Michael Alves v. Hewlett-Packard Comprehensive ( 2022 )

FILED
NOT FOR PUBLICATION
MAR 10 2022
UNITED STATES COURT OF APPEALS MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
FOR THE NINTH CIRCUIT
MICHAEL ALVES, No. 21-55476
Plaintiff-Appellant, D.C. No.
2:16-cv-09136-RGK-JEM
v.
HEWLETT-PACKARD MEMORANDUM*
COMPREHENSIVE WELFARE
BENEFITS PLAN; HEWLETT-
PACKARD ENTERPRISE COMPANY,
Defendants-Appellees.
Appeal from the United States District Court
for the Central District of California
R. Gary Klausner, District Judge, Presiding
Submitted March 7, 2022**
Pasadena, California
Before: IKUTA, LEE, and FORREST, Circuit Judges.
Michael Alves appeals the district court’s ruling that Sedgwick Claims
Management Services, Inc. (“Sedgwick”), the ERISA plan administrator of the
*
This disposition is not appropriate for publication and is not precedent
except as provided by Ninth Circuit Rule 36-3.
**
The panel unanimously concludes this case is suitable for decision
without oral argument. See Fed. R. App. P. 34(a)(2).
Hewlett-Packard Comprehensive Welfare Benefits Plan (the “Plan”), did not abuse
its discretion in denying Alves’s long-term disability benefits.1 We review the
district court’s decision de novo. See Gabriel v. Alaska Elec. Pension Fund, 773
F.3d 945, 953 (9th Cir. 2014).
Sedgwick did not abuse its discretion in concluding that Alves was not
“Totally Disabled” as defined in the Plan because Alves’s medical record did not
show that he was “unable to perform the material and essential duties of his Own
Occupation” or “unable to perform any occupation for which he is or may become
qualified” over the relevant time periods. Sedgwick reasonably construed the
Plan’s language and provided a detailed explanation for its determination. See
Williby v. Aetna Life Ins. Co., 867 F.3d 1129, 1138 (9th Cir. 2017). Moreover,
Sedgwick’s decision was supported by substantial evidence, including multiple
persuasive medical opinions from Drs. Taj Jiva, Rizwan Karatela, Heidi Connolly,
Stephen Broomes, Brian Strizik, and Frank Polanco, concluding that Alves was not
functionally impaired in a manner that would prevent him from performing his
sedentary occupation. See Boyd v. Bert Bell/Pete Rozelle NFL Players Ret. Plan,
410 F.3d 1173, 1179 (9th Cir. 2005). We reject Alves’s argument that Sedgwick’s
1
It is undisputed that the Plan grants the administrator discretionary
authority.
2
decision is undercut by Dr. Stephen Broomes’s conclusion that Alves was limited
to sitting continuously for 30 minutes per hour, or by Dr. Maryam Balouch’s
conclusion that Alves needed to elevate his legs. Neither of these diagnoses would
preclude Alves from performing sedentary work.
Nor did Sedgwick abuse its discretion by failing to consider the disability
determination issued by the Social Security Administration (“SSA”). Sedgwick
reasonably explained that the Plan applied a different definition of disability than
did the SSA. Specifically, the SSA was directed by its Medical-Vocational
Guidelines to find Alves disabled, regardless of whether Alves had the residual
functional capacity to perform “the full range of sedentary work.” Therefore,
Sedgwick did not abuse its discretion by reaching a different conclusion than that
reached by the SSA. Alves also argues that Sedgwick abused its discretion by
failing to compare and contrast the medical evidence it relied on with that relied on
by the SSA. However, Sedgwick was not required to perform such an analysis,
given that it relied on other medical evidence in the record, evaluated the SSA’s
contrary conclusion, and gave a reasonable explanation for not adopting it. See
Montour v. Hartford Life & Acc. Ins. Co., 588 F.3d 623, 635 (9th Cir. 2009).
Alves’s other challenges to Sedgwick’s conclusion also fail. Contrary to
Alves’s assertions, Sedgwick considered and discussed Alves’s leg edema and
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stress conditions in its denial letter. Nor did Sedgwick err in hiring specialists to
focus on their areas of specialty in reviewing Alves’s condition, especially since
one of Sedgwick’s reviewing doctors thoroughly evaluated Alves’s medical record
from a cumulative, “whole-body” perspective and concluded Alves was not
disabled.
AFFIRMED.
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