United States District Court, E.D. Pennsylvania
G. SMITH, J.
action brought under the Employee Retirement Income Security
Act of 1974 (“ERISA”), 28 U.S.C. §§
1001-1191c stems from the defendant's alleged wrongful
denial of the plaintiff's claim for long-term disability
benefits. The plaintiff worked as a plant controller for a
corrugated packaging industry and sought short-term
disability benefits due, among other things, his morbid
obesity, difficulty ambulating, and osteoarthritis in his
right hip. Although the defendant initially denied the
request for short-term disability benefits, it reversed its
decision after concluding that the plaintiff's
impairments prevented him from performing his own job.
plaintiff then sought long-term disability benefits. Under
the disability policy the plaintiff needed to show that he
could not perform the material and substantial duties of his
own occupation. The disability policy provides that the
defendant would consider the requirements of the
plaintiff's occupation as the occupation is performed in
the national economy.
reviewing the plaintiff's documentation, the defendant
determined that the plaintiff's occupation was properly
designated as a controller and it was performed as a
sedentary or light duty occupation in the national economy.
The defendant then determined that the plaintiff was capable
of sedentary work and, as such, concluded that the plaintiff
was not disabled and entitled to longer-term disability
payments because he could perform the material and essential
duties of a controller. The plaintiff contested the denial by
filing the instant action, which was eventually removed from
state court to this court.
parties have filed cross-motions for summary judgment on the
propriety of the defendant's denial of benefits. They
agree that the court should review the defendant's denial
of benefits under the arbitrary and capricious standard of
review. As explained below, the court finds that there are no
genuine issues of fact that prevent the court from disposing
of this case at the summary judgment stage. In addition,
although the court recognizes the highly deferential standard
applicable to this case, the record compels the court to
conclude that the defendant abused its discretion in denying
long-term disability benefits in this case. Accordingly, the
court will grant the plaintiff's motion for summary
judgment, deny the defendant's motion for summary
judgment, and remand the case to the defendant.
plaintiff, Craig Van Arsdel, filed a complaint against
Liberty Life Assurance Company of Boston (“Liberty
Life”) in the Court of Common Pleas of Philadelphia
County on April 3, 2014. Notice of Removal
(“Notice”), at Ex. 1, Compl., Doc. No.
In the complaint, the plaintiff alleges that he developed
severe arthritis in his right hip along with a multitude of
other ailments while working as a plant controller for Pratt
Industries. Compl. at ¶¶ 3, 8. By January 4, 2013,
the plaintiff could not continue working at his job, and he
applied for short-term disability (“STD”)
benefits under a group disability insurance policy that he
purchased from Liberty Life in 2011. Id. at ¶¶
4, 9. Although Liberty Life initially denied the claim, it
provided him with STD benefits from February 1, 2013, until
April 7, 2013, after he successfully appealed from the
denial. Id. at ¶¶ 9, 10. On March 28,
2013, the plaintiff applied for long-term disability
(“LTD”) benefits. Id. at ¶ 11.
Liberty Life denied the LTD benefits claim on or about May 2,
2013, and although the plaintiff appealed from the denial,
Liberty Life affirmed its prior denial on August 23, 2013.
Id. at ¶¶ 19-20.
upon Liberty Life's denial of his claim for LTD benefits,
the plaintiff asserted state-law causes of action for breach
of contract and statutory bad faith in the original
complaint. Id. at 8-9. On May 2, 2014, Liberty Life
filed a notice of removal claiming that removal to federal
court was proper because the plaintiff was actually asserting
an ERISA claim. See Notice at ¶ 10 (referencing
28 U.S.C. §§ 1331, 1441(b) and 29 U.S.C. §
1132). The plaintiff then filed an amended complaint on June
11, 2014, in which he appears to have repeated the underlying
factual allegations from the original complaint, but added an
alternative cause of action under ERISA to the preexisting
state-law causes of action. Amended Compl., Doc. No. 3.
