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Hovan was employed as a commercial litigator with Troutman Sanders LLP. She worked in complex litigation, including class actions, intellectual property disputes, and commercial arbitrations. Hovan’s job required her to make reasoned decisions, use critical thinking skills, solve complex problems, manage an involved workload, multitask efficiently, and interact appropriately with clients, coworkers, and judges. Hovan’s ability to perform these functions came into question when she sought disability benefits in relation to her bipolar disorder diagnosis.
Troutman Sanders provided its employees with long-term disability coverage (the “Plan”) through a group policy issued by MetLife. MetLife served as the claims administrator. Under the Plan, MetLife was required to pay benefits to any covered employee who became and remained disabled. The Plan gave MetLife “discretionary authority to interpret the terms of the Plan and to determine eligibility for and entitlement to Plan benefits,” and further provided that any such interpretation or determination “shall be given full force and effect, unless it can be shown that the interpretation or determination was arbitrary and capricious.”
For claimants disabled by a mental or nervous disorder, the Plan authorized up to 24 months of benefits if the claimant was unable to “perform each of the material duties of [her] Own Occupation.” The Plan defined “Own Occupation” as: [T]he duties that You regularly perform and that provides Your primary source of earned income. For Attorneys, Own Occupation means the specialty in the practice of law in which You were engaged just prior to the date Disability started. Such job is not limited to the specific position You have with the Policyholder or could have with any other employer.
The Plan further specified that “Your Disability benefit payments will end . . . the date You fail to provide required Proof of continuing Disability.”
Hovan was first diagnosed with bipolar disorder in 2005, when she experienced two manic episodes requiring hospitalization and treatment with medication. After stabilizing, she discontinued medication in 2007 and later attended law school.
Her symptoms did not reappear for several years. In February 2019, Hovan ceased work due to a mental health crisis stemming from her bipolar disorder. She began treatment USCA11 Case: 24-111674 Opinion of the Court 24-11167 with psychiatrist Dr. Michael Lara, who reported to MetLife that Hovan exhibited “impaired judgment,” “poor decision making,” mood swings, racing thoughts, and that she was “able to engage in only limited stress situations and . . . limited interpersonal relations.” In June 2019, Hovan entered an intensive outpatient program, which she completed the following month.
In late July 2019, MetLife concluded that Hovan was disabled and approved her claim for long-term disability benefits commencing on June 1, 2019.
From September 22, 2020, to October 16, 2020, Hovan was admitted to a partial hospitalization program at PeakView Behavioral Health in Colorado. Upon her discharge, her PeakView psychiatrist, Dr. Sohail Punjwani, concluded she had a “good prognosis.” He wrote: The patient tolerated all medication changes/increases well with no complaints of side effects. This patient is not at imminent risk nor gravely disabled and safe to discharge. The patient presents today for routine follow up and medication management. The patient has no complaints at this time and reports mood is stable. Patient denies anxiety or depression. Patient denies difficulty falling or staying asleep. Patient denies changes in appetite.
Patient denies suicidal or homicidal ideations. Patient denies visual or auditory hallucinations. After her discharge from PeakView, Hovan began seeing a therapist, Ms. Sherrie Stevens. During multiple sessions with Ms. USCA11 Case: 24-1116724-11167 Opinion of the Court 5 Stevens between November 2020 and early March 2021, Ms. Stevens documented fluctuations in Hovan’s mood, with occasional reports of depression, mania, and anxiety. Hovan at times mentioned fleeting, passive suicidal thoughts but denied any plan or intent to harm herself. She also admitted to discontinuing medication because she felt it was unnecessary. Despite these reports, Ms. Stevens consistently recorded that Hovan’s “functional status” was “intact,” her affect was “appropriate,” her cognition was “oriented/alert,” and her interpersonal functioning was “interactive.” Ms. Stevens did not opine on Hovan’s occupational limitations or her ability to perform her work as a commercial litigator.
In January 2021, MetLife reviewed Hovan’s disability claim and attempted to contact therapist Ms. Stevens. After several unsuccessful attempts to get in touch with Ms. Stevens, and after reviewing the available notes that Ms. Stevens wrote during the therapy sessions, MetLife notified Hovan of its decision to terminate her disability benefits. This decision was effective as of October 16, 2020, the date of her discharge from PeakView. Outcome: Defendant’s motion for summary judgment granted. Affirmed