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Hollinger v. Metropolitan Life Insurance Co.

April 16, 2009

ROBERT HOLLINGER, PLAINTIFF
v.
METROPOLITAN LIFE INSURANCE COMPANY, MET DISABILITY, DEFENDANT



The opinion of the court was delivered by: William W. Caldwell United States District Judge

MEMORANDUM

I. Introduction

We are considering a motion for summary judgment filed by the Defendant, Metropolitan Life Insurance Company ("MetLife"). Plaintiff, Robert Hollinger ("Hollinger"), filed this lawsuit pursuant to section 502(a)(1)(B) of the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1132(a)(1)(B), for wrongful termination of short-term disability ("STD") benefits.

We will examine the motion under the well-established standard. Lawrence v. City of Philadelphia, 527 F.3d 299, 310 (3d. Cir. 2008). Upon review of the motion, the supplemental briefs, and the administrative record, we will grant Defendant's motion for summary judgment and enter judgment in favor of MetLife.*fn1

II. Background

Hollinger was employed by Home Depot, Inc. as a Receiving Department Supervisor. On December 6, 2005, he went to the emergency room ("ER") complaining of fatigue, weakness and shortness of breath. Pl.'s Br. In Opp. at 2. The treating ER physician ordered blood work, which later indicated both an elevated Epstein-Barr titer and liver enzyme, which may indicate the presence of illness. Hollinger followed up with his family physician, Dr. Robert Stremmel, for further treatment and care. Dr. Stremmel diagnosed Hollinger with dyspnea, fatigue and laryngitis, and noted that the ER diagnosed mononucleosis.*fn2

Def.'s Ex. A at 9. On December 14, 2005, Hollinger ceased work claiming mononucleosis and fatigue. Def.'s Statement of Material Facts ("SMF") ¶ 7. He was seen by Dr. Illfelder on December 26, 2005 complaining of gastrointestinal problems. After examination, Dr. Illfelder diagnosed panic attacks.

Def.'s Ex. A at 47. On reevaluation, Dr. Illfelder again diagnosed panic attacks and noted that Hollinger did not have "clear-cut symptoms of mononucleosis." Id. at 53.

On January 26, 2006, Hollinger applied for short-term disability ("STD") benefits pursuant to the Home Depot Welfare Benefits Plan (the "Plan"). In order to qualify for benefits, the Plan provides that:

* the disability period must be expected to last more than 14 consecutive calendar days...;

* you must be under the care of a qualified doctor (qualified doctors include legally licensed physicians and practitioners who are not related to you and are performing services within the scope of their licenses);

* you must not be able to perform the duties of your regular job; and

* MetLife must receive certification accompanied by appropriate medical documentation of a disability from your attending doctor before benefits are considered for payment.

Def.'s Ex. A at 445. On February 3, 2006, MetLife initially denied Hollinger's claim because it did not receive medical records in support of his claim. Def.'s SMF ΒΆ 9. After receipt of the medical records, MetLife noted that the file lacked 1) diagnostic tests that Hollinger had mononucleosis; 2) physical findings such as sore throat, swollen glands or an abnormal white cell count; 3) neurological evaluations or diagnostic ...


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