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Tekmen v. Reliance Std. Life Ins. Co.

Tekmen v. Reliance Std. Life Ins. Co.

United States Court of Appeals for the Fourth Circuit

September 14, 2022, Argued; December 16, 2022, Decided

No. 20-1510

Opinion

WYNN, Circuit Judge:

Reliance Standard Life Insurance Company denied Anita Tekmen's claim for longterm disability benefits after concluding that she was not "Totally Disabled" as defined by her disability insurance plan. Tekmen brought this action under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132(a)(1)(B), arguing that the denial of benefits violated that Act. After conducting a bench trial under Federal Rule of Civil Procedure 52, the district court awarded judgment to Tekmen. Reliance appeals.

On appeal, we affirm that the district court appropriately resolved the matter under Rule 52 and did not clearly err in its factual findings. We also affirm that Tekmen was [*2]  entitled to long-term disability benefits under the terms of the plan.

In October 2013, Tekmen, while employed as a Financial Analyst for Adsum, Inc., performed financial management services, including analyzing complex financial management systems, maintaining knowledge of business processes and financial software, and conducting technical evaluations and reports. The position required reasoning, cognitive exertion, and the ability to hear and understand easily. Through her employment with Adsum, Inc., Tekmen received coverage under a long-term disability insurance policy provided by Reliance.

Tekmen was involved in a rear-end car accident on October 24, 2013. At an urgent-care facility several hours later, she reported experiencing neck and lower-back pain, dizziness, headache, and wooziness. The treating provider wrote a letter indicating that Tekmen could return to work four days later. Tekmen did so.

Shortly after returning to work, Tekmen was treated by Dr. Frederick W. Parker III, a Family Medicine physician, who diagnosed that she had a concussion. At that time, Tekmen reported experiencing dizziness and headaches. She continued to report significant symptoms three weeks after [*3]  the accident, including dizziness, sensitivity to light and noise, and difficulty concentrating. She also reported vestibular symptoms,1 including unsteadiness and difficulty with balance. Tekmen began participating in vestibular therapy, and by late December 2013, her symptoms had begun to improve.

In January 2014, however, Tekmen reported to Dr. Parker that she had developed "an exaggerated auditory response to light vibration, motion and noise." J.A. 618.2 This new sensitivity to sound and vibration—called "hyperacusis"—caused Tekmen "extreme distress." Id. At this time she also reported experiencing tinnitus3 and difficulty concentrating.

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2022 U.S. App. LEXIS 34818 *; 55 F.4th 951

ANITA TEKMEN, Plaintiff - Appellee, v. RELIANCE STANDARD LIFE INSURANCE COMPANY, Defendant - Appellant.

Subsequent History: Rehearing denied by, En banc Tekmen v. Reliance Std. Life Ins. Co., 2023 U.S. App. LEXIS 1052 (4th Cir., Jan. 17, 2023)

Prior History:  [*1] Appeal from the United States District Court for the Eastern District of Virginia, at Alexandria. (1:18-cv-01304-AJT-MSN). Anthony John Trenga, Senior District Judge.

Disposition: AFFIRMED.

CORE TERMS

district court, symptoms, summary judgment, disability, impairment, cases, bench trial, factual findings, material fact, disability benefits, total disability, denial-of-benefits, hyperacusis, vibration, de novo, Occupation, long-term, administrative record, treating physician, worsened, parties, satisfactory, noise, summary judgment motion, genuine issue, psychiatric, sensitivity, diagnosed, courts, entitled to benefits

Civil Procedure, Summary Judgment, Entitlement as Matter of Law, Appropriateness, Judgments, Entitlement as Matter of Law, Legal Entitlement, Genuine Disputes, Materiality of Facts, Appellate Review, Standards of Review, Appeals, Standards of Review, De Novo Review, Pensions & Benefits Law, Judicial Review, De Novo Standard of Review, Handling of Claims, Scope of Review, Clearly Erroneous Review, Abuse of Discretion, Governments, Courts, Authority to Adjudicate, Opposing Materials, Memoranda in Opposition, ERISA, Claim Procedures