Day v. United Health Group, Inc. Short Term Disability Plan, No. 7:2012cv00114 - Document 18 (W.D. Va. 2012)

Court Description: MEMORANDUM OPINION. Signed by Judge Samuel G. Wilson on 12/13/12. (eot)

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CLERK' A CE u.:.DI coUr S OFFI SQ T ROANOKE,VA FI LED I TH E UN I N TED STA TES D I STR ICT CO U R T FO R T H E W ESTER N D I STR I O F V I G I I CT R N A R O AN O K E D IV ISIO N PAT R I I A .D AY , C A 2E2 13 2 1 22 J UL BY: . LE CLERK Y f- PUR LERK C i lA ct on N o.7: v00114 vi i 12c Pl nt f ai i f, M EM O M N D UM O PI I N N O UNI TED H EALTH GRO UP,I NC. SH O R T TER M D ISA BILITY PL AN , D efendant. By:Sam ue G .W is l l on U ni e St e D i t i tJudge t d at s s r c Pl i ifPa r c a A .Da brngst sa ton pur ua t t Em pl e Re iem e I om e a ntf ti i y i hi c i s nt o he oye tr nt nc Se lrt Ac of1 29U. C.j 1 e s q.(t SA' ,orc rbe ft unde he s t cziy t 974, S. 001 t e i ERl ' t e ove ne is r r hor) t r di a lt pl n. Da a t def nda , t dHe 1h Gr up Shor-f r Dia lt Pln1 e m s biiy a y nd he e nt Unie at o t-e m s biiy a (t eP1n' h v fldcos mo in f rs mmayj d me t th a ', a e ie r s to s o u r u g n .Thea miitai erc r i t s t ) d n sr tv e o d n hi c s s o t t ie He 1 Gr u I c mo ae (untd- at' a disd sg ae cams a e h ws ha Untd at o p n o rtd t ie le l ' n t e in td li h t l h) a i sr t ha f ldicr ton t i e pr tt Pl n' t r sa m a be ft dee mi to , dm nita or ve ul s e i o ntr e he a s e m nd ke ne is tr nai ns a t tU niedl ea t s c ai sa i sr t c r f l r vi w e t m a era sbe o e i and c m e nd ha t - lh' l m dm ni t a or a e uly e e d he t i l f r t l a t t r as bl c uson t tDa wasnotdia e wihi t m e ni ofhe be ft pln o he e ona e oncl i ha y s bld t n he a ng r neis a be us s ha nots itd m e ca e de e t ta t ly de ca e he d ubm te di l vi nc ha cual monsr t he i biiyt ta ed r na lt o p ro m h r o Ac o digy,h c u t rn st Pln' moin frsl r ud me ta d e fr e j b. c r n l t e o r g a t he a s to o t mma yj g n n d n e Da smo inf rsl r j g n . e is y' to o l mmay ud me t 1I hercom pl nt D a i r l namest def n ai , y ncorecty he endantasçunied Healh Gr d t t oup,l Shor nc. t Ter Diabiiy Pl ' m s lt an.' 1. l 2006, y sa t wo ki a ac t m e - e vcer pr e a i f aUnie a t n Da t red r ng s uso rs r i e es nt tve or tdHe lh s sdir , ie He l r S r ie ,n o poae (f ie He lh r ' Amo oh r ub i ay Untd at e e vc s I c r rtd V td atca e). hca un ng te s d n ayd te , y'j br q ie he t feda p o maeyeg t fv c lsp rd y e e tr u is Da s o e ur d r o il p r xi tl ihy-i e al e a , s he e pa i n a c dul t e t ppoi m e s upda e pa i nti or a i r pond t c t e c pl i s a nt nt , t te nf m ton, es o us om r om a nt , nd pe f m hea da ae r AsaUnie He t r e o ,Da had a ce st s r-e m ror vy t nty. t d alhca e mpl yee y c s o ho tt r dia lt be iss d s ne dt m.Ac r ngt t beneisha s biiy neft houl he e he codi o he tt ndbook( c co ans whih nti tetnn o t ePln , td at d sg ae Se g c Cli M a a e nt r ie h e s f h a ) Uni He l e in td d wik ams n g me Se vc s e h (le g c ' a t tid p rycamsa miitao .Th b neish n b o p o i e t t G d wik' s he h r - a t li d nsrt r e e ft a d o k r v d s ha s ) e pl yee m us s ts y f c ie i t be û ons de e D i a e ' m o s t a if our rt r a o i i r d s bl d': c * You ha bee s e f c t f ceby a Physcin a utyo Diabiiy wihi ve n e n a e-o-a i a bo ur s lt t n 1 busnes days of t fr tday of a enc r a e t t di a lt l a of 0 i s he is bs e el t d o he s biiy e ve a e e; bs nc * YourPhysc a ha pr de M e c lEvi nc t ts ii n s ovi d di a de e ha upporsyo i biiy t t ur na lt o pero m t M ae ilDutes ofyourOwn Oc upai n; f r he tra i z c to * Y ou a e unde t Re a a A ppr i t Ca e ofa Phys c an;and r r he gul r nd opra e