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Menge v. AT&T, Inc.

United States Court of Appeals, Tenth Circuit

December 17, 2014

KENT D. MENGE, Plaintiff - Appellant,
v.
AT&T, INC., a Delaware corporation; AT&T UMBRELLA BENEFIT PLAN NO. 1; AT&T OPERATIONS, INC., a Delaware corporation; THE AT&T DISABILITY INCOME PROGRAM, Defendants-Appellees.

(D.C. No. 1:11-CV-00728-PAB-KLM) (D. Colo.)

Before HOLMES, BACHARACH, and McHUGH, Circuit Judges.

ORDER AND JUDGMENT [*]

Carolyn B. McHugh Circuit Judge

Kent D. Menge appeals pro se from a district court order that upheld the denial of his claim for short-term disability benefits under the Employee Retirement Income Security Act (ERISA). We have jurisdiction under 28 U.S.C. § 1291, and we affirm.

Background

Mr. Menge began working for AT&T in April 2007 as an account manager. His "core responsibilities [were] to answer calls and emails from his [assigned] customers, " and he was required to "develop[ ] and appl[y] knowledge of the clients['] business drivers and goals and [create] innovative solutions to address the customers['] need[s]." R., Vol. I at 73, 74.

As an AT&T employee, Mr. Menge was covered by the company's Umbrella Benefit Plan No. 1. That plan includes a Disability Income Program (DIP), which provides short-term disability benefits, here, for twenty-six weeks, when an employee is "unable to perform all of the essential functions of [the] job or another available job assigned by [AT&T] with the same full-time or part-time classification for which [the employee is] qualified." Id. at 315.

Although AT&T funds and administers the DIP, it has delegated its claims administration responsibilities to Sedgwick Claims Management Services. To fulfill its responsibilities, Sedgwick operates an Integrated Disability Service Center (IDSC) and a Quality Review Unit (QRU). AT&T gives Sedgwick "sole discretion to interpret the [DIP]" and it insulates Sedgwick's coverage and benefits determinations from attack unless they are arbitrary and capricious. Id. at 347.

On September 26, 2007, Mr. Menge was driving his car into the AT&T parking lot, when he was rear-ended by another vehicle. He suffered a mild concussion and he developed neck pain. He underwent physical therapy for several weeks but discontinued it in November 2007.

In January 2008, Mr. Menge saw his primary-care physician, Kari Kearns, M.D., for depression, insomnia and anxiety. He also submitted a short-term disability claim under the DIP, as directed by his supervisor. The IDSC denied his claim, and Mr. Menge returned to work in early February 2008. The QRU subsequently denied Mr. Menge's appeal, citing a progress note by Dr. Kearns indicating that Mr. Menge was "overall feeling much better" and that his depression was "slowly improving." Id., Vol. VII at 140.

Mr. Menge began seeing Evan Katz, D.C., for continuing neck pain. Dr. Katz opined that Mr. Menge "had a loss of cervical lordosis, " "facet injury, " and a "slight disc bulge with some disc herniation in [the] low back, which [would] cause some significant pain with radicular-type symptoms." Id. at 619. Orthopedist Elizabeth Yurth, M.D., evaluated Mr. Menge and found cervical inflammation with pain, in addition to concentration and memory deficits, headaches, and "probable mild traumatic brain injury." Id. at 410.

In April 2008, Mr. Menge submitted another claim for short-term disability benefits. The IDSC granted the claim, but for only a one-month period: April 18, 2008, through May 18, 2008. In denying benefits subsequent to that period, the IDSC stated that it had reviewed medical records from Drs. Kearns, Katz, and Yurth, and despite the presence of depression, "some suicidal ideations, " "distracted and delayed response[s] to questions, " "mild disc protrusion at C5-6, " and "capsular distention [of the facet joints] at C3-4, C4-5, and C5-6, " there was no data or documentation showing "significant emotional or cognitive deficits" or physical limitations that would preclude the performance of Mr. Menge's job duties. Id. at 464.

When his disability benefits expired, Mr. Menge took unpaid leave under the Family and Medical Leave Act until July 10. He notified AT&T that he would be unable to return to his job, and he then utilized vacation and personal days for the remainder of the month. AT&T responded, granting him the opportunity at full salary and benefits to search for another job until September 14, 2008. Mr. Menge was unable to find a new position, and he was terminated on September 15, 2008.

Mr. Menge continued consulting with various medical professionals. His psychiatrist, Dr. Frederick Sakamoto, proffered an additional diagnosis of bipolar disorder. He recommended that Mr. Menge not work due to problems with "memory, concentration, focusing, depression, [and] anxiety." Id. at 452. But Dr. Sakamoto noted improvements in Mr. Menge's mood and anxiety during July and August 2008 visits, ...


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