# Diane M. Moon v. Unum Provident Corporation

> Court of Appeals for the Sixth Circuit · March 22, 2005 · 405 F.3d 373

URL: https://www.frixlaw.com/law-library/cases/9497929

## Case

- **Full name:** Diane M. MOON, Plaintiff-Appellant, v. UNUM PROVIDENT CORPORATION, Defendant-Appellee
- **Court:** Court of Appeals for the Sixth Circuit
- **Decided:** March 22, 2005
- **Citations:** 405 F.3d 373; 34 Employee Benefits Cas. (BNA) 2567; 2005 U.S. App. LEXIS 4775; 2005 WL 664330
- **Precedential status:** Published
- **Opinion:** Dissent by Siler
- **Judges:** Siler, Clay, Bertelsman
- **Cited by:** 138 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/9497929

## How later opinions describe it (automated extraction)

- holding that when an insurer’s benefits denial rests on evidence generated by conflicted physicians, courts must view the insurer’s rationale “with some skepticism”
- holding that denial of coverage based on a selective review is arbitrary and capricious
- noting that below and I assume for purposes of this case, where the non-retired plaintiffs are seeking a judgment to clarify future benefits, that exhaustion was not required under § 1132(a)(1)(B). 19 No. 09-3513 Szoke v. United Parcel Serv. of Am., Inc. federal courts are lim…
- holding that plan administrator’s decision is arbitrary and capricious because record could not support a reasoned explanation for termination of benefits

## Opinion text

SILER, Circuit Judge, dissenting.
I respectfully dissent because I think under the highly deferential arbitrary and capricious standard, the district court did not err in upholding the denial of benefits.
Certainly, as the majority observes, Dr. Feagin was on Unum’s payroll, so that fact must be considered. Nevertheless, he is a qualified board-certified internist physician who concluded that Dr. Watson’s opinions were “rather unorthodox” because Dr. Watson opined that Moon would have higher blood pressure in the sitting position than in the supine position. Dr. Feag-in also decided that Moon could work based upon Dr. O’Brien’s blood pressure tests revealing that Moon’s pressure was higher in the supine position and Dr. O’Brien’s observation that “with proper and effective antihypertensive medication, I suspect her blood pressure is indeed controllable and should not alone be considered disabling.” Dr. Feagin further found that Moon had no “evidence of significant hypertensive end organ damage.” He admitted Moon could not perform medium to heavy work, but he concluded she could do sedentary or light work.
As Black & Decker Disability Plan v. Nord, 538 U.S. 822, 829-33 , 123 S.Ct. 1965 , 155 L.Ed.2d 1034 (2003), holds that the opinion of the treating physician is not to be given deference over that of other physicians, I would find that the decision not to award long-term benefits by Unum was not arbitrary and capricious, because it was based on Dr. Feagin’s conclusions. Were we to view the matter under a de novo standard, I might very well decide otherwise.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/9497929. Public record. Not legal advice.