r ii * YolrM edi lCondii i notwor r l t a i a M e c ly De e m i bl z ca ton s k-e aed nd s di a l t r na e l mpaim e . r nt ( n. 25, No.11. Admi R. ECF ) Thebe ksha net ndboo dei d edia Evi e'a Scla doc ntton,prvi d k fnes t c l denc ' s t le r ume ai o de M l by t Ph i in s he ysca uppori yotrDia lt offm ci nali par e sa f nc i na lmiai tng l s biiy, t to m im nt nd u to l i ttons duet aM e cal Dee mi e I im e t twoul pr ven you fom pe f mi t o di ly tr nabl mpar nt ha d e t r ror ng he M aeil te o y u OwnOc u ain . . aeya do a e u tl ( mi R. 2 ECFNo tra Du is f o r c p t . sf l n /r d q aey. Ad n. 5 , o . 11) A C e c ly Dee mi bl I pa nne 'i a Ci ime t tr s t fom a t m ia , . û di a l tr na e m i nt' s n çmpar nt ha e uls r na o c l M 2Th Plnd f st tra Duis' stth esnilaksf n to sa o eain , n tesil, e a eme ç e il te'a El e se ta ts ,u cin nd p rto s a d h kls Ma l a lte ,knowldge,r i ng a e re ,ge aly r uie by e pl r fom t ee biiis e tani nd xpe ince ner l eq r d m oye s r hos ngage i apa tc a dn riulr o c p t nta c n o b ra o bymo iido o te . ( mi. 51ECFNo 1 . cu ai h t a n t e e sna l dfe r mitd' Ad n R. , o ' . 1) phys ol ca orps hol ca a i ogi l yc ogi l bnor a iy w hi h c n be s w n by m e c l ac e a e c i ca m lt c a ho di aly c pt bl lni l a l r t y di gnosi t c ques A physc lo m e ali i ntmus beesa ihe by nd abo a or a tc e hni . i a r nt mpanne t t bls d M e c Evi econssi ofsg ,s dial denc itng i ns ympt m s a lbor t r fndi ,a no onl by t o , nd a a o y i ngs nd t y he i vi lss e ntofs oms' Ad n. 52,ECFNo.11) And,a codi t t ndi dua' utme ympt . '( mi R. . c r ng o he ha ndbook,Sedgwi k d s t e l i r g a di c e i w ih r pec t c a m sa a c t he xc us ve i ht nd s r ton, t es t o l i nd ppea s ha l, t i e pr tt pl st r s t a i se t pl n' be is t dee mi t a i bl f t o nt r e he an' e m , o dm nitr he a s neft ,o tr ne he pplca e acs a dt a pyt ep a str t tefcs' ( mi. 1 , No. 1) n o p l h ln' ems o h a t. Ad n R. 1 ECF 1 . ' I M a c of201 Day e ba ke on apr r c e s resofdoct viist di nos he n rh 0, m r d ota t d e i or st o ag e r a d mia p i ( ihs ei iilyatiu e t arc re c o dv riul i)b c ligh r b o n l an wh c h ntal trb td o e u rn e f ie t i s y al e c t n physci n,D r Fida D a t . O ve t phone D r Das oo ' ofi e t d D a t s a ho e ia . r us s oor r he , . t r s t c ol y o t y m fom wor untls f tbe tr pr s rbe a i otc a at ow r sdue'dit a s ta ofk e r k i he el te , e c i d ntbi i s nd d l e i ' e , nd e n t appoi men f Aprl7t On M a c 24t Da sa homefom wor a we t s e Dr nt t or i h. r h h, y tyed r k nd nt o e . W ila Fi t la t Bl Ii Ca e Ce t rf he o oi ion defc e y.Dr Fi el t d lim n e t he ue tdge nc r n e or r ng ng r ii nc . nt no e t tDa wa mor dl obes had di riultsand tbr ha y s bi y e, ve tc ii i omya gi a us d s e e aloxyg n l a, nd e upplm nt e frs t sofbrah.( o hornes e t Admi R.28,ECFNo.113. Dr Fi e rc n. - ) . ntl e omme dt tDa nde ha y pr e d wih io i u i t te the det inc Da r tml t wor on t 25t butsa d oc e t r n nf sons o r a r k e y. y et ed o k he h, tye hom e a i ont 26t13 Be or t e ofM ar h, D a m ade he c a m f s tt r di a lt he 1. f e he nd c ga n y r l i or hor- e m s biiy be ft t rt Pln. ne is mde he a On Aprl7, 0, y viied Dr Da t f he s hed e a nt e .Dr Da t r i 201 Da st . soor or r c uld ppoi m nt . soo di gnos Day w ih pa ta l r ol d di ri ults abdom i pai ofa unknow n c us ion a ed t r i ly es ve ve tc ii , nal n n a e, r detc e y a m i a obest Two da lt r Da unde we aCT s n ofhe a m e i i nc ne a, nd iy. ys a e , y r nt ca r bdo n, whi r ve l d no e de ofdi ri ults On Aprl1 t Da we bac t Dr Da t ' ch e a e vi nce ve tc ii. i 3 h, y nt k o . soors 3B e e Da r t ned t wor a Unied on M ar h 25, 201 (heda f