Theron Oliver was a Systems Support Specialist working for Coca-Cola, which provided long-term disability benefits to its employees. In October of 1999, Mr. Oliver was involved in a car accident. As a result, he developed severe headaches and pain and stiffness in his neck and upper back. He then applied for and received 26 weeks of short-term disability benefits before applying for long-term disability benefits.
As part of his claim for long-term disability benefits, he submitted statements from two of his physicians. Dr. Arrowsmith, an orthopaedic surgeon, indicated that Mr. Oliver was unable to sit for more than one hour and could not lift over ten pounds. Dr. Arrowsmith also stated that Mr. Oliver could not sit for more than three hours per day, and only then in short episodes; he could walk no more than three hours per day; and could not stand for more than four hours per day. Lastly, Dr. Arrowsmith stated that Mr. Oliver was unable to work.
Mr. Oliver’s other physician, Dr. Fugedy, a pain management specialist, informed Broadspire, the third-party administrator of the policy, that Mr. Oliver was incapacitated because of his severe headaches and neck and arm pain. Dr. Fugedy also stated that Mr. Oliver could never:
- Reach above shoulder level;
- Pull; or,
- Drive a car.
Dr. Fugedy also stated that Mr. Oliver could not work.
Broadspire then conducted an independent review of the attending physician statements submitted by Mr. Oliver’s doctors. The reviewing physician stated that there was no objective evidence to support Mr. Oliver’s claim, and Broadspire denied his claim on June 19, 2000.
Mr. Oliver continued to treat with a neurologist, and submitted additional medical records that supported his disability to Broadspire. Broadspire had another physician conduct a review of Mr. Oliver’s records. Once again, Broadspire’s doctor was of the opinion that there was no objective evidence to support the disability. Broadspire then denied his claim for the second time on October 16, 2000, stating that there was not enough medical documentation to support his claim. Mr. Oliver hired an attorney who appealed Broadspire’s denial a second time, which Broadspire then denied for a third time on April 30, 2001.
Mr. Oliver then filed suit against Coca-Cola and Broadspire in August 2004. The court held that Broadspire had wrongfully denied Mr. Oliver his benefits, and awarded him future disability benefits and back benefits and interest of more than $200,000. The court ruled that the evidence presented to Broadspire overwhelmingly supported Mr. Oliver’s claim for total disability benefits, and that Broadspire had mischaracterized the records submitted. Coca-Cola, through Broadspire, also failed to consider a number of items that provided objective evidence of Mr. Oliver’s disability.
See Oliver v. Coca-Cola Co., 49 F.3d 1181 (11th Cir. 2007).