Life filed a motion to dismiss the state-law causes of action
in the complaint on June 18, 2014. Doc. No. 5. In the motion,
Liberty Life argued that the court should dismiss the
state-law claims for breach of contract and statutory bad
faith because ERISA preempted those claims. See
Memorandum of Def. Liberty Mutual Ins. Co. in Supp. of Mot.
to Dismiss Counts I and II of Pl.'s Am. Compl. at 2-6,
Doc. No. 5. The plaintiff filed a response to the motion on
June 26, 2014. Doc. No. 6. In the response, the plaintiff
asserted that the court should deny the motion because the
disability insurance plan at issue fell within the
“safe harbor” provision, 29 C.F.R. §
2510.3-1(j), and was exempt from ERISA coverage. Memorandum
of Law in Supp. of Pl.'s Reply to Def.'s Mot. to
Dismiss Counts I & II of the Am. Compl. at 6-7, Doc. No.
court resolved the motion to dismiss via a memorandum opinion
and order filed on September 5, 2014. Doc. Nos. 9, 10. In the
memorandum opinion and order, the court (1) denied the motion
to dismiss the state-law claims in counts I and II of the
amended complaint because the parties' contentions raised
issues of fact that the court could not resolve through a
motion to dismiss, and (2) provided the parties with a period
of time to conduct limited discovery on the potential
applicability of the safe harbor provision and then file
motions for summary judgment on this issue. Memorandum Op. at
4-6, Doc. No. 9; Order, Doc. No. 10. With respect to this
discovery period, the parties sought and received two
extensions of time to finish conducting discovery on the safe
harbor issue. Doc. Nos. 11-14.
13, 2015, the parties filed cross-motions for summary
judgment on the applicability of the safe harbor provision
and the viability of the state-law claims in the amended
complaint. Doc. Nos. 17-21. Liberty Life then filed an answer
to the amended complaint with affirmative defenses on May 28,
2015. Doc. No. 22. On the same date, Liberty Life filed a
response to the plaintiff's statement of facts in support
of his motion for summary judgment and a brief in opposition
to the plaintiff's motion for summary
judgment. Doc. Nos. 23, 24. The court heard oral
argument on the cross-motions for summary judgment on July 8,
2015. On March 29, 2016, the court entered a memorandum
opinion and order in which the court (1) granted Liberty
Life's motion for summary judgment and entered judgment
in its favor and against the plaintiff as to counts I (breach
of contract) and II (statutory bad faith) of the amended
complaint, and (2) denied the plaintiff's motion for
summary judgment. Doc. Nos. 29, 30.
April 27, 2016, the parties filed a stipulation, attaching
thereto the documents they agreed comprised the
administrative record in this case. Doc. No. 32. Liberty Life
filed a motion for summary judgment, statement of undisputed
material facts, and supporting memorandum of law, with
respect to the remaining ERISA cause of action, on April 28,
2016. Doc. Nos. 33-35. The plaintiff filed a motion for
summary judgment, statement of undisputed material facts, and
supporting memorandum of law as to his ERISA claim on April
29, 2016. Doc. No. 36. After a couple of extensions, Liberty
Life filed a response to the plaintiff's motion for
summary judgment and statement of undisputed material facts
on May 26, 2016. Doc. Nos. 42, 43. The plaintiff then filed a
response in opposition to Liberty Life's motion for
summary judgment on May 27, 2016. Doc. No. 44. The motions
are ripe for disposition.
Standards of Review
Summary Judgment Standard
district court “shall grant summary judgment if the
movant shows that there is no genuine issue as to any
material fact and the movant is entitled to judgment as a
matter of law.” Fed.R.Civ.P. 56(a). Additionally,
“[s]ummary judgment is appropriate when ‘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 a judgment as a
matter of law.'” Wright v. Corning, 679
F.3d 101, 103 (3d Cir. 2012) (quoting Orsatti v. New
Jersey State Police, 71 F.3d 480, 482 (3d Cir. 1995)).
An issue of fact is “genuine” if “the
evidence is such that a reasonable jury could return a
verdict for the nonmoving party.” Anderson v.
Liberty Lobby, Inc. 477 U.S. 242, 248 (1986). A fact is
“material” if it “might affect the outcome
of the suit under the governing law.” Id.
party moving for summary judgment has the initial burden
“of informing the district court of the basis for its
motion, and identifying those portions of the pleadings,
depositions, answers to interrogatories, and admissions on
file, together with the affidavits, if any, which it believes
demonstrate the absence of a genuine issue of material
fact.” Celotex Corp. v. Catrett, 477 U.S. 317,
323 (1986) (internal quotation marks omitted). Once the
moving party has met this burden, the non-moving party must
counter with “‘specific facts showing that there
is a genuine issue for trial.'” Matsushita
Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574,
587 (1986) (citation omitted); see Fed. R. Civ. P.
56(c) (stating that “[a] party asserting that a fact .