lowighe frt caus y e ur o k t t c 0 t y ol n r is dia l pr ae a s n e)Da sfrta s nc fo wor frt pu p eo h rdia iiycl m wa s bii eltd b e c y' is b e e r m k o he r os f e s blt ai s t M a ch 26,2010. r ofi e, tl c fc sil ompli ng ofl wera a ni o bdomi lpai Afe r vi wi t r s t ofDa sCT s n, na n. tr e e ng he e uls y' ca Dr Da t rs ult d t tt pai i Da sa . soo pec a e ha he n n y' bdomen c d be I e e r d' fom he s ne a oul < f re ' r r r pi , nd he s ntDay f r a s na M R I Tw o phys c a eva ua e D a s M RI A cc di t Dr D a d e o pi l . i i ns l t d y' . or ng o . vi Ke ,t M lls yes he t howe s emid a r ltes i udi s d om l bno maii , ncl ng ome si l bul ng dic and lghty gi ss h p rr p idj it.Dr Rih r G. her itmrtdDa sM lla s wigmid y e to he on s . c ad S ry ne ee y' t s ho n l dege r tve di c di e s a bone s ls i t t a i r i ne a i s s a e nd ptr n he hor c c eg on. Da f l y olowed up wih D r Fi elon Apr l23,201 r gar ng he ion de i i y. Dr t . nt i 0, e di rr f c enc . Fi e not t tDay w asf e i m ode a e y be t rf l w i he tr tion i uson butt ts nt l ed ha e lng r t l te olo ng r i s r nf i ha he woul lkey nee mor i u i di l d e nf sons.Fo da lt r Da viied Dr Dasoo wih r ne d ur ys a e , y st . t r t e we co pli sofa m ant bdomi lpai Dr Da t no e t tDa slb wor a a na n. . soor t d ha y' a k nd bdom i lCT s a na cn a a e nor a t ts ha m id di ri ultswih no i l mm a i He a s not t t ppe r d mal nd ha he d l ve tc ii t nta ton. lo ed ha he M R1s d çomedicoge cdie e'b t thewa ç f l c nce t tt s( s r howe l s s ni s as ' ut ha s t uly onvi d ha hi wa not c u i )h rds o o t't mi . 6 , No. 12. Dr Dat o rf re Da t a a sng e ic mf r. Ad n R. 9 ECF 1 - ) . so r eer d y o ' a e , y ook r o . lp s r ne oszge f aco pl t w o kup. Oneday lt r Da t he M m t Dr Phii Fihe . ur lr on or m ee r 4 Dr Fihe f . s r ound t tDa had lr bone s lsi t t a i s ne, ha y a ge ptr n he hor c c pi dege ai dicdie e ner tve s s as t o houtt l hr ug he umba s ne,a a i r sng n r pi nd n nc ea i mountofl umbos c alpai Dr Fihe te t ar n. . s r r aed Da wi ac rio tr i a dl c la et ei ij cin. y t o t seod n o a n sh tc ne to h c On M a 7, 0, y s Dr Bnl Long f a y 201 Da aw . ce or bdom i lpan t tDa a ti ut d t a na i ha y trb e o pos i ea sbl bdom i lhe ni Afe t e na r a. tr he xnmi ton,Dr Long not C O di nossf na i . ed I N ag i oundy' 'but prs rbe wegh rducto a a ii lmmaor dr g,a at lpr a ' ( n. 8 e ci d i t e in, n nt-nfa t y u nd l bowe ogrm. Admi R. 0, ' ECFNo.112. Da t nviie herfmiyprcii r Dr Ande s f he a - ) y he std a l a ttone, . ron,or r bdomi lpan. na i Dr A nde s di nos d Day w ih r g hi pai a hype t oi s ,a pr c i ed Ce e e . r on ag e t i ht p n nd r hyr di m nd es r b l br x, 4Theneu os geoneve aly i or edDa t thew o d notco i a t ofs g y t alvit he r ur nm l nf m y ha ul nsder ny ype ur er o le ae r dso o t ( eAd n. 6 ECFNo l - ) ic mfr. Se mi R. 9, . 13. Phe r n,a Fl rl s on M a 7t Da unde we ahi x-ay a t Le s Gal ne ga nd exe i.Alo y h, y r nt p r t he wi- e M e c Ce e . Thex-a r por i c t t tDa ha l ni a oseoa t ii'andno dial nt r r y e t ndi aed ha y d t m l t rhrts' mi f a tle , s oc tons ordi e e r l t bone de t u ton. Day f l w ed up w ih D r A nde s r c tr s di l a i , s as - e a ed sr c i olo t . r on on M a 1 t r ga di he abdom i lpai a he not d t tDay ha tbr ya gi a t ts y 9 h e r ng r na n, nd e ha d i om l a nd ha he wa t t fusrt 'a he pai ( mi R. ECFNo.113. Dr Ande s prs rbe s ç e r taed' bout r n. Ad n. 24, qui - ) . ron e ci d a 1 dos ofEl l an a i pr s nt ow e avi, ntde es a . On M a 21 201 D a f l e up w ih D r Fi t lr ga di he i on de i i ncy. D r y , 0, y olow d t . n e e r ng r r fce . Fi e not d t D a s a m i pe s s e bu t ts ha t w onde f r s nt l e hat y' ne a r i t d t ha he d ç a r ul e pons ' t he fr tt o e ' o r is w i u i .