Donovan v. Eaton Corporation Long Term Disability Plan, 462 F.3d 321 (4th Cir. 2006) – decided September 5, 2006 – United States Court of Appeals for the Fourth Circuit – Robert E. Hoskins

I represented Donovan. I think of Donovan as a companion case to Evans v. Eaton Corporation Long Term Disability Plan, 514 F.3d 315 (4th Cir. 2008), (click here to see my discussion on the Evans decision). Donovan sought long term disability benefits from the same plan as Evans. Donovan involved the same counsel as Evans, the same district court and Judge, the same type of claim, and the same plan, sponsor and administrator. However, the outcomes in Donovan and Evans could not be more different. As discussed elsewhere in this site, in Evans, the court reversed the District Court’s decision in Evans’ favor. The court did so, in my opinion, based upon the factual conclusions it reached about the plan’s reviewing physicians. In Donovan, like Evans, the plaintiff prevailed in the district court. (Click here to see the district court decision.) In Donovan, the Fourth Circuit upheld the lower court’s decision in Donovan’s favor based upon similar factual findings as the District Court had made. In Donovan, the court decided that the plan’s wholesale disregard of Donovan’s treating physicians’ opinion was an abuse of discretion. The court stated:

“. . . Ms. Donovan contends, the issue in this case is whether the Plan’s denial of benefits to Ms. Donovan was supported by substantial evidence in the record. She argues it was not; thus, the Plan’s decision was unreasonable and an abuse of discretion. We agree.

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The district court found that the Plan’s wholesale disregard of Dr. Welshofer’s affidavit in favor of his earlier April 2004 statement, which was based on incomplete information, was unreasonable. We agree. Dr. Welshofer’s affidavit is further supported by Dr. Lins’ office notes in August 2004 that Ms. Donovan’s neck and right arm pain had been getting worse over the previous six months but that the pain had been present for the last three years. In light of this evidence, Ms. Donovan is entitled to LTD benefits from March 2004 to September 2004.” Donovan, 462 F.3d 321, 326, 329. (Click here to view the whole Fourth Circuit decision.)

That the different ultimate outcomes in Evans and Donovan was the direct result of the Fourth Circuit’s perception of relevant fact is clear from the Evans opinion. In Evans, the court wrote:

“Finally, Donovan v. Eaton Corp., 462 F.3d 321 (4th Cir. 2006), featured the same defendant, the same plan, and the same general issue as this case. The panel there affirmed the district court’s decision for the claimant, according to Evans, because it regarded Eaton as “picking and choosing” medical evidence in its own favor. Appellee’s Brief 28. Consistency, Evans argues, demands the same conclusion from us. But “picking and choosing” is just a pejorative label for “selecting,” and what rightly offended the Donovan court was not Eaton’s selectivity (which is part of a plan administrator’s job), but its “wholesale disregard” of evidence in the claimant’s favor. Donovan, 462 F.3d at 329. Here, by contrast, Eaton addressed the evidence in Evans’s favor thoughtfully and at length. The benefits cancellation letter of April 2004, for example, gave due regard to the evidence in Evans’s favor: “[Y]ou have a history of rheumatoid arthritis,” Broadspire wrote, “but recent notes indicate that you has a decrease in your symptoms and are doing well on Enbrel.” As to Evans’s back, an MRI “revealed degenerative disk disease,” but no “functional impairment that would preclude you from performing sedentary job duties.” Eaton’s assessment of the evidence in this case was fair, and it is entitled to the deference that is the result of careful work.” Evans, 514 F.3d 315, *25-27.

Donovan has been cited by other courts or law review articles 15 times including by the United States Court of Appeals for the Eleventh Circuit.

This case was featured featured on the front page of South Carolina Lawyers Weekly newspaper. I was quoted in the article. Click here to view the news story.