. . is genuinely disputed must support the assertion by . . .
citing to particular parts of materials in the record . . .;
or . . . [by] showing that the materials cited do not
establish the absence . . . of a genuine dispute”). The
non-movant must show more than the “mere existence of a
scintilla of evidence” for elements on which the
non-movant bears the burden of production. Anderson,
477 U.S. 242, 252 (1986). Bare assertions, conclusory
allegations, or suspicions are insufficient to defeat summary
judgment. See Fireman's Ins. Co. v. DuFresne,
676 F.2d 965, 969 (3d Cir. 1982) (indicating that a party
opposing a motion for summary judgment may not “rely
merely upon bare assertions, conclusory allegations or
suspicions”); Ridgewood Bd. of Educ. v. N.E. for
M.E., 172 F.3d 238, 252 (3d Cir. 1999) (explaining that
“speculation and conclusory allegations” do not
satisfy non-moving party's duty to “set forth
specific facts showing that a genuine issue of material fact
exists and that a reasonable factfinder could rule in its
favor”). Additionally, the non-moving party
“cannot rely on unsupported allegations, but must go
beyond pleadings and provide some evidence that would show
that there exists a genuine issue for trial.” Jones
v. United Parcel Serv., 214 F.3d 402, 407 (3d Cir.
2000). Moreover, arguments made in briefs “are not
evidence and cannot by themselves create a factual dispute
sufficient to defeat a summary judgment motion.”
Jersey Cent. Power & Light Co. v. Township of
Lacey, 772 F.2d 1103, 1109-10 (3d Cir. 1985).
court “may not weigh the evidence or make credibility
determinations.” Boyle v. County of Allegheny,
139 F.3d 386, 393 (3d Cir. 1998) (citing Petruzzi's
IGA Supermarkets., Inc. v. Darling-Del. Co. Inc., 998
F.2d 1224, 1230 (3d Cir. 1993)). Instead, “[w]hen
considering whether there exist genuine issues of material
fact, the court is required to examine the evidence of record
in the light most favorable to the party opposing summary
judgment, and resolve all reasonable inferences in that
party's favor.” Wishkin v. Potter, 476
F.3d 180, 184 (3d Cir. 2007). The court must decide
“not whether . . . the evidence unmistakably favors one
side or the other but whether a fair-minded jury could return
a verdict for the plaintiff on the evidence presented.”
Anderson, 477 U.S. at 252. “Where the record
taken as a whole could not lead a rational trier of fact to
find for the non-moving party, there is no ‘genuine
issue for trial'” and the court should grant
summary judgment in favor of the moving party. Matsushita
Elec. Indus. Co., 475 U.S. at 587 (citation omitted).
summary judgment standard is the same even when, as here, the
parties have filed cross-motions for summary judgment.
Erbe v. Connecticut Gen. Life Ins. Co., No. CIV.A.
06-113, 2009 WL 605836, at *1 (W.D. Pa. Mar. 9, 2009) (citing
Transguard Ins. Co. of Am., Inc. v. Hinchey, 464
F.Supp.2d 425, 430 (M.D. Pa. 2006)). “When confronted
with cross-motions for summary judgment . . . ‘the
court must rule on each party's motion on an individual
and separate basis, determining, for each side, whether a
judgment may be entered in accordance with the summary
judgment standard.'” Id. (citing
Transguard, 464 F.Supp.2d at 430).
Standard of Review for Benefit Denials Under ERISA
plaintiff has brought this action under section 502(a)(1)(B)
of ERISA, which permits a participant or beneficiary of a
covered policy to bring a civil action to recover the
benefits due under the terms of the policy. 29 U.S.C. §
1132(a)(1)(B). Generally, the court must review the denial of
benefits “under a de novo standard unless the
benefit plan gives the administrator or fiduciary
discretionary authority to determine eligibility for benefits
or to construe the terms of the plan.” Firestone
Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115
(1989). “If the plan gives the administrator or
fiduciary discretionary authority to make eligibility
determinations, ” the court must review its decision
“under an abuse-of-discretion (or arbitrary and
capricious) standard.” Viera v. Life Ins. Co. of N.
Am., 2 F.3d 407');">642 F.3d 407, 413 (3d Cir. 2011) (citations
the parties agreed in their submissions that the court should
apply the abuse of discretion (or arbitrary and capricious)
standard of review in this case. See Memorandum of
Law in Supp. of Pl.'s Mot. for Summ. J. Pursuant to Fed.
R. Civ. Pro. 56(a) (“Pl.'s Mem.”) at 3
(stating that “the parties agreed in their submissions
that the Pratt plan gives the administrator the required
discretion” to make eligibility determinations and, as
such, the arbitrary and capricious standard applies), Doc.
No. 36-1; Memorandum of Def. Liberty Life Assurance Co. of
Boston in Supp. of Mot. for Summ. J. on Count III of
Pl.'s Am. Compl. (“Def.'s Mem.”) at 15
(“The Deferential ‘Arbitrary and Capricious'
Standard of Review is Applicable to this Dispute.”
