Date: 06-13-2025

Case Style:

Tracy W. Penland v. Metropolitan Life Insurance Company

Case Number: 21-CV-3000

Judge: Henry M. Herlong

Court: United States District Court for the District of South Carolina (Anderson County)

Plaintiff's Attorney: Leila Louzri

Defendant's Attorney: Derrick Quattlebaum

Description: Anderson, South Carolina insurance lawyer lawyer represented the Plaintiff seeking restoration of long-term disability benefits.

Penland stopped working in August 2015 following complications from colon surgery and various other conditions. He pplied for long-term disability benefits from his employer, and in February 2016, those benefits were approved. Under the terms of his employer’s long-term disability plan, disability “means that, due to Sickness or as a direct result of accidental injury . . . [the claimant is] receiving Appropriate Care and Treatment and complying with the requirements of such treatment unless, in the opinion of a Physician, future or continued treatment would be of no benefit.”

For the first twenty-four months of the sickness or accidental injury, the claimant must be unable to earn “more than 80% of [their] Predisability Earnings at [their] Own Occupation from any employer in [their] Local Economy.” J.A. 1499. Then, “after such period, [a claimant must be unable to earn] more than 60% of [their] Predisability Earnings from any employer in [their] Local Economy at any gainful occupation for which [they] are reasonably qualified taking into account [their] training, education[,] and experience.” J.A. 1499.

The long-term disability plan also contains limitation provisions. As is relevant here, if the disability is “due to” mental or nervous disorders or diseases, neuromuscular, musculoskeletal, or soft tissue disorder, or chronic fatigue syndrome and related conditions, the lifetime maximum disability benefits is limited to twenty-four months. But the limitation does not apply to disabilities due to neuromuscular, musculoskeletal, or soft tissue disorder if the claimant can produce “objective evidence of” a series of conditions, including radiculopathy.2 J.A. 1520.

In January 2021, MetLife sent Penland an initial termination of benefits letter. This letter explained that MetLife had referred Penland’s claim to two independent medical consultants: Dr. Joshua Lewis, who specializes in internal medicine, and Dr. Naveed Natanzi, who specializes in physical medicine and rehabilitation. These consultants determined that Penland had already received the maximum lifetime long-term disability 1 Citations to the “J.A.” refer to the Joint Appendix filed by the parties in this appeal. The plan defines radiculopathy as “disease of the peripheral nerve roots supported by objective clinical findings of nerve pathology.” J.A. 1521.4 benefits. The letter specified that Penland’s medical records do not support the presence of non-limited conditions that cause symptoms sufficient to prevent him from performing any gainful occupation.

Outcome: Summary judgment granted.

Affirmed

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Defendant's Experts:

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