( n.R.26,ECF No.113. Appr maeyt mo hsltr Da ha nf sons Admi -) oxi tl wo nt ae , y d ulr s ta oundsonhe t oi a ut r s Theulr ound r porsf r hyr d nd e u . tas e t ound t tDa sutr wa ha y' e us s G ll e lr e 'wihsg so mu t l fb o d ( mi R. 3 ECFNo. 1 3 a dt a h r ç dy n ag d' t in f li e ir i s Ad n. 3 , mi p 1 -) n h t e t oi wa e a ge c itntwihgoie ( n.R.43,ECFNo.113) Fi ly, J y28, hyr d s nlr d, onsse t tr Admi - . nal on ul 201 Da s w D r Fi herf a he a 0, y a . s or not r ppoi t e ,c pl i ng oflz bos r la t ac c n m nt om a ni tm ac a nd hor i ed ha y crbe r i s t nt' nd l co bur ng ' pan. D r Fihernot t tda des i d he pan asç nsa ' a G ni ,'andhe i 5 . s pr s rbe we g l s c i e c i d i ht os , ontnuedm e c ton, hr e c uda e dur l,a a f l up vii i di a i t e a l pi as nd olowst n Au u t ( mi R. 4, No.1 - . g s. Ad n. 4 ECF 13) AsDay wasviii docor i s r h ofadi gnoss s wasalopt s i he s t stng t s n ea c a i , he s l ung r horr tr dia lt c am . On Aprl13, e m s biiy l i i 2010,Se dgwik i s d isfrtde a ofDa scli ,sa i c s ue t is ni l y' am ttng t ti ha notr c ve t r uie m e ca doc nt to fom Dr Dasoor On t s meda ha t d e ei d he eq r d di l ume ai n r . t . he n y, ho ve ,Dr Dat s ntt rquieddoc ntton(aldant tndi Physca we r . soor e he e r ume ai c le ç e ng At iin Sttme noi t tDa ha a t di riultsa l rdicpr a e.Hee ane t t ae nf), tng ha y d cue vetc ii nd umba s olps xpli d ha 5Acc di t Dr Fs e' a p it n n ts Da as sw DrFihe o J ne1 , 01 . (e Ad n R. or ng o . ih rs p onme t oe, y lo a . s r n u 1 2 0 S e mi. 4 , No. 13) At o p itDrFih rb c meDa sp i r p i- n g me t h iin a dh wrt a 4 ECF 1 -. s me on, . se e a y' rmay anma a e n p ysca , n e oe n a ndu t Da sJ 11h a nt e not i whih hesae t tDa hadat dde m o y' une t ppoi m nt es n c ttd ha y t poorpr ognossf r t i t i or eum ng o wok' ( eAd n R. 9, No 1 - ) S d wikddn t e ev t t d e d m u tl c mb r2 , 01 , l r ' Se mi. 6 ECF . 13. e g c i o rc ie ha a d n u n iDe e e 2 2 0 wel a rS d wik' fn l e ii .( e Ad n. 7 ECFNo. 13) he e g c s ia d cson S e mi R. 6, 1-. Da h dc mpli do a d mia p i ;h th so jcief ig c nsse o a d mi l y a o ane f b o n l an ta i b e tv i n s o itd f b o na nd tndene sa a hi whiebl c l c ;a t tDaywast et st wa k,be o see e r s nd gh t ood e l ount nd ha mabl o i, l nd, r l p due t he pai D r Das oorc ude t tD a w a t aly di abl d fom w or f o M ar h 25, o r n. . t oncl d ha y s ot l s e r k rm c 201 t oug M ay 1 201 0, hr h 0, 0. By lte da e M a 4, e tr t d y 2010,Sedg c is d iss ond de a ofDay' cli l is wik s ue t ec ni l s a m. n t de allte ,Se ni e tr dgwik sa e t ti ha r vi wed Dr Da t ' Ate ng Physcan St tmen , c t t d ha t d e e . soors tndi ii ae t FM LA pa r k fom Dr Da t , t s t ofM RIr uls Sedgwi k co ude t tt pe wor r . soor and wo e s es t . c ncl d ha he ç dc lif r to s b te (i)no d mo srt ta E ywa ) a l t p ro t e l ia n o main u mitd d d t e n tae h t Da s un b e o e fnn h me mae il u iso (elo o c p to a d o t a (h wa )u d rt er g lra a p o rae tra d te f h r wn c u ain n /r h t s e s n e h e ua nd p rp it c r ofaphysca a r r ' t n. 48, No.112. OnM ay24t Da ae iin s equied.' Admi R. ECF -) h, y a i s r tve y a a ed Se i k' dec s on. dm ni t a i l ppe l dgw c s i i On Augus 2nd,Se wi k e it a i pe t dg c nlsed n nde nden r vi wi physcin, .Robe t t e e ng i a Dr r D. Pe re, t eval e D ay' m edi levi nce. Dr Pe re c i r d a r f ofdoc e a i a ti o ca de . t i ons de e at um nt ton6 nd uat s c onduc e a s t tve t e t d ubsan i el conf r nc w ih Dr M i Gil7(woote t l c e e e of e e e e e t . ke ls t h r e e onf r nc s f r d ltl hel .OnAugus 1 h,Dr Perec ee hi fvepa rpo t l