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Weeman v. Life Insurance Company of North America

United States District Court, D. Maine

September 26, 2019




         An insured under a long-term disability insurance policy brings this claim against his employer’s disability insurer, arguing that the insurer unlawfully denied him benefits to which he was entitled under the policy. Both parties move for judgment on the administrative record. After reviewing the record and applying the arbitrary and capricious standard to the insurer’s denial of disability benefits, the Court concludes that the insurer had a reasonable basis and sufficient evidence to support its denial of the insured’s claim. The Court therefore grants the insurer’s motion for judgment on the administrative record and denies the insured’s motion.

         I. BACKGROUND

         A. Procedural History

         On July 12, 2018, Mitchell A. Weeman filed a complaint against Life Insurance Company of North America (LINA) alleging that LINA-a provider of long-term disability insurance governed by the Employee Retirement Income Security Act (ERISA) through Mr. Weeman’s employer, Brookfield Power U.S. Holding America Company (Brookfield)-acted arbitrarily and capriciously in denying Mr. Weeman’s claim for such benefits. Compl. ¶¶ 5, 26-27 (ECF No. 1). LINA answered Mr. Weeman’s Complaint on September 11, 2018. Answer (ECF No. 5). On October 10, 2018, LINA filed the Administrative Record for this case with the Court. Letter to United States District Ct. (ECF No. 8).

         On November 28, 2018, both Mr. Weeman and LINA moved separately for judgment on the administrative record. Mot. for J. on the Administrative R. (ECF No. 9) (Pl.’s Mot.); Def.’s Mot. for J. on the Administrative R. (ECF No. 10) (Def.’s Mot.). Both parties filed statements of facts appended to their motions. Pl.’s Mot., Attach. 1, Pl.’s App. to Mot. for J. on the Administrative R. (ECF No. 9) (Pl.’s App. of Facts); Def.’s Mot., Attach. 1, Def.’s App. of Facts (ECF No. 10) (Def.’s App. of Facts). On December 12, 2018, Mr. Weeman responded to LINA’s motion. Pl.’s Objs. to Def.’s Mot. for J. on the Administrative R. (ECF No. 11) (Pl.’s Objs.). On December 19, 2018, LINA responded separately to both Mr. Weeman’s motion and statement of facts. Def.’s Mem. in Opp’n to Pl.’s Mot. for J. on the Administrative R. (ECF No. 12) (Def.’s Opp’n); Def.’s Reply to Pl.’s App. of Facts (ECF No. 13). On December 27, 2018, Mr. Weeman replied to LINA’s response to his motion. Resp. to Def.’s Objs. to Pl.’s Mot. for J. on the Administrative R. (ECF No. 14) (Pl.’s Reply). On January 4, 2019, LINA filed a motion to strike Mr. Weeman’s reply. Def.’s Mot. to Strike Pl.’s Reply Mem. (ECF No. 15) (Def.’s Mot. to Strike).[1]

         B. Statement of Facts

         1. The Parties

         Brookfield employed Mr. Weeman as a senior production technician. Administrative R. at 1339. The overview of job responsibilities for this position states that “[t]he worker is responsible to operate the main and auxiliary generating equipment and machinery and other plant-related equipment; to perform predictive, preventive and reactive mechanical and electrical (limited to 600V) maintenance to the equipment and machinery; and to perform civil and structural maintenance and construction activities.” Id. at 1337. This position, according to LINA’s occupational analysis, required medium strength, id. at 1304, including “exerting 20 to 50 pounds of force occasionally, or 10 to 25 pounds of force frequently to move objects, ” as well as “significant walking or standing.” Def.’s App. of Facts ¶ 21, n.1. Mr. Weeman worked his last day for Brookfield on February 28, 2015. Administrative R. at 3. He began receiving long-term disability benefits on August 29, 2015. Id. at 534-35.

         LINA is a wholly-owned subsidiary of Connecticut General Corporation, itself a wholly-owned subsidiary of Cigna Corporation. Def.’s Corporate Disclosure Statement (ECF No. 6). LINA is the “named fiduciary” of Brookfield for “deciding claims for benefits” and “deciding any appeals of denied claims” under Brookfield’s “employee welfare benefit plan subject to the Employee Retirement Income Security Act of 1974 (“ERISA”).” Administrative R. at 1413.

