Wessberg v. Unum Life Insurance Company of America

Background

Ann D. Wessberg brought claims under the Employee Retirement Income Security Act (ERISA) challenging Unum Life Insurance Company of America’s termination of her long-term disability benefits. Wessberg alleged that cancer treatment left her with chronic fatigue, autonomic dysfunction, orthostatic hypofunction, cognitive impairment, and depression. Unum terminated her benefits, briefly reinstated them for the period surrounding a surgical procedure, and terminated them again. Unum upheld the termination after Wessberg appealed and later reopened the appeal.

The case’s initial scheduling order required the parties to produce the administrative record—the evidence considered by Unum when deciding Wessberg’s benefits claim. Wessberg later advised Unum that she believed the record was incomplete and sought additional discovery, an extension of the discovery deadline, and permission to add evidence. The evidence she sought to add included August 2021 treatment notes from Dr. Laxmana Godishala, a June 2022 letter from treating oncologist Dr. Danielle Tippit, and a declaration from neuropsychologist Dr. Rodney A. Swenson about “chemo brain.”

Magistrate Judge’s Order and Appeal

Magistrate Judge Leo I. Brisbois denied Wessberg’s motion to expand the administrative record. He found that the materials were not necessary for adequate review of the benefits decision, that Wessberg could have submitted them during Unum’s claim administration, and that she was attempting to present better evidence after the claims process had ended. Wessberg timely objected to, and appealed, the denial of her motion to expand the record. The opinion addresses that objection rather than deciding the underlying entitlement to benefits.

Court’s Analysis

The district court reviewed the magistrate judge’s nondispositive pretrial ruling under a highly deferential standard. It could reverse only if the ruling was clearly erroneous or contrary to law.

The court explained that ERISA benefits review generally is limited to the evidence before the plan administrator when the claim was denied. Under Eighth Circuit law, a court may allow additional evidence only when the claimant shows good cause. An opportunity to submit evidence during the administrative process, followed by a failure to submit it, weighs against good cause. Additional evidence may be allowed when it was not available when the insurer made its decision.

For Dr. Godishala’s August 10, 2021 treatment notes, the court agreed that Wessberg could have submitted them before Unum’s final decision on October 1, 2021, including during the reopened appeal. The court also found that the notes were cumulative because the administrative record already documented Wessberg’s diagnosis. Wessberg therefore did not show good cause for adding them.

For Dr. Tippit’s June 6, 2022 letter, the court reasoned that Wessberg could have sought and submitted the letter while Unum was processing the claim. Although Dr. Tippit became Wessberg’s oncologist near the end of the claims process, the process continued until early October 2021. The court also noted that the record already contained substantial medical evidence concerning Wessberg’s ability to work. The court concluded that Wessberg lacked good cause to add the letter.

For Dr. Swenson’s declaration, the court found that the declaration provided general information about chemotherapy’s effects on the brain, information that should have been available during the administrative proceedings. The declaration was submitted after the claims process ended and after Wessberg had received her diagnosis. Because Unum had reopened the appeal and given Wessberg an opportunity to supplement the record, the court concluded that she had not shown good cause to add the declaration.

Disposition

The court held that the magistrate judge did not clearly err in denying the motion to expand the administrative record. The order therefore: (1) denied Wessberg’s objection to the magistrate judge’s order; and (2) affirmed the magistrate judge’s order. The opinion did not decide the merits of Wessberg’s ERISA benefits claim.