i,heexpl ne t t ite p) t 2t . ti ompltd s i - ge e r. n t ai d ha The pa int i mor dl obes wih s ve a c te s bi y e t e r l omor dii i l ng bi tes ncudi hypot oi s a vinm i D det i nc a ong w ih ion de i i y. The e a e hyr dim nd t n k e y l t r f c enc s r cu r nty be ng t e t d w ih r e o e of pa en e alion i u i . The m or re l i r a e t ec nt ns t r t r r nf s ons e 6Thebe isha neft ndboo pr dest t on a l t çcl m sAdm i srt w ilt i o a ot a1 k ovi ha, ppea,he t ai nitaor l ake nt cc mt l commen s doc t , ument, e dsa ot i or ton s tedt s r t a s r cor nd her nf ma i ubmit o uppo t he ppeal t rgar t whehe t wihout e d o t r he if r t nwa s b te i c n e t nwihtecam fr n ft. ( n. 1 , No. 1)Ac odn t n omai s u mitd n o n ci t h li o be ei ' Admi R. 4 ECF 1 . c rig o o o s' t r t Dr Pe er viwedpr es notsfom Bl Ri Ca erCa edaedM arh 24, 0,hr he epor, . ki e e ogr s e r ue dge nc r t c 201 t oughM a 21 y , 201 , ogr snotsfom anunknownpr de dae M a c 31 201 t ough J y 1 201 pr es noesfom 0. pr es e r ovi r td r h , 0, hr ul 4, 0; ogr s t r t Ce e f Gasr ntr ogydae Aprl7, he ntr or toe e ol td i 2010,hr t ough Aprl27, 0;pr es not 9o Dr Dasoordae i 201 ogr s es m . t td M arh 1 201 pr e snot fom Dr Fihe datdAprl28,201 t oughJ y28,201 . ogr snot fom c 0, 0; ogr s es r . s r e i 0,hr ul 0,pr es es r Dr. Longda e M a 7,201 ,a x-a fom Lewi- eM edi Ce e dae M a 7,201 ,aCT fom Lewi- l td y 0. n r y r sGal cal ntr td y 0. r sGae M e c lCe e dae Aprl9, 0;M R1 fom Ca ii H e lh S t daedM arh 2,201 andAprl1 201 dia ntr td i 201 sr rlon at ysem t c 0, i 9, 0; lbsfom a un a r n knownpr de da e Marh 24,201 t oughJ y 1 2010;alb fom Le HiM e c Ce e ovi r t d c 0, hr ul 4, a r e dial ntr fom Aprl7, 0.alb fom Le i- eM e ca Ce e La a o yfom J y 1 201 tssfom Le i- e r i 201 , a r w sGal di l ntr bort r r ul , 0; e t r w s Gal I gn a Brmbeo fo J l 2 , 01 Da sjbd s r to a mic l ne u me ia rc r sd tdMa 4 ma ig t a ltn rm uy 0 2 0; y' o eci in;nd sel o s dc le o d ae y , p a 201 ,h o g J l 1 , 01 t mi. 48 ECFNo 1 -. 0 tru h uy 4 2 0. Ad n R. , . 13) 1Daycl m st Dr Gil i notadocor buts ha ofe e not ngt s ai hat . ls s t , he s fr d hi o uppo tt ta s ri r ha s e ton. r c ntr c ds i c t t t s i s he e t unde go a hyser c om y. Pe t e e e or ndi a e ha he s c dul d o r t et r he r c ds t s i e e or , hi s xpec e t ei nae t unde l ng ca e of t chr c io t d o lmi t he ryi us he oni r n dek i nc Pr e s whi h we e as i ntfe i ude m or d obe iy a t e y. oblm , c r lo de ii d, ncl bi st nd o t uc i s ee a bsr tve l p pnea. The e a e no r c ds of a r pi a o y c ula i n t r r e or ny es r t r ons t to o i c e t tt obsnltve see a ndiat ha he t c i l p pneawoul pr cl s de a y wèr a tviis d e ude e ntr k c i te . A c r a M R1 w ih f tonalas e s e no est tt pa i nthas a qua e l f a di c t unc i s s m nt t ha he te de t e t v nrc lree to fa to a dt r i n e d n eo a y c g iiei ar n , e tiua j ci n rcin n hee s o vie c f n o ntv mp ime t whi woul pr cl s den a y wor a tviis She doe ha ge r lz a ch d e ude e t r k c i te . s ve ne a ied nd no pecfc mus ul ke eal c ns ii c os l t ompl i s but t s alo s d not pr cud ant, he e s houl el e s n a y a tvii . Dr Gil c imed durng t t l onf r et ta stsa ede t r c i tes . ls onfr i he eec e enc ha i/tnd wor tton woul bea a o it lvelofwo k. ksa i d n ppr pra e e r ( n. 51 ECFNo.113. Dr Perec l t ttfo a oc upai lmedii Admi R. , - ) . ti oncuded ha,trm n c tona cne pe s c i ,doc e ato doe nots r pe tve um nt i n s uppor t e o t bedia e fom he r gulr the mplyee o s bl d ' r re a l rsrce s d n ayj b. ( mi R. , No 1 - . S d wikr s n e t DrPeres l etitd e e tr o ' Ad n. 51 ECF . 