(emphasis omitted)), Doc. No. 34. Under this standard,
“[a]n administrator's decision is arbitrary and
capricious if it is without reason, unsupported by
substantial evidence or erroneous as a matter of law.”
Fleisher v. Standard Ins. Co., 679 F.3d 116, 121 (3d
Cir. 2012) (internal quotations omitted). “A decision
is supported by substantial evidence if there is sufficient
evidence for a reasonable person to agree with the
decision.” Courson v. Bert Bell NFL Player Ret.
Plan, 214 F.3d 136, 142 (3d Cir. 2000).
arbitrary and capricious standard of review “is narrow,
and the court is not free to substitute its own judgment for
that of the defendants in determining eligibility for plan
benefits.” Abnathya v. Hoffmann-La Roche,
Inc., 2 F.3d 40, 45 (3d Cir. 1993) (internal quotation
omitted). Although “the arbitrary and capricious
standard is extremely deferential, [i]t is not ... without
some teeth. Deferential review is not no review, and
deference need not be abject.” Kuntz v. Aetna
Inc., No. CIV. A. 10-877, 2013 WL 2147945, at *4 (E.D.
Pa. May 17, 2013) (citations and internal quotation marks
omitted); see Connelly v. Reliance Standard Life Ins.
Co., No. CIV. A. 13-5934, 2014 WL 2452217, at *4 (E.D.
Pa. June 2, 2014) (“Although the arbitrary and
capricious standard is highly deferential, the court must
still consider the quality and quantity of the medical
evidence and the opinions on both sides of the issues, so as
to avoid rendering courts ‘nothing more than rubber
stamps for any plan administrator's decision.'”
(quoting Glenn v. MetLife, 461 F.3d 660, 674 (6th
Cir. 2006), aff'd sub nom. Metro. Life Ins. Co. v.
Glenn, 554 U.S. 105 (2008)).
addition, [o]n a motion for summary judgment in an ERISA case
where the plaintiff claims that benefits were improperly
denied, a reviewing court is generally limited to the facts
known to the plan administrator at the time the decision was
made. Post v. Hartford Ins. Co., 501 F.3d 154, 168
(3d Cir. 2007), overruled on other grounds,
Doroshow, 574 F.3d 230. “Consequently, when, as
here, a plaintiff alleges that a plan administrator . . .
abused its discretion in deciding to terminate benefits, [the
Court] generally limit[s][its] review to the administrative
record, that is, to the ‘evidence that was before the
administrator when [it] made the decision being
reviewed.'” Sivalingam v. Unum Provident
Corp., 735 F.Supp.2d 189, 194 (E.D. Pa. 2010) (quoting
Mitchell v. Eastman Kodak Co., 113 F.3d 433, 440 (3d
Cir. 1997)); see also Johnson v. UMWA Health & Ret.
Funds, 125 F. App'x 400, 405 (3d Cir. 2005)
(“This Court has made clear that the record for
arbitrary and capricious review of ERISA benefits denial is
the record made before the Plan administrator, which cannot
be supplemented during the litigation.”).
v. Devereux Found., No. CIV. A. 13-7337, 2015 WL 451096,
at *6 (E.D. Pa. Feb. 2, 2015)
additional point, the plaintiff argues that there are
“procedural” conflicts of interest insofar as
there were several deficiencies in Liberty Life's
decision-making process. See, e.g., Pl.'s Mem.
at 4, 24-29. With regard to purported conflicts of interest,
courts reviewing the decisions of ERISA plan administrators
or fiduciaries in civil enforcement actions brought pursuant
to 29 U.S.C. § 1132(a)(1)(B) should apply a deferential
abuse of discretion standard of review across the board and
consider any conflict of interest as one of several factors
in considering whether the administrator or the fiduciary
abused its discretion.
of Schwing v. The Lilly Health Plan, 562 F.3d 522, 525
(3d Cir. 2009) (citations omitted).
such, the court must “review various procedural factors
underlying the administrator's decision, as well as
structural concerns regarding how the particular ERISA plan
was funded, to determine if the conclusion was arbitrary and
capricious.” Miller v. American Airlines,
Inc., 632 F.3d 837, 845 (3d Cir. 2011). In this regard,
“‘the procedural inquiry focuses on how the
administrator treated the particular claimant.'”
Id. (quoting Post v. Hartford Ins. Co., 501
F.3d 154, 162 (3d Cir. 2007), abrogated on other grounds
by Estate of Schwing, 562 F.3d 522 (3d Cir.