         2. The Long-Term Disability Plan

         Mr. Weeman was eligible to participate in the group policy of disability insurance issued by LINA to Brookfield under policy number FLK-960752 (Group Policy). Def.’s Reply to Pl.’s App. of Facts ¶ 3; Administrative R. at 1391-1415 (Group Policy). “All active, Full-time Maine Operating Services Employees of [Brookfield] regularly working a minimum of 30 hours per week and subject to a collective bargaining agreement” are eligible to receive benefits under the Group Policy. Administrative R. at 1393; see also Id . at 1410. “Full-time means the number of hours set by the Employer as a regular work day for Employees in the Employee’s eligibility class.” Id. at 1411.

         LINA “will pay Disability Benefits if an Employee becomes Disabled while covered under [the Group Policy]. The Employee must satisfy the Elimination Period, be under the Appropriate Care of a Physician, and meet all the other terms and conditions of the Policy.” Id. at 1400. “The Elimination Period is the period of time an Employee must be continuously Disabled before Disability Benefits are payable.” Id. An employee is considered disabled under the Group Policy, and thus qualified to receive benefits, if, “solely because of Injury or Sickness, he or she is: 1. unable to perform the material duties of his or her Regular Occupation; or 2. unable to earn 80% or more of his or her Indexed Earnings from working in his or her Regular Occupation.” Id. at 1394. “Regular Occupation” is defined as “[t]he occupation the Employee routinely performs at the time the Disability begins.” Id. at 1412. “Indexed Earnings” are defined as follows:

For the first 12 months Monthly Benefits are payable, Indexed Earnings will be equal to Covered Earnings. After 12 Monthly Benefits are payable, Indexed Earnings will be an Employee’s Covered Earnings plus an increase applied on each anniversary of the date Monthly Benefits became payable. The amount of each increase will be the lesser of: 1. 10% of the Employee’s Indexed Earnings during the preceding year of Disability; or 2. the rate of increase in the Consumer Price Index (CPI-W) during the preceding calendar year.

Id. at 1411. “Covered Earnings” are defined as “an Employee’s wage or salary as reported by the Employer for work performed for the Employer as in effect just prior to the date Disability begins. Covered Earnings are determined initially on the date an Employee applies for coverage.” Id. at 1394. “After Disability Benefits have been payable for 24 months, ” the employee is considered disabled if:

solely due to Injury or Sickness, he or she is: 1. unable to perform the material duties of any occupation for which he or she is, or may reasonably become, qualified based on education, training or experience; or 2. unable to earn 60% or more of his or her Indexed Earnings.

Id. When claiming disability benefits, the claimant is required to “provide [LINA], at his or her own expense, satisfactory proof of Disability before benefits will be paid.” Id. at 1400.

         3. Mitchell A. Weeman’s Short-Term Disability Claims

         Mr. Weeman’s relevant medical history begins with a total hip replacement he received on September 19, 2013, due to his end-stage arthritis. Id. at 1442-45. Following this procedure, Mr. Weeman filed a claim for short term disability benefits which was approved on November 7, 2013. Id. at 623-24. The letter Mr. Weeman received from LINA approving his claim stated that benefits would be paid through December 11, 2013. Id. On September 26, 2014, Mr. Weeman received a left kidney nephrectomy to treat his renal cell carcinoma. Id. at 1423-25. On October 31, 2014, Mr. Weeman’s short term disability benefits were approved through October 30, 2014. Id. at 609. On November 12, LINA sent a letter to Mr. Weeman notifying him that, because LINA had been informed he was “released to return to work as of October 23, 2014, therefore benefits [were] payable through October 22, 2014.” Id. at 606.