13) e g c e po d d o . ti' n ' r por by a ki hi t s cik q si i e d t clrf whet rDay ha a r titons e t s ng m wo pe t ue tons nt nde o a iy he d ny esrci o rt ni t wor Dr Perea we ed,G s cii r titonsora omm oda i woul n eur ng o k. . ti ns r G pe fc esrc i NO cc tons d b a p ia l f rti e ly e Th e o e i no ds be fo h rr g lrs d nayj b. e p lc b e o h s mpo e . e mply e s t ia ld r m e e ua e e tr o ' ' ( n. 56, No.11 3. Admi R. ECF -) Shorl a trDr Pe re c ude hi r pol Sed c i or d Da by l te t ti wa ty fe . ti oncl d s e t gwi k nf me y e tr ha t s uphol ng t de alofD a sc a m f di a lt be tt . The l te e a ne is r a oni a di he ni y' l i or s biiy ne i s e tr xpl i d t e s ng t lngh a c l d t t û s d on t si or ton,weha de em i d t tt m e ca e t nd oncude ha ,i e Ba hi nf ma i ve t r ne ha he di l i or ton s nf ma i ubmit doe notde onsr t t tyou a euna et pe f m t m ae i ldute o ted s m ta e ha r bl o ror he t ra i s f yo o oc pai ' Thi lws ti t r ul. ur wn cu ton.' s a ui s he es t II. The Pl n' de a of Da scl m hi ed on t r quie en t D a of e a t m e ca a s ni l y' ai ng he e r m t hat y f r c ual di l e de - no s a e e sofs pt m s vi nce t t t m nt ym o --ofa c ton t tr nde e D a unabl t pe f r he ondii ha e r d y e o ro m r s de a yoc e ntr cupa i Thoug Dayha c ton. h s ompie a extnsve me c lr cor Sedgwi k c d ld n e i di a e d, c oul c l t tt r c d i s to s h e de . Gi n t tco l i t doc o s a r nt onc ude ha he e or s hor n uc vi nce ve ha ncuson, he t r ' ppa e di t uly i c fk t n onnec i t e si e de e t D a s c pl i s a t Pl n' di c e i i tng he xi tng vi nc o y' om a nt , nd he a s s r ton n m a ng isde son,t c tfndst tt Pl n' de son wa r as bl Ac r ngl t ki t cii he our i ha he a s cii s e ona e. co di y, he c u t lg a t h Pln smo inf rs mma yj g n a d n Da s o r wil rn t e a ' to o u r ud me t nd e y y'. W hen a t SA be i pl n ves sw ih t pl n ad i s r t t di c e i r nt ERI neft a t t he a m ni t a or he s r tona y a hort t m a elgi lt de e m i tons f be t i r e ,a r vi w i co zte ua est ut iy o ke i biiy t r na i or ne k a i s e e ng tr val t he pl n a nitaorsde son f a e ofdicr ton.'W ila sv. er Lie I . ,609F. a dmi sr t ' cii or bus s ei ' lim M to. f ns Co. 3d 622,629-30(t Ci.201 .Unde t a eofdicei sa r arviwi c ts d 4h r 0) r he bus s rton tndad, e e ng our houl notdit b apln ad i sr t r sdec son i t decson i r as sur a m nita o ' ii f he ii s e onabl eve i t c twoul e, n f he our d ha co et a c r r c l i i pe nty. 1 a 630. Ther e ng c ti nott ve m o onta y oncuson nde nde l d. t eviwi our s o s b ttt iso j d me tn pa eo teplna miitao ' j d me t I I ma igta u si e t wn u g n i lc f h a d n sr trs u g n . d. n kn h t u de e m i ton,co t l t t ei f t s e e a e i 800 h v. a - a tSt e .I t r na i ur s ook o he ght ac or num r t d n t W lM r or s nc. Aso s He 1 & W efr Pln 2 F.d3 5(t Ci. 0 0 : s c . at h lae a , 01 3 3 4h r 2 0 ) ()t lng geoft pln; 1 he a ua he a ( t pur e a goasoft pln; 2) he pos s nd l he a ()t ade cyoft maerasc i rdt maket decso andt de e 3 he qua he t il onsdee o he iins he gre t whi h t y s o c he uppor i; tt ()whehe t fduca y' i e eai wasco itntwih ohe pr vii i 4 t r he i ir s ntmrtton nsse t t r o sons n t pl a wih e riri er e a i oft pl he an nd t a le nt pr t tons he an; ()whehe t de sonma ngpr s wa r a one andprncpld; 5 t r he cii ki oce s s e s d iie ()whehe t decson wa consse t wih t pr e al a s t tve 6 t r he ii s itn t he oc dur nd ubsani r quie e sofERI ; e r m nt SA ()a e ena sa r r e n t t e r ieofdicein;a 7 ny xtr l tndad elva t o he xe cs srto nd ()t fducir smoi sa a c lc ofi ees i ma ha . 