When reviewing “the process that the administrator used
in denying benefits, ” courts consider “numerous
‘irregularities' to determine ‘whether, in
this claimant's case, the administrator has given the
court reason to doubt its fiduciary neutrality.'”
Id. (quoting Post, 501 F.3d at
165). “Ultimately, [the court]
‘determine[s] lawfulness by taking account of several,
often case-specific, factors, reaching a result by weighing
all together.” Id. (quoting Metro Life
Ins. Co. v. Glenn, 554 U.S. 105, 117 (2008)).
The Applicable Record 1.The Disability Plan
Liberty Life provided short- and long-term disability
insurance to employees of Pratt Industries pursuant to a
group disability income policy (the “Disability
Policy”). Defendant's Statement of Material Facts
in Supp. of Mot. for Summ. J. (“Def.'s
Facts”) at ¶ 1;Administrative Record (“Admin.
R.”) at 0001-0051, Doc. No. 32-1. The Disability
Policy covered the plaintiff because he was a plant
controller with Pratt Industries. Amended Compl. at
¶¶ 3, 4; Defendant's Answer and Affirmative
Defenses at ¶¶ 3, 4.
regard to the provision of short-term disability
(“STD”) benefits, the Disability Policy states
that “[w]hen Liberty [Life] receives Proof that a
Covered Person is Disabled due to Injury or Sickness and
requires the Regular Attendance of a Physician, Liberty
[Life] will pay the Covered Person a Weekly Benefit after the
end of the Elimination Period, subject to other provisions of
this policy.” Admin. R. at 0018. To provide further
guidance on eligibility for STD benefits, a covered employee
must refer to the definition section of the Disability Policy
as it contains the definitions of numerous terms and phrases
applicable to claims for STD benefits.
regard, the Disability Policy defines the term
“Disabled” to mean “as a result of Injury
or Sickness the Covered Person is unable to perform the
Material and Substantial Duties of his Own Job.”
Plaintiff's Proposed Stipulation of Facts
(“Pl.'s Facts”) at ¶ 2; Defendant's
Resp. to Pl.'s Proposed Stipulation of Facts
(“Def.'s Resp.”) at ¶ 2; Admin. R. at
0008. The Disability Policy defines the terms
“Injury” and “Sickness” to mean:
means bodily impairment resulting directly from an accident
and independently of all other causes. For the purpose of
determining benefits under this policy:
Disability which begins more than 60 days after an Injury
will be considered a Sickness; and 2. any Injury which occurs
before the Covered Person is covered under this policy, but
which accounts for a medical condition that arises while the
Covered Person is covered under this policy will be treated
as a Sickness.
. . .
means illness, disease, pregnancy or complications of
pregnancy. Admin. R. at 0010, 0012. The Disability Policy
also defines the phrase “Material and Substantial
Duties” as “responsibilities that are normally
required to perform the Covered Person's Own Job and
cannot be reasonably eliminated or modified.”
Id. at 0010. Finally, the Disability Policy defines
the phrase “Own Job” as “the Covered
Person's job that he was performing when his Disability
or Partial Disability began.” Id.; Def.'s
Facts at ¶ 3; Def.'s Resp. at ¶ 2.
long-term disability (“LTD”) benefits, the
Disability Policy includes an initial provision identical to
the one providing for STD benefits. Admin. R. at 0027. Some
of the applicable definitions to the terms and phrases,
however, are different. In particular, the Disability Policy
defines “Disabled” or “Disability”
with respect to LTD benefits as meaning “during the
Elimination Period and the next 24 months of Disability the
Covered Person, as a result of Injury or Sickness, is unable
to perform the Material and Substantial Duties of his Own
Occupation.” Id. at 0008; Pl.'s Facts at
¶ 2; Def.'s Resp. at ¶ 2; Def.'s Facts at
the definition of “Disabled” applicable to STD
benefits, the LTD benefits' definition references the
phrase “Own Occupation.” Admin. R. at 0008. The
Disability Policy defines “Own Occupation” as
“the Covered Person's occupation that he was
performing when his Disability or Partial Disability began.
For the purposes of determining Disability under this policy,
Liberty [Life] will consider the Covered Person's
occupation as it is normally performed in the national
economy.” Admin. R. at 0010; Pl.'s Facts at ¶
2; Def.'s Resp. at ¶ 2; Pl.'s Facts at ¶
15. Also, after receiving benefits for 24 months, LTD
benefits will continue if the claimant's condition
prevents him or her from performing the duties of any
occupation. Admin. R. at 0008; Def.'s Facts at ¶ 15.
with the above-referenced provisions applicable to claims for
STD and LTD benefits, the Disability Policy provides that
“Liberty [Life], at its own expense, may have the right
and opportunity to have a Covered Person, whose Injury or
Sickness is the basis of a claim, examined or evaluated at
reasonable intervals deemed necessary by Liberty [Life]. This
right may be used as often as reasonably required.”