         Mr. Weeman stopped working on February 27, 2015, id. at 252, 589, in preparation for a March 2, 2015, biventricular ICD implantation to be performed by Dr. Charles M. Carpenter at the Maine Medical Center in Portland, Maine. Id. at 1328-30. An ICD is an “implantable cardioverter defibrillator.” Id. at 1327. On March 10, 2015, Mr. Weeman visited Maine Medical Partners in Scarborough, Maine for a “routine wound check.” Id. at 1351. Nurse Practitioner Anna Stasiv wrote in her notes that Mr Weeman had “tolerated the [March 2] procedure well without any complications” and that Mr. Weeman “state[d] that he is doing well.” Id. Shortly thereafter, Mr. Weeman again applied for short term disability benefits[2] and on March 27, 2015, LINA approved his application for short term disability benefits though March 22, 2015. Id. at 586-87. In its letter approving Mr. Weeman’s claim, LINA noted that Mr. Weeman’s claim would remain open “through April 25, 2015 so that if [he was] not able to return to work by March 23, 2015, [he would] have an opportunity to send [LINA] the enclosed Medical Request Form completed for consideration of further benefits.” Id. at 586. On April 6, 2015, Dr. Carpenter wrote a letter stating that he had “explained to [Mr. Weeman] that he can no longer continue to work with electrical equipment” after the implantation of his ICD device, which was “for progressive heart disease.” Id. at 1327. On April 17, 2015, LINA sent Mr. Weeman a letter informing him that his eligibility for short term disability benefits would expire on July 26, 2015. Id. at 563-64. On April 30, 2015, Dr. Carpenter wrote a second letter stating that “Mr. Weeman has end-stage heart and kidney disease, ” and that he had told Mr. Weeman “that, under no circumstances, can he return to work as an electrician” due to his implanted defibrillator. Id. at 1326. On May 22, 2015, Mr. Weeman was seen by cardiologist Dr. Jeffrey Rosenblatt, who stated in his notes that Mr. Weeman was “doing well since his ICD BiV placement.” Id. at 1323-25.

         4. Mitchell A. Weeman’s Long-Term Disability Claim

         On June 29, 2015, LINA created a long-term disability claim file for Mr. Weeman. Id. at 3, 5. On July 3, 2015, the Social Security Administration awarded Mr. Weeman Social Security disability benefits, which he received from October 21, 2015, until November 16, 2016. Id. at 1218, 1278. On July 9, 2015, LINA conducted an occupational analysis of Mr. Weeman’s position as an auxiliary equipment operator and concluded that the position required medium strength, frequent climbing and reaching, and occasional stooping, kneeling, crouching, and exposure to electrical shock. Id. at 1303-04. LINA confirmed approval of Mr. Weeman’s long-term disability claim by letter dated August 12, 2015. Id. at 534-35. Benefits began on August 29, 2015-after the 180-day elimination period following Mr. Weeman’s March 2, 2015, date of disability. Id.

         Dr. Rosenblatt saw Mr. Weeman again on November 19, 2015 and wrote that “Mr. Weeman is doing well from a cardiac standpoint. He is settling in to not working but does say he should probably find something else to do to keep him busy besides working on the ‘honey-do list.’ He denies chest pain, palpitations, or shortness of breath.” Id. at 1295. Dr. Rosenblatt also wrote that Mr. Weeman “fe[lt] well, no change in exercise tolerance, weight gain of approximately 15 lbs.” Id.

         On April 1, 2016, Dr. James Wasserman, a nephrologist, saw Mr. Weeman for “Followup for Stage III Chronic Kidney Disease.” Id. at 1112. Dr. Wasserman wrote:

[Mr. Weeman] continues to have difficulty with loss of work. He is now very sedentary and not pursuing any particular activities. He is not walking, pursuing hobbies, or spending more time with friends. We talked about the importance of this for mental and physical health as well as social well-being. We put this in the context of his increased weight and increased fluid intake.

Id. Mr. Weeman saw Courtney Anson, a physician’s assistant at Maine Medical Partners Urology, on April 27, 2016. Id. at 1078-80. The appointment was for follow-up on Mr. Weeman’s renal cancer, and Ms. Anson found no evidence of recurrence. Id. at 1080.

         Mr. Weeman returned to see Dr. Rosenblatt on May 6, 2016, and Dr. Rosenblatt noted that he was “doing well without any complaints of palpitations, shortness of breath, or chest pain.” Id. at 906. “Th[e] conversation focused around diet and exercise.” Id. Dr. Wasserman next saw Mr. Weeman on September 8, 2016, for further follow-up on his stage III chronic kidney disease. Id. at 1110. He denied “[c]hest pain at rest” and “[c]hest pain with exertion.” Id. at 1111. With regard to Mr. Weeman’s congestive heart failure, Dr. Wasserman found “[n]o signs or symptoms of decompensation.” Id.

