United States District Court, E.D. Arkansas, Western Division
OPINION AND ORDER
Kristine G. Baker, United States District Judge
an action filed under the Employee Retirement Income Security
Act of 1974, 29 U.S.C. § 1001 et seq.
(“ERISA”), by plaintiff Karen Roebuck (Dkt. No.
1). Defendant USAble Life (“USAble”) filed an
answer to Ms. Roebuck's complaint (Dkt. No. 6), and the
parties submitted an administrative record (Dkt. No. 12). Ms.
Roebuck then filed a motion for summary judgment (Dkt. No.
15). USAble responded, and Ms. Roebuck replied (Dkt. Nos. 18,
Ms. Roebuck's motion is styled as one for summary
judgment, she does not cite Federal Rule of Civil Procedure
56 in either her motion or brief in support (Dkt. Nos. 15,
16). Furthermore, USAble's response asks the Court to
affirm USAble's disability benefits determination (Dkt.
No. 18, at 15). Accordingly, the Court treats Ms.
Roebuck's motion for summary judgment as a motion for
judgment on the administrative record.
considered the parties' respective positions regarding
Ms. Roebuck's entitlement to disability benefits, the
Court finds that Ms. Roebuck's claim should be dismissed
with prejudice (Dkt. Nos. 15, 18, 19). The relief requested
by Ms. Roebuck is denied.
issued a long-term disability insurance policy (the
“Policy”) to Arkansas Blue Cross and Blue Shield
(Dkt. No. 12-10, at 108). The Policy states that, if a
policyholder “become[s] disabled while insured under
the policy, we will pay long term disability insurance
benefits after you satisfy the elimination period.”
(Id., at 140). The Policy contains a clause that
authorizes USAble to “have the sole discretionary
authority to determine eligibility for participation or
benefits and to interpret the terms of the policy.”
(Id., at 131).
Policy defines “disabled” as satisfying the
“Occupation Test, ” which is defined as follows:
1. During the elimination period [sic] the first 24 months
and of a period of disability, an injury, sickness, or
pregnancy requires that you be under the regular care of a
physician, and prevents you from performing all of the
material duties of your regular occupation with reasonable
2. After 24 months of disability, an injury, sickness, or
pregnancy prevents you from performing all of the material
duties of any gainful occupation with reasonable
accommodations for which your education, training, and
experience qualifies you.
(Id., at 122). The effective date of the Policy is
January 1, 2011, the renewal date is January 1, 2012, and the
“anniversary date” of the Policy is
“January 1, 2011[, ] and [e]ach [s]ucceeding January
1.” (Id., at 108, 110). The Policy defines the
“elimination period” as 180 days (Id.,
Ms. Roebuck's Initial Claim
Roebuck worked as a registered nurse who evaluated insurance
claims for Blue Cross Blue Shield from October 2012 until
December 28, 2015 (Dkt. No. 12-9, at 6-7). Ms. Roebuck was
involved in a motor-vehicle collision on December 21, 2013
(Dkt. No. 12-6, at 19). At the hospital following the
accident, Ms. Roebuck complained of neck pain, lower back
pain, and soreness in her chest (Id.). She received
treatment as a result of her injuries (Id.).
Ms. Roebuck initially continued to work after the 2013
accident, eventually, she quit working. Ms. Roebuck's
last day of work was December 23, 2015, and she filed an
application for long-term disability income benefits under
her employer's long-term disability plan, which is issued
by USAble, on June 29, 2016 (Dkt. Nos. 12-9, at 7-9; 12-11,
at 102). In her application, she cited her symptoms as
“low back pain, neck/[left] arm and shoulder pain,
bilateral wrist pain/numbness . . . .” (Dkt. Nos. 12-9
at 6; 12-11, at 111).
administrative record includes medical evidence, including
but not limited to the following. On February 3, 2014, Ms.
Roebuck had an MRI performed on her lumbar spine (Dkt. No.
12-10, at 87). This procedure revealed the following:
At L4-L5, there is small central disc protrusion. In
conjunction with facet overgrowth and ligamentum flavum
thickening, this results in mild spinal canal narrowing. The
disc protrusion measures 4 mm anterior to posterior. Spinal
canal is narrowed to a minimum dimension of 11 x 14 mm. There
is some crowding of the nerve roots but no high grade
effacement of the thecal sac. These changes result in mild
narrowing of subarticular recesses bilaterally, but no
high-grace impingement of the descending nerve roots
identified. The neural foramina are patent.
MRI was performed on Ms. Roebuck on February 3, 2014, this
time on her cervical spine. This MRI revealed the following:
L paracentral disc extrusion C5-6 resulting in mild spinal
canal narrowing and contacts and flattens the anterior L
aspect of the spinal cord. No. signal abnormalities. Mild L
neural foraminal encroachment. L Paracentral disc protrusion
C6-7 without sig stenosis. Mild L neural foraminal
(Dkt. No. 12-1, at 189).
January 15, 2015, Dr. Kenneth Rosenzweig performed a
“lumbar facet joint inflection-fluoroscopic
guided” procedure on Ms. Roebuck (Dkt. No. 12-3, at
13). On January 29, 2015, he performed a
“[r]adiofrequency denervation” procedure on Ms.
Roebuck (Id., at 11). On February 12, 2015, he
performed another “radiofrequency denervation” on
Ms. Roebuck (Id., at 9). On June 18, 2015, he
performed a “[f]luoroscopically guided SI joint
injection, right and left” on her (Id., at 7).
He performed another “[f]luoroscopic SI joint
injection, left and right” on her on September 10, 2015
(Id., at 5).
October 1, 2015, Ms. Roebuck had another cervical spine MRI
performed (Dkt. No. 12-11, at 31). This MRI revealed the
At C2-C3 and C3-C4, no significant disc bulge or herniation
or evidence for neural compromise is seen.
At C4-C5, a minimal central focal disc bulge present with no
evidence for neural compromise.
At C5-C6, there is a mild to moderate left paracentral disc
herniation which extends minimally into the left foramen with
very mild cord flattening to the left [of] the midline and
mild left foraminal stenosis.
At C6-C7, there is a mild posterior disc protrusion with left
paracentral predominance extending slightly into the left
foramen and with extrusion and subligamentous inferior
extension below the disc level in the left
paracentral/central distribution approximately three fourths
of the height of the C7 vertebral body. There is mild to
moderate left foraminal ...