The opinion of the court was delivered by: McCLURE, District Judge.
On February 25, 2000, plaintiff Robert G. Ernest, proceeding
pro se, commenced this action with the filing of a complaint in
the Court of Common Pleas, Montour County, Pennsylvania.
Plaintiff claims entitlement to monthly income benefits for
disability under a policy issued by The Paul Revere Life
Insurance Co. (Paul Revere) in conjunction with a collective
bargaining agreement between plaintiff's union and his former
employer, Textron, Inc. (Textron).*fn1 Specifically, plaintiff
claims that he is totally disabled due to acute bronchial spasm
and occupational bronchitis, rendering him unable to work in his
occupation as "Excello machine operator."
The case was removed to this court by notice of removal filed
by defendant Paul Revere on March 20, 2000 on the ground that the
agreement constitutes a plan subject to the terms of the Employee
Retirement Income Security Act (ERISA), 29 U.S.C. § 1001 et seq.
Now before the court are plaintiff's motion requesting this
court to "apply the de novo standard of review and make a final
judgment," and cross-motions for summary judgment. For the
reasons that follow, we will deny plaintiff's motion for summary
judgment and grant defendants' motion, pursuant to Fed.R.Civ.P.
I. SUMMARY JUDGMENT STANDARD
Summary judgment is appropriate if the "pleadings, depositions,
answers to interrogatories, and admissions on file, together with
the affidavits, if any, show that there is no genuine issue as
to any material fact and that the moving party is entitled to
judgment as a matter of law." Fed. R.Civ.P. 56(c) (emphasis
. . [T]he plain language of Rule 56(c) mandates
the entry of summary judgment, after adequate time
for discovery and upon motion, against a party who
fails to make a showing sufficient to establish the
existence of an element essential to that party's
case, and on which that party will bear the burden of
proof at trial. In such a situation, there can be `no
genuine issue as to any material fact,' since a
complete failure of proof concerning an essential
element of the nonmoving party's case necessarily
renders all other facts immaterial. The moving party
is `entitled to judgment as a matter of law' because
the nonmoving party has failed to make a sufficient
showing on an essential element of her case with
respect to which she has the burden of proof.
Celotex Corp. v. Catrett, 477 U.S. 317, 323-24, 106 S.Ct. 2548,
91 L.Ed.2d 265 (1986).
The moving party bears the initial responsibility of stating
the basis for its motions and identifying those portions of the
record which demonstrate the absence of a genuine issue of
material fact. Id. at 323, 106 S.Ct. 2548. He or she can
discharge that burden by "showing . . . that there is an absence
of evidence to support the non-moving party's case." Id. at
325, 106 S.Ct. 2548.
Issues of fact are genuine "only if a reasonable jury,
considering the evidence presented, could find for the non-moving
party." Childers v. Joseph, 842 F.2d 689, 693-94 (3d Cir. 1988)
(citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249, 106
S.Ct. 2505, 91 L.Ed.2d 202 (1986)). Material facts are those
which will affect the outcome of the trial under governing law.
Anderson at 248, 106 S.Ct. 2505. The court may not weigh the
evidence or make credibility determinations. Boyle v. County of
Allegheny, 139 F.3d 386, 393 (3d Cir. 1998). In determining
whether an issue of material fact exists, the court must consider
all evidence and inferences drawn therefrom in the light most
favorable to the non-moving party. Id. at 393; White v.
Westinghouse Elec. Co., 862 F.2d 56, 59 (3d Cir. 1988).
If the moving party satisfies its burden of establishing a
prima facie case for summary judgment, the opposing party must do
more than raise some metaphysical doubt as to material facts, but
must show sufficient evidence to support a jury verdict in its
favor. Boyle at 393 (quoting, inter alia, Matsushita Elec.
Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586, 106 S.Ct.
1348, 89 L.Ed.2d 538 (1986)).
The facts at hand are, for the most part, not in dispute.*fn2
Plaintiff is a former employee of defendant Textron. As a benefit
of his employment, plaintiff received one or more employment
benefits, including a group long-term disability benefit under
Textron's group policy with Paul Revere. According to the policy,
benefits are payable only if the claimant becomes "totally
On October 31, 1995, plaintiff submitted to Paul Revere an
Employee's Statement for Disability Benefits. In his statement,
plaintiff claimed to be totally disabled due to acute bronchial
spasm and occupational bronchitis, rendering him unable to
perform in his capacity as Excello machine operator.
On November 26, 1995, plaintiff's treating physician, Dr.
Norman Ekberg, signed and submitted to Paul Revere an Attending
Physicians' Statement that listed plaintiff's primary diagnosis
as "sarcoidosis, stage II, and occupational bronchitis." Dr.
Ekberg indicated that the plaintiff could not tolerate "exposure
to inhaled vapors, dusts, [or] volatile agents," but reported
that "patient may work in an atmosphere free of bronchial
irritating substances with no limitation on physical activity."
After reviewing plaintiff's statement, Paul Revere's Customer
Care Specialist, Jean Mantolesky, informed plaintiff that the
medical documentation submitted was insufficient to support his
claim of total disability and that additional information was
necessary in order to reach a decision. Subsequently, on February
1, 1996, Paul Revere received a letter from Dr. Mark Guilfoose
confirming the diagnosis of occupational bronchitis. Dr.
Guilfoose reported that plaintiff was disabled from occupations
that would expose him to environments containing "bronchial
irritating substances such as industrial solvents and oils."
On February 2, 1996, Paul Revere referred plaintiff's file to
Sharon Elliot, Vocational Rehabilitation Consultant. Elliot
recommended review of plaintiff's file by a medical consultant
and also contacted an ergonomist, who suggested the use of a
On February 6, 1996, Fred Lewis, Textron's Human Resources
Manager, provided Mantolesky with a list of jobs held by
plaintiff while employed at Textron and information as to whether
or not plaintiff was exposed to coolant or cutting oil.*fn4
Lewis also indicated that Textron had been tested for oil mist on
several occasions, with results well below the permissible
exposure limit set by the Occupational Safety and Health
On February 20, 1996, Dr. Michael Theerman completed medical
review of plaintiff's claim file. According to Dr. Theerman,
plaintiff was precluded from working in a dusty, smokey or
solventladen environment. Dr. Theerman concluded that plaintiff
could not perform his occupation as Excello machine operator
unless plaintiff was able to wear a respirator the entire day.
Dr. Theerman also commented that if the job of tool and gauge
inspector could be performed in a "clean room" and "not on the
shop floor" then that job would not be precluded. On February 21,
1996, Mantolesky contacted Textron and spoke with Jodi Black,
Human Resources Assistant, who verified that tool and gauge
inspection was done in a separate and clean room without exposure
to bronchial irritants.
On March 5, 1996, Paul Revere denied plaintiff's claim for
long-term disability benefits, finding that plaintiff was not
totally disabled under the terms of the policy. Specifically,
benefits were denied because the medical evidence did not
substantiate limitations that would preclude the plaintiff from
performing the duties of his occupation if reasonable
accommodations were made. Paul Revere concluded that plaintiff's
use of a prescribed respirator would be a reasonable
accommodation that would not preclude him from performing his
occupation. Additionally, plaintiff could perform the reasonably
related occupation of tool and gauge inspector without being
exposed to coolant or cutting oil. Paul Revere informed plaintiff
of his right to appeal its decision.
Paul Revere received notice of plaintiff's appeal from a letter
dated March 29, 1996. Included was a second claim form and an
Attending Physicians' Statement of Disability from Dr. S. William
Snover who diagnosed plaintiff as having "chronic, mechanical low
back pain." Dr. Snover indicted that plaintiff was not totally
disabled due to the above diagnosis. Also provided was a second
statement from Dr. Snover diagnosing plaintiff with "repetitive
motor disorder, carpal tunnel syndrome, right hand." Again, Dr.
Snover indicated that plaintiff's carpal tunnel syndrome was not
totally disabling. Additionally, plaintiff provided Paul Revere
with a copy of a letter from Dr. Ekberg, dated March 25, 1996, in
which Dr. Ekberg discussed the effectiveness of the respirator
recommended by Paul Revere in its denial letter to plaintiff.
Specifically, Dr. Ekberg stated that the ...