in

mental functioning” did not necessarily establish his ability to

engage in “gainful occupation”).

42. Similarly, Dr. Deol’s note that Cyr was doing “remarkably well”

does not necessarily indicate that Cyr was no longer disabled.

43. RSL did not raise Cyr’s lack of credibility as grounds for denying

benefits in either of its denial letters. Therefore, to the extent

RSL relies on inconsistencies and post-termination revisions to

show Cyr is not a reliable narrator—and may be making a false

claim—the Court is precluded from considering that rationale to

conclude that RSL properly terminated Cyr’s benefits. Collier, 53

F.4th at 1187 (finding the district court improperly considered

the claimant’s lack of credibility when the insurer did not raise

credibility as grounds for denying her claim for benefits). And

there is no indication that Cyr’s physicians—who treated her over

the course of many years—found her not to be credible.

44. On balance, the evidence weighs in Cyr’s favor, and she meets

her burden of establishing her entitlement to LTD benefits. The

preponderance of the evidence shows that Cyr’s diagnoses and

their symptoms preclude her from performing the material duties

of her occupation.

III. Conclusion

For the reasons stated above, the Court finds in favor of Cyr. Cyr

is to submit a proposed judgment no later than August 7, 2026. RSL

may submit objections to the proposed judgment no later than August

14, 2026. Counsel are to meet and confer and attempt to resolve the

issue of attorneys’ fees and costs no later than August 21, 2026. If no

resolution is reached, Cyr’s motion for attorneys’ fees must be filed no

later than September 28, 2026. Cyr’s pending motion for partial

summary judgment, dkt. 76, is denied as moot.

IT IS SO ORDERED.

Date: July 15, 2026 □□□ dS agape SE

Dale S. Fischer

United States District Judge

4'Though Dr. Gibbs questioned whether Cyr was correctly diagnosed with

MS, the Court interprets his question to regard not Cyr’s credibility but the

accuracy of the initial diagnosis.