United States District Court, E.D. Michigan, Southern Division
K. MAJZOUB U.S. MAGISTRATE JUDGE.
OPINION AND ORDER GRANTING  DEFENDANT'S
MOTION FOR SUMMARY JUDGMENT AND DENYING  PLAINTIFF'S
MOTION FOR SUMMARY JUDGMENT
J. Tarnow Senior United States District Judge.
Jill Majeske, brings this suit against her employee welfare
benefit plan to recover short term disability benefits.
Defendant, the Quicken Loans and Affiliated Companies Welfare
Benefits Plan (“the Plan”), is subject to the
Employee Retirement Income Security Act of 1974
(“ERISA”). Plaintiff brings this action under 29
U.S.C. § 1132(a)(1)(B). The Administrative Record has
been filed with the Court [Dkt. # 18], and both parties now
seek summary judgment. Because Plaintiff has not shown that
Defendant acted arbitrarily or capriciously when it denied
her claim for benefits, Defendant's motion will be
granted and Plaintiff's will be denied.
and Procedural Background
is a loan underwriter at Quicken Loans, Inc. Defendant is an
ERISA Employee Benefits Plan sponsored by Quicken Loans, Inc.
and administered by Liberty Mutual Group.
Majeske sought treatment at Bio Energy Medical Center on May
22, 2017. She complained about a wide range of health
problems, including chronic fatigue. On June 15, 2017, Ms.
Majeske underwent laboratory work testing for Lyme Disease.
She was tested according to Western Blot IgM method.
(Administrative Record, HA0140-41). The Western Blot test
measures the presence of certain antibodies against Lyme
Disease and assigns their presence in various bands.
(Id.). The three such bands that were positive from
Ms. Majeske blood sample were sufficient to trigger a
positive result for Lyme disease according to the
laboratory's criteria, but not for those of the Center
for Disease Control (“CDC”). (Id.).
Thus, on June 30, 2017, the laboratory, IGeneX, issued a
report showing that Ms. Majeske tested positive for
Borreliosis, or Lyme Disease, according to the IGeneX
criteria, but negative for the disease according to the
CDC/NYS criteria. (Id.).
Carson, N.P., on an August 21, 2017 consultation, found that
Ms. Majeske suffered from fatigue that was “[l]ikely
related to a host of factors, including nutritional
deficiencies, Hashimoto's hypothyroidism, digestive
imbalances, Lyme disease, [and] Epstein Barr
reactivation.” (HA 0175). The next day, August 22,
2017, Ms. Carson wrote a letter “to whom it may
concern” opining that it was in Ms. Majeske's best
interest to take 90 days off work to pursue treatment for
these ailments. (HA 0128). Ms. Carson reiterated her position
in a second letter on September 14, 2017. (HA0177). A third
letter, dated November 9, 2017, expanded the list of symptoms
and opined that “[e]xtensive labwork performed has
included the IgM Western Blot which was positive for
Borreliosis, as well as labwork confirming her autoimmune
thyroiditis, multiple nutritional deficiencies, dysbiosis,
and immunodeficiency…” (HA0178). She added that
external stressors exacerbate symptoms and slow recovery, and
that Ms. Majeske's time off work was necessary for her
recovery. On November 27, 2017, the Bio Energy Medical Center
Medical Director, James. R. Neuenschwander, M.D. opined that
the IgeneX positive markers, along with a “non existent
CD57 (activated natural killer cell) count, ” indicated
chronic Borreliosis. (HA0179).
Neuenschwander continued to describe the indications of
chronic Borreliosis as follows,
Jill has the classic pattern of normal lymphocyte count and
IP flow. Positive IgM with negative IgG western blot along
with a low CD57 (in the absence of other immunodeficiency).
Jill also had an elevated C-reactive protein, an indicator of
inflammation, along with a high TPO antibody level indicating
her hypothyroidism is due to Hashimoto's, an autoimmune
disease. Based on this evidence, Jill was diagnosed with
chronic Borreliosis (I am differentiating this from the
acute/subacute form of Borrelia commonly known as Lyme
disease) and was treated with three months of a standard oral
Borrelia protocol-Doxycycline and Hydroxychloroquine. This
treatment resulted in a significant increase in her symptoms
(typically seen with antibiotic treatment of chronic
infections and known as the Jarisch/Herxheimer reaction).
These symptoms included significant increase in fatigue and
brain fog, hypersomnolence, and joint pain. These symptoms
resulted in the necessity for short term disability. Due to
the chronicity of her symptoms, she likely needs a longer
course of treatment, but is unable to pursue this at this
time due to her work situation. Given the symptom complex and
biochemical evidence to support her diagnosis along with the
classic response to antibiotic treatment, she deserves to
qualify for short term disability payment for the three
months that she was under treatment.” (HA0179).
Majeske filed her initial application for short term
disability on August 23, 2017. (HA0106). A disability nurse
manager concluded that based on the evidence before her-Ivy
Carson's office notes from 8/21/2017 visit by Ms. Majeske
and the aforementioned letter from Ivy Carson-restrictions
and limitations were not supported “due to lack of
medical evidence that would indicate a level of impairment.
(Id.). Defendant received Ms. Majeske's first
letter of appeal on September 14, 2017. (HA0107). The appeal
included a summary of care and a lab order from Ms. Carson,
dated 5/22/2017, lab reports dated 6/15/2017, summary of care
dated 8/21/2017, and the letter dated 9/14/2017 from Ms.
Carson. Ms. Majeske's claim was then reviewed by an
independent physician, Dr. Sara Keiler.
Keiler spoke with Ms. Carson about Ms. Majeske's
worsening symptoms, including fatigue, and joint pain.
(HA0115-16). Ms. Carson told Dr. Keiler that she believed
that Ms. Majeske's symptoms were caused by her Lyme
disease and the treatment thereof, in addition to a history
of mold exposure. (Id.). She disputed Ms.
Carson's Lyme disease diagnosis on the grounds that Ms.
Majeske tested negative according to the CDC standard for
Lyme disease diagnosis. (HA0117). She also found that EBV
serologies were more consistent with a past infection than a
current infection. Dr. Keiler also noted that Ms.
Majeske's hypothyroidism was under control with
medication. Finally, Dr. Keiler also found that mold
inhalation has not been linked in medical literature to
fatigue, so it was a dubious explanation for Ms.
Majeske's fatigue. (Id.).
received Ms. Majeske's second level of appeal on December
1, 2017. (HA0108). That appeal considered the November 9, and
November 27, 2019 letters from Ms. Carson and Dr.
Neuenschwander respectively. Ms. Carson also provided notice
after the second level appeal was denied of a “new
diagnosis of an autoimmune condition (Hashimoto's
thyroid).” (Id.) Ms. Majeske's second
level appeal was reviewed by an independent physician, Dr.
Jeffrey Sartin. Dr. Sartin opined that Ms. Majeske's file
lacked documentation from psychiatric providers as to whether
her depression and anxiety was disabling, that it lacked
documentation of physical examinations that would indicate
impairing diagnoses, and that it lacked evidence of reported
or observed cognitive or physical side effects to Ms.
Majeske's medications. (HA0123). Dr. Sartin noted that,
In evaluating complaints of cognitive disfunction, in
particular where anxiety and depression are involved, one
would generally need input from the neurological and
psychiatric perspective, as well as detailed neurocognitive
testing and brain imaging. These are lacking in medical
Sartin also observed that Ms. Majeske's Lyme disease
testing was negative according to CDC criteria for both IgM
and IgG. Dr. Sartin placed several phone calls to Dr.