8 he i ay' tve nd ny ontit ntr t t y ve W iln ,609F. a 630(ii 800t 201F. a 342 . lims 3d t ctng h, 3d t -43) l t s case,Sedgw i r i pr m mil on t s n hi ck eled i y he econd partoft Pl sdi abiiy he an' s lt dei to na l t tûl y')Physcan( o de M e ca Evi ncet ts fniin, mey ha tDa s ii pr vi ) di l de ha uppors( r t he) 8 i biiyt pe f m t M ae ilDutesofg r OwnOc upai ' ( n.R. ECFNo.11 na lt o ror he tra i he) c ton. Admi 25, ' ' , Ad n. 6 ECFNo. 13. I d cdigwh t e tee it me ia e i e c s p o td mi R. 2, 1 - ) n e i n eh r h xsi ng d c l v d n e u p re Da si biiyt pe f m he occ ton,Se y' na lt o ror r upa i dgwik e oye an i pe ntr e ng c mpl d nde nde eviwi physcin,Dr Pere, o e ia . ti t xmni t e de et tDa ha s ne he vi nc ha y d ubmit d. The e d ei l d te vi enc ncude pr r s no es x- a ,CT s ns M m s a va i o he t t a l b r por s D r Pe re' tve og es t , r ys ca , , nd rous t r es s nd a e t . . t i s i - pager por s e t howst the e ua e t te de e a no e s ve a m e c lc tonsa ha val t d ha vi nc nd t d e r l di a ondii nd o g i me ia te t n s b tf t n ti go j ciei iai t tDa sv ro sc n iin n ong dc lr ame t, u omd oh n b e tv ndc tng ha y' a iu o dto s w oul a t ly pr ve he fom pe f m i he ço n oc upa i ' Dr Peti t r or d c ua l e nt r r r or ng r ç w c ton. ' . r e he ef e concude t tt r a oc upa i me cnepe s ci ,doc e a i doe no s po t he l d ha t om n c tonal dii f r pe tve um nt ton s t up r t e ly et b d sbldfo h rr g a t e titdsd nayj b' ( mi R. , No mpo e o e ia e r m e e ulr mrsrce e e tr o . Ad n. 51 ECF . ' 113. Ont tr a oni Se wi de e Da scli Thought c thasnodoub t t - ) ha e s ng, dg ck nid y' am. he our t ha D a s c pl nt a e ge ne t c t nnots y,bas d on t a i sr tve r cor t t y' om ai s r nui , he our cn a e he dm ni t a i e d, ha Se dgwik unr s na y d i d t tDa sm e ca e de f ie t de o taet ts c d c ea o bl ec de ha y' di l vi nce a ld o m nsr t ha he oul notpe f r he s de a y oc upa i r o m r e nt r c ton. Da c e t ti ra 800t f c or f l i he f vor Fis,s a guest tt tDr y ont nds ha mpo tnt h a t s al n r a . r t he r ha ha . Da to ( e p y iin f u t a s wa dsblda t a Gh ln a eo tepln'Bo t so r h r h sca ) o nd h t he s ia e nd h tt e a gu g f h a '( oh t f t t t ontmpltst tf pupos so s tem dia lt be is t Plnwilrl o acor wo) t e ae ha or c e f hor tr sbiiy neft,he a l ey n t erp r o 1 o rPh sca s p o t o ia iiyt p ro m yoz o o c p to ' ( e h e o t f Y u y iin' u p ri f n b l o ef r l wn c u ain. M m. ve t r ' Supp.M o.Summ . .9,ECFNo.1 (mphassadde .ThePln' defnii ofdia lt doe t J 2) e i d) a s ton sbiiy s not ho e r asD a s , w ve , y ugges s ves he tea i phys c a w ih t a hort t de e m i he t , t r r tng i i n t he ut iy o t r ne r dia lt sa us Raher i r quie he teai physcin t pr deme c e i nc t t s biiy tt . t , t e r s r r tng i a o ovi dial vde e ha ac ua l s ppor sheri lt t per or he occ ton. The aut iy t det r i w he he t t ly u t nabiiy o f m r upa i hor t o e m ne t r he me ia e i e c if c s p o t s c afndn , n t ma et eutmaed sb ly dc l v d n e n a t u p rs u h i ig a d o k h li t ia ii t 9 detnni to i Sedgwik'.( eAdmi R.25,ECFNo.11 (ç dg c CM Sdeemi s e nain,s c s Se n. ) fse wik tr ne wh t e o n ty uaeDia lda d fn db t ePln'; j=a 1 )Cls d wik h st e eh r r o o r s b e s eie y h a .) ( .t 1 l e g c j a h ' # exc usve r g a di cr ton,w ih r pec t c a m s a a l i i ht nd s e i t es t o l i nd ppea s t i e r t pl s t r s t l , o nt m et he an' e m , o a rit rt pl n' be is t dee mi t a ia ef c sa t a y t pln' tr t dmilse he a s neft, o tr ne he pplc bl a t nd o ppl he a s e ms o t efcs' An t n oh n i ( S s g e t t a p a a miitao smu t c o ds e il h a t. ). d t l ti g n ERI A) u g ss h t ln d nsrt r s a c r p ca l d e e t t o ni ofte tng physcins' Blck a De kerDia lt Pln v. d,538 ef r nce o he pi ons r a i i a .' a nd c s biiy a Nor U. 8 S ( S. 22, 31 2003) . Se ond, a t ke i s w ih Sedgwi k' e pl ym e ofD r Pe r e hi