         On November 3, 2016, Mr. Weeman saw Ms. Anson because of a “Renal Mass.”[3]Id. at 1165. Ms. Anson wrote that Mr. Weeman showed “[n]o evidence of recurrence” of his renal cancer. Id. at 1167. On November 4, 2016, Mr. Weeman again saw Dr. Rosenblatt, who stated that “Mr. Weeman feels well. There are no changes in his medical status. He remains on total disability due to the presence of the defibrillator and his working environment, which would contraindicate the use of an ICD in that environment.” Id. at 903. Also, on November 4, 2016, Dr. Rosenblatt completed a “Disability Management Solutions Medical Request Form” stating that Mr. Weeman “[h]as an ICD Cannot work around Electrical current.” Id. at 1163. Dr. Rosenblatt also wrote that Mr. Weeman “[c]annot work” and based on his experience would never be able to return to work. Id.

         On December 6, 2016, Mr. Weeman completed a disability questionnaire that he received from LINA “[a]s part of [LINA’s] evaluation of [Mr. Weeman’s] claim and ongoing eligibility for disability benefits.” Id. at 1215-16, 1219. In response to the question, “In your own words, tell us why you cannot work in your own or in any occupation, ” Mr. Weeman wrote, “Can not work in high magnetic fields; can no longer work with electrical equipment.” Id. at 1216. In response to the question, “What is primary physical and/or mental condition preventing you from working now, ” Mr. Weeman wrote “End stage heart and kidney disease. Also have an implanted defibrillator.” Id. Mr. Weeman stated that he did one hour of yard work three days a week, a half hour of gardening once a week, an hour of reading seven days a week, and three hours of watching television seven days a week. Id. He also stated that he walked a half mile and used a computer every day, including “Windows” and “email.” Id. As part of this questionnaire, Mr. Weeman signed a disclosure authorization form, authorizing his medical care providers to give LINA records related to his care. Id. at 1219.

         On January 12, 2017, Mr. Weeman again saw Dr. Wasserman, who wrote that “[h]e continues to have difficulty with loss of work. He remains very sedentary. He continues to mourn previous lifestyle.” Id. at 1108. Dr. Wasserman also noted that on that visit, Mr. Weeman was “not interested in following up in integrative nephrology clinic to discuss a more holistic approach to his health issues.” Id. Dr. Wasserman further wrote that the “[m]ost important factor and correctable factor for [Mr. Weeman’s] current health is increased activity, healthy diet, reduce caloric intake and weight reduction.” Id. at 1109.

         On March 8, 2017, Ms. Anson completed a “Disability Management Solutions Medical Request Form” stating that from her perspective, Mr. Weeman’s renal cancer posed no work restrictions. Id. at 1194. On April 26, 2017, Dr. Wasserman returned to LINA a blank “Disability Management Solutions Medical Request Form” with a note scrawled on the cover letter stating, “Per Dr. Wasserman, Please ask PCP or Cardiology to complete. Thanks.” Id. at 1197-98.

         5. Denial of Continued Long-Term Disability Benefits

         After receiving twenty-four months of benefits payments as of August 29, 2017, it became Mr. Weeman’s obligation to provide evidence that he was “1. unable to perform the material duties of any occupation for which he . . . is, or may reasonably become, qualified based on education, training or experience; or 2. unable to earn 60% or more of his . . . Indexed Earnings.” Id. at 534, 1394.

         On May 10, 2017, Dr. Shadrach Jones[4] completed an “Internal Resource Response” in which he “reviewed all available medical and/or vocational evidence, for which [he had] been trained, bearing on Disability and/or functional capacity and . . . considered its impact on the whole person in order to provide an accurate representation of the medical and/or vocational facts of the claim file.” Id. at 110. Dr. Jones noted that “[t]he evaluation by Dr. Rosenblatt on 11/4/16 documented that customer [Mr. Weeman] presented for follow up reporting that he felt well denying dyspnea and chest pain, ” and that “[t]he examination by Courtney Anson, PA-C, on 11/3/16 documented that customer had a normal mental status, clear lungs, normal heart sounds, and no abdominal masses.” Id. Dr. Jones concluded that “[t]he treating provider[’]s opinion [that Mr. Weeman could not work] is not well supported by medically acceptable clinical or laboratory diagnostic techniques and is inconsistent with the other substantial evidence in the claim file” because “[t]he customer[’]s cardiac disease would not preclude normal, sedentary activities, ” “[t]here is no current documentation of heart failure or syncope, ” and [t]here is no current documentation of symptoms at rest.” Id. at 111. Dr. Jones wrote that while Mr. Weeman’s “cardiomyopathy will limit aerobic capacity” and “[t]he implantable defibrillator must not be exposed to intense electromagnetic fields, ” Mr. Weeman is able to “frequently sit, reach at desk level, fine manipulate, simple grasp and firm grasp[, ] occasionally stand, walk, and reach above the head and below the waist and lift, carry, push and pull 10 lbs. on an occasional basis and a negligible amount of weight on a frequent basis.” Id.

         Mr. Weeman saw Dr. Rosenblatt again on May 10, 2017. Id. at 899. Dr. Rosenblatt noted that “Mr. Weeman is doing relatively well. He does find he is short of breath when he exerts himself, but admits he has not really been doing much exercise outside.” Id.

         On May 11, 2017, Darci Bakos, [5] a Vocational Rehabilitation Specialist, completed a “Transferable Skills Analysis” (TSA) of Mr. Weeman, based in part on the disability questionnaire he filled out on December 6, 2016, and the medical review conducted by Dr. Jones on May 10, 2017. Id. at 1160-61. Ms. Bakos listed Mr. Weeman’s skills and abilities as follows: “knowing the function of system specialty operated; directing work of others; coordination of eyes, hands, and fingers to run or adjust system; reading panel-board meter, dials, and gauges and using math skills to interpret readings; and remaining calm during emergencies.” Id. at 1160. Ms. Bakos also noted that Mr. Weeman “uses a computer daily, with knowledge of Windows and email.” Id. Based on Mr. Weeman’s “skills, education attainment, work history, age, and wage requirements/station in life” and “based on [his] physical limitations and restrictions as outlined by Dr. Jones, ” Ms. Bakos stated her opinion that Mr. Weeman could work as a “Relay Record Clerk.” Id. at 1161. Apart from the title, there is no description of what this position entails. While the TSA does state that such positions can be “perform[ed] in the labor market of Bar Mills, ME, ” it gives no indication that such positions were, indeed, available. Id.

         Based on the TSA, LINA rejected Mr. Weeman’s claim of continued disability by letter dated May 11, 2017. Id. at 468-70. Disability Claim Manager David R. wrote that Mr. Weeman was “not Disabled from any occupation as defined by” the Group Policy. Id. at 468, 470. David R. stated that Mr. Weeman’s claim was reviewed by “[a] claim manager, medical director, vocational rehabilitation counselor, and senior claim manager, ” who looked at “[t]he information in [Mr. Weeman’s] file, including medical information from cardiologist Dr. Jeffrey Rosenblatt, urologist Dr. Matthew Hahn, [6] and nephrologist Dr. James Wasserman.” Id. In a section entitled “How Was the Claim Decision Reached?, ” David R. wrote:

Our review of your file shows that you have a history of congestive heart failure and renal cancer. Treatment is provided by Drs. Rosenblatt, Hahn, and Wasserman. We wrote to your physicians and requested copies of your medical records and completion of forms.
Dr. Rosenblatt provided us with copies of your records through November 4, 2016, and completed a medical request form, on which he opined that you will never be able to return to work.
Dr. Hahn provided us with copies of your records through November 3, 2016, and completed a medical request form, on which he indicated that no work restrictions were given to you.
Dr. Wasserman advised that he defers to your cardiologist with regard to your work capacity.
The information in your file was reviewed by our medical director (MD), who is a licensed physician Board Certified in internal medicine, and specializing in occupational and environmental medicine. When examined by Dr. Rosenblatt on November 4, 2016, you reported feeling well and denied dyspnea and chest pain. Your blood pressure was 124/56, pulse 66, and respirations 14. A grade III/IV systolic murmur was noted, but the rest of your examination was within normal limits. Your examination on November 3, 2016 documented that you had a normal mental status, clear lungs, normal heart sounds, and no abdominal masses. The MD noted that there is no documentation in your file of current heart failure, syncope, or symptoms at rest.
The MD opined that your cardiac disease should not preclude sedentary work. Your implanted defibrillator should not be exposed to intense electromagnetic fields. The MD opined that you may frequently sit, reach at desk-level, fine manipulate, simple grasp and firm grasp occasionally; stand, walk, and reach above head and below the waist and lift, carry, push and pull ten pounds on an occasional basis and a negligible amount of weight on a frequent basis. There are no documented impairments of speech, hearing, vision, or cognition.
We had a certified vocational rehabilitation counselor perform a transferable skills analysis to determine if suitable occupations exist that you should be qualified and able to preform based upon your education, experience, and our MD’s assessment of your work capacity as described above. We note that you completed high school and obtained an electrical license. You previously worked as a senior production technician, and report basic home computer use. A suitable sedentary occupations [sic] was identified that you should be qualified and able to perform: relay record clerk (D.O.T. 221.367-054).
The Dictionary of Occupational Titles defines sedentary work as follows: “Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.”
We are aware that you have been awarded Social Security Disability Insurance (SSDI) benefits by the Social Security Administration (SSA), and have considered that fact in our claim review. We have confirmed that there is no new information in your SSA file since the time of your initial Social Security Award. As a result, we are in receipt of more recent information than the SSA had to consider at the time of its decision.
We have identified a suitable sedentary occupation that you should be qualified and able to perform based upon your education, experience, and our MD’s assessment of your work capacity. Therefore, you are not Disabled from any occupation and are not eligible for benefits beyond August 28, 2017.

Id. at 469. The letter went on to explain Mr. Weeman’s options for appealing LINA’s determination. Id. at 469-70.

         On May 16, 2017, Dr. Rosenblatt returned a second “Disability Management Solutions Medical Request Form, ” again stating that Mr. Weeman was “[u]nable to work” and could not return to work “in the near future.” Id. at 1155. He did not provide further explanation for this conclusion.

         6. Michell A. Weeman’s First Appeal

         On June 7, 2017, [7] Mr. Weeman was seen by internist Dr. David Kispert[8] for “evaluation for disability insurance.” Id. at 887. Dr. Kispert wrote that Mr. Weeman would “need additional evaluation and treatment prior to determining disability status” related to “complaints of arthritis in multiple joints . . ..” Id. at 888. On June 20, 2017, Mr. Weeman was seen by nurse practitioner Chelsea Ginn, [9] who worked with Dr. Johnson, for “discussion of long-term disability.” Id. at 889, 891. Ms. Ginn’s exam found “normal ROM [range of motion] with flexion and extension” in his hands and “no evidence of erythema, edema, or warmth of the joints . . ..” Id. at 890. On July 5, 2017, Mr. Weeman was seen by Dr. Ellis Johnson[10] for an annual physical exam. Id. at 676. While Dr. Johnson wrote that Mr. Weeman was “[i]n general . . . feeling OK, ” he went on to state that Mr. Weeman was “no longer able to work due to his ICD and diffuse osteoarthritis.” Id. Dr. Johnson also wrote that Mr. Weeman was “not able to work at a computer due to his ongoing hand arthritis and has trouble sitting at a desk due to his back arthritis.” Id. at 679.

         On July 7, 2017, Mr. Weeman appealed LINA’s rejection of continued disability benefits. Id. at 1151-52. Mr. Weeman wrote that he felt he was “unable to complete the required duties of a sedentary position, like” relay record clerk, because he did not “have proper keyboarding skills due to a combination of the osteoarthritis of both hands, inability to straighten one of [his] fingers, and improper technique, ” which he stated was a result of not knowing touch typing and only typing with his two index fingers, “which results in decreased productivity of [his] computer skills.” Id. at 1151. Mr. Weeman went on to say that, while he had reported basic home computer use, his computer skills were “not up to the standard of your basic entry level worker, ” as his computer skills include only “minimum emailing, light browsing of web pages, and minimal typing in a word document.” Id.

         On July 18, 2017, Dr. Krystian Bigosinski[11] saw Mr. Weeman for a “Sports Medicine Initial Office Visit.” Id. at 680. Dr. Bigosinski wrote that Mr. Weeman’s “bilateral hand pain . . . could be coming from some osteoarthritic changes, ” stating that “[b]ilateral hands revealed diffuse swelling throughout all of the fingers and the right middle finger is especially swollen and tender. He is not able to extend the middle finger fully and . . . . [o]n both hands he cannot close his hands entirely and make a fist due to swelling and pain.” Id. at 680-81. A ...

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