Admin. R. at 0045; Pl.'s Facts at ¶ 4; Def.'s
Resp. at ¶ 4. With regard to interpreting its
provisions, the Disability Policy provides that
“Liberty [Life] shall possess the authority, in its
sole discretion, to construe the terms of this policy and to
determine benefit eligibility hereunder. Liberty[ Life's]
decisions regarding construction of the terms of this policy
and benefit eligibility shall be conclusive and
binding.” Admin. R. at 0046; Pl.'s Facts at ¶
5; Def.'s Resp. at ¶ 5. In addition to having
responsibility for deciding questions concerning benefit
eligibility, Liberty Life is “responsible for paying
benefits to covered persons determined to be eligible for
such benefits.” Stipulation at ¶ 3, Doc. No. 32;
Pl's Facts at ¶ 6; Def.'s Resp. at ¶ 6.
Plaintiff's Application for STD Benefits
January 2013, the plaintiff submitted a disability claim for
STD benefits with Liberty Life. Admin. R. at 0071,
0370. On the claim form, the plaintiff
indicated that his injury or illness began on January 4,
2013, and his last day of work was on that date. Admin. R. at
0370. When asked to describe “how and where the injury
occurred” or the “onset and nature of your
illness, ” the plaintiff stated: “Impaired
mobility and inability to walk unassisted. Right leg unable
to sustain weight. Extended periods of obesity may have
caused deterioration in function of joints and tendons.
Despite significant weight loss, impairment has
increased.” Admin. R. at 0370.
of Liberty Life's investigation into the plaintiff's
claim for STD benefits, it requested medical records and
information from an internal medicine/primary care physician,
Dr. Ryan Minnich, who the plaintiff had identified as his
treating physician. Def.'s Facts at ¶ 4; Pl.'s
Facts at ¶ 13; Def.'s Resp. at ¶ 13; Admin. R.
at 0071, 0370. In response to this request, Liberty Life
received various documents from Dr. Minnich reflecting
treatment records and medical reports during 2012. Def.'s
Facts at ¶ 5; Admin. R. at 0373-0395.
among those medical records was a March 15, 2012 carotid
ultrasound report showing that the plaintiff had
“Bilateral 16-49% stenosis of internal carotid
arteries.” Pl.'s Facts at ¶ 10; Def.'s
Resp. at ¶ 10; Admin. R. at 0384. The records also
contained an April 24, 2012 report from cardiologist Roger B.
Rehr, M.D., F.A.C.C. Pl.'s Facts at ¶ 11; Def.'s
Resp. at ¶ 11; Admin. R. at 0386-0389. This report
indicated that the plaintiff “is a delightful, morbidly
obese, 58-year-old man currently weighing 417 pounds.”
Admin. R. at 0386.
plaintiff had informed Dr. Rehr that [o]ver the past 6-9
months [he] has noticed a decreased exercise tolerance. If he
walks even 25 feet he will become diaphoretic and short of
breath. He has had no chest discomfort. He has had no
orthopnea or PND but he does sleep in a recliner due to back
Pl.'s Facts at ¶ 11; Def.'s Resp. at ¶ 11.
Dr. Rehr also reported about an exercise stress test that the
plaintiff performed in September 1999, during which
“[h]is functional capacity was 30% impaired.”
Admin. R. at 0386.
his review of systems, Dr. Rehr noted that [p]ertinent
positives reported by the patient include episodic weight
gain or weight loss, right knee discomfort with walking,
dyspnea with exertion, or diaphoresis. The patient does
report that his wife has indicated that he stops breathing
sometimes when he is sleeping. He was set up to have a sleep
study in 2004 . . . but refused to complete the study because
of the smell of the EEG electrode paste on his scalp.
Otherwise, on questioning the patient, comprehensive review
of all other systems is negative.
physical examination, Dr. Rehr noted that the plaintiff
“is morbidly obese. He has difficulty lying down on the
examination table and then again sitting up because of his
appears to be in no acute distress and is not short of breath
at rest.” Id. Dr. Rehr's impressions of
the plaintiff were: “Increased dyspnea with exertion
and diaphoresis with exertion over the past 6-9 months[;] . .
. Morbid obesity[;] . . . Likely obstructive sleep apnea[;] .
Dyslipidemia[;] . . . Diabetes[;] . . . [and] Medical
“Discussion/Plan, ” Dr. Rehr indicated in
pertinent part as follows:
plaintiff] presents a problem in terms of his morbid obesity
and his medical noncompliance. He previously refused to
complete a sleep apnea study because of the electrode paste.
He has not taken any of his medications for the past two days
because he “forgot”. He did manage to lose
substantial weight and dropped down to 340 pounds in February
of 2010 but then gained it all back.
time he has shortness of breath with relatively small amounts
of exertion, which have been present and without significant
change for the past 6-9 months. Because of his risk factor
status I was concerned about the possibility that this might
represent coronary artery disease and I wanted to obtain a
dobutamine echocardiographic stress test with him. I
discussed the procedure of that study, the risks of it,
etc[.], and he refused at this time to have the study because
“he has to walk too far when he goes to The Reading
Hospital for studies”. As he describes it, with his
morbid obesity he is unable to walk as far as he needs to. I
indicated to him that The Reading Hospital has Valet parking
and we could arrange for a wheelchair to meet him at his car
and take him to the stress test area, but he declined that at
this time. He said he will “let that one alone for
now” or something with that meaning, indicating that he
did not want to pursue testing at this time in spite of the
reasons for it, which I explained fully to him.
indicated to [him] the importance of taking medications as
prescribed and pointed out that stopping the metoprolol
could, in fact, precipitate a myocardial infarction. He
agreed to start on his medications again tonight and to take
them faithfully. He is going to monitor his blood pressure
twice daily, while at rest, over the next month and he will
see me back in the office in a month and we will make further
adjustments in his therapy.
I discussed with him the real need to get him set up for
sleep apnea testing again and, as you will see from the
enclosed note, I have sent a letter to Respiratory
Specialists trying to do everything possible to get him to
proceed with the sleep apnea test. I am hopeful, if
necessary, they will modify their procedure slightly in order
to be able to get some useful information on a perhaps less
than optimal study as opposed to no information obtained
because a perfectly performed test cannot be done.
included in the medical records was a May 4, 2012 report from
Karen Delong, MSN, CRNP, from Respiratory Specialists, which
indicated that the plaintiff suffered from obstructive sleep
apnea. Id. at 0391-0395; Pl.'s Facts at ¶
12; Def.'s Resp. at ¶ 12. Although Nurse Delong
discussed with the plaintiff about the possibility of a sleep
study and recommended that he get one, the plaintiff did not
choose to schedule any studies at that time. Admin. R. at
Minnich also provided Liberty Life with an Attending
Physician's Statement dated January 18, 2013.
Id. at 0373-0374; Pl.'s Facts at ¶ 14;
Def.'s Resp. at ¶ 14. In this statement, Dr. Minnich
stated that he had treated the plaintiff since January 13,
2012, and the plaintiff's last visit with him occurred on
January 15, 2013. Admin. R. at 0373. Dr. Minnich also stated
that the plaintiff was advised to cease work “by [his]
employer due to his abnormal gait.” Id. Dr.
Minnich identified the following diagnoses: Abnormality of
gait, morbid obesity, obstructive sleep apnea, Legg-Calve
Perthes Disease, hypertension, “NIDDM, ” and
hyperlipidemia. Id. His prognosis for the plaintiff
was “fair.” Id. Dr. Minnich's
proposed treatment plan was “His maintain [sic] of
treatment is weight loss related to morbid obesity. He is not
a surgical candidate.” Id. at 0374. In
completing the remainder of the form, Dr. Minnich indicated
that the plaintiff had (1) a Class 4 physical impairment,
defined as a “[m]oderate limitation of functional
capacity; capable of clerical/administration activity;”
(2) a Class 3 mental/nervous impairment, defined as
“[p]atient is able to engage in only limited stressful
situations and engage only in limited interpersonal relations
(moderate limitations);” and (3) a Class 3 cardiac
impairment, defined as a “[m]arked
[l]imitation.” Id.; Pl.'s Facts at
¶¶ 14-18; Def.'s Resp. at ¶¶ 14-18.
of its assessment of the plaintiff's claim for STD
benefits, Liberty Life also received an Employer's
Statement form completed by Erin Cutler
(“Cutler”), a regional human resources manager of
Pratt Industries. Id. at 0404. The form indicates
that the plaintiff's occupation was a controller, and
this position was “[a]ccountable for all accounting
operations at the company, accounts payable, accounts
receivable, invoicing, billings, and other financial
duties.” Id. The form also listed the physical
requirements of the job as involving sitting for 80% of the
day, standing for 10% of the day, and walking for 10% of the
day. Id. The form also identified the lifting
requirements as five pounds. Id.
the review process, nurse Karen Hughes reviewed the
plaintiff's file and prepared a January 31, 2013 file
note summarizing the results of her review. Id. at
0070; Def.'s Facts at ¶ 7. In the notes of Ms.
Hughes' file summary, she noted, inter alia, the
following: (1) the plaintiff contemplated medical leave after
Pratt Industries recommended it due to his mobility issues;
(2) the plaintiff was ambulating with a cane and reporting
discomfort of his right knee; (3) the plaintiff had comorbid
conditions of diabetes and morbid obesity, but the diabetes
was well controlled per recent lab work; and (4) the
plaintiff's physical examination was “ESSENTIALLY
NORMAL” and there were no documented musculoskeletal
examinations. Id. Based on her observations that
there were no physical exam findings to support a gait
abnormality; thus, she concluded that “WHILE THE
[PLAINTIFF] MAY NEED TO UTILIZE A CANE AS NEEDED FOR COMFORT,
THERE IS NO EVIDENCE OF FUNCTIONAL DEFECTS TO NECESSITATE AN
ASSISTIVE DEVICE.” Admin. R. at 0070; Def.'s Facts
at ¶ 7.
letter dated February 5, 2013, Liberty Life denied the
plaintiff's claim for STD benefits. Def.'s Facts at
¶ 8; Pl.'s Facts at ¶ 31; Def.'s Resp. at
¶ 31; Admin. R. at 0362-0364. In denying the claim,
Liberty Life stated that it had reviewed the records from Dr.
Minnich and had consulted with a disability nurse case
manager. Def.'s Facts at ¶ 8; Pl.'s Facts at
¶ 31; Def.'s Resp. at ¶ 31; Admin. R. at
0362-0363. Liberty Life noted that his medical condition was
not of such severity to “prevent [him] from performing
[his] sedentary job duties, which require[d him] to sit 60%
[sic], with occasional walking 10% of the time.”
Pl.'s Facts at ¶ 31; Def.'s Resp. at ¶ 31;
Admin. R. at 0363. In addition, Liberty Life stated that
[a]lthough you were diagnosed with gait abnormality and it
was documented you reported symptoms of pain in your right
knee and in the right side of your pelvis, there were no
abnormal physical exam findings to support restrictions and
limitations. While it is noted you ambulate with a cane as
needed for comfort, there is no evidence of functional
deficits to necessitate an assistive device.
We understand that you may have symptoms associated with your
condition; however, the above information does not support a
condition of such severity to preclude you from performing
your job as a Controller for Pratt Industries, U.S.A.
Id.; see Def.'s Facts at ¶ 8.
February 7, 2013, shortly after the decision to deny the
plaintiff's STD benefits claim, Liberty Life received a
physical job evaluation form completed by Cutler on behalf of
Pratt Industries USA. Def.'s Facts at ¶ 9; Pl.'s
Facts at ¶ 45; Def.'s Resp. at ¶ 45; Admin. R.
describing the physical requirements of the plaintiff's
controller job, unlike the earlier form she completed on
behalf of Pratt Industries, Cutler indicated that the job
required him to sit 3 hours a day, stand 2 hours a day, and
walk 2 hours a day. Def.'s Facts at ¶ 9; Pl.'s
Facts at ¶ 45; Def.'s Resp. at ¶ 45; Admin. R.
at 0360. Cutler also stated that the plaintiff was required
to bend frequently, reach above shoulder level frequently,
reach shoulder level frequently, and reach below shoulder
level frequently. Pl.'s Facts at ¶ 45; Def.'s
Resp. at ¶ 45; Admin. R. at 0360.
plaintiff also had to lift up to 20 pounds daily. Pl.'s
Facts at ¶ 45; Def.'s Resp. at ¶ 45; Admin. R.
at 0360. In the comments section, Cutler stated that
“[a] great deal of the Controller job requires
significant walking and getting around the plant for physical
inventory and taking stock of product.” Pl.'s Facts
at ¶ 45; Def.'s Resp. at ¶ 45; Def.'s Facts
at ¶ 9; Admin. R. at 0360.
plaintiff appealed from Liberty Life's decision to deny
STD benefits via a letter dated February 20, 2013, and
attached medical documentation. Admin. R. at 0345-0359. In
his letter, the plaintiff stated, inter alia, that
(1) he experienced pain and fatigue while using his cane, but
it was “bearable as long as I am going a short
distance, ” (2) he experienced
“excruciating” pain when he takes his weight or
load off of his leg, (3) he has “unbearable” pain
in his lower back if he