e l tonsof c D y a s s ue t c s m o nt . t i , s va ua i t me c le de sa hi phonecal t o he media pr e sona s Da ar ue t spoi t he di a vi nce nd s ls o t r c l of s i l . y g s hi n t r800t f t t Cthelng mde h acor wo t a uageoft p1n', a et Plnr fr t d l Physcin' he a ' bec us he a ee s o ç r i a ' ) Yot a nott n i pe ntphysc a ' Howe r t c t s r not ng i t Pln pr ve i nd i nde nde a ii n. ' ve ,he our dice ns hi n he a e ntng Se dgwik fom e pl ng a i pe n physc a t e ua et e si me c e de i c r m oyi n nde nde t ii n o val t he xitng dial vi nce n ai ofSedg ck' de ii ( . mi R. ECFNo.11 (çse c ha t rg t d wi s cson. Cf Ad n. 47, ) Gl dgwik) s he iht o r que tt tyou a oryo t Physci n c a i y orve iy t m e c li or a i t tyou oryot e s ha nd/ tr i a lrf rf he di a nf m ton ha l r Physc a s i.A r que tf c a ii a i orve ii a i may i l i pe ntme ca ii n ubm t e s or l rfc ton rtc ton ncude nde nde di l exn nai ns f nc i lc pact e ua i ,s cond me c lo ni ,pee -o- rr viws mi to , u tona a iy val tons e di a pi ons rt pee e e , j bst e au to s s r ela c a dohe smia me n . o ie v lai n , u v iln e n t r i lr a s' l. Thid,a fnaly,Da poi st 800t fcorsx( t rt de ii wa consse r nd i l y nt o h a t i whehe he cson s itnt wiht pr e lala s tntverquie ntofERI a t s r aleg dee t i t t he oc dtr nd ubsa i e r me SA) nd o eveal l ed fcs n he Pl n' t e de all ter . She c a m st tt e de e t r nde t l te snonc pla w ih a s hr e ni e t s l i ha hes f c s e r he e tr om i nt t ER I ' m a t t tde a l te s i ude t s ii r as f t de a a s cii SA S nda e ha ni l e t r ncl he pec f c e on or he ni l nd pe f c r ernc t t plnpr sononwhiht de ali ba e Se 29C. R.j25 50 1g) s e ef e e o he a ovii c he ni s s d. e F. 60. 3- ( ; e alo29U. C.j 11 Ha nge mi dt ltescosl t co ttndst tt yae s S. 33. vi xn ne he etr l ey,he ur i ha he r 10 s tnta l c ubsa ily ompla wih ERI i t tt y c an ç sae e ofr as t t unde t int t SA n ha he ont i 1 t tm nt e ons ha , a r he cr um sa esoft c e, r itd as fc e l cea unde sa ng oft a nita o ' ic t nc he as pe m te ufi i nty l r rt ndi he dmi sr t rs postont per tefci rvi ' Br nv. l 1 F. 158,1 (t Ci.1 ;s e ii o mi fe tve e ew. oga Holand, 05 3d ' 65 4h r 997) e as La s v.Ol Do ni Fr i Li l .277F. x31 321( hCi.2008) lo ron d mi on eMht ne.nc, App' 8, 4t r . I a hi t r cor i t s c e s st ta t rm uli e doc orvi isand m y i d f nyt ng, he e d n hi as how ha f e tpl t st ra m e ca t t , y' own doc o ssr ggl d t a ti ehe pa n t a pa tc a me c lfndi di l ess Da s t r tu e o trbut r i o ny riul r di a i ng. ( .eg.Admi R. ECFNo.112.( .Dasoornotngt thewasGnotf l c nc d See . , n. 69, - ) Dr t , i ha i uly onvi e t t( y' a mals nalM llwa c usnglhe dic or. Eve i t cour woul have ha Da s bnor pi t sa i r somf t' ). n f he t d i pe nty c et a c r r c uson r gar ng Day' diabiiy cli Se nde nde l om o onta y oncl i e di s s lt a m, dgwik' c s dec s on i t s c s w a r as na esa i i no wihi t c tspr vi e t di t b i. i i n hi a e s e o bl nd t s t t n he our ' o nc o s ur t 1 11. The c r c l ou t oncudest tSedg ik' de ii n- a ng pr s wasr s ne a ha w c s c so m ki oce s ea o d nd prncpl d,a t tt ma e i l on whih i r le a uael s i i e nd ha he t ra s c t e id deq t y uppored isde son. Fo t t t t cii r ha r a o and f rt ot rr s ns s a e t s c ti una e t c l t tSe i k' de a of e s n, o he he ea o t t d, hi our s bl o onc ude ha dgw c s ni l Da ss ttr dia lt cai wasunr s na e.Ac or ngl t c tgr nt t Pl n' y' hor-e m s biiy l m ea o bl c di y,he our a s he a s moin frs mmayj d me t n d n e Da smoinf rs mma yj d me t to o u r u g n a d e is y' to o u r u g n . EN TER :D e e be 1 201 c m r 3, 2. UNI STATESDI CT J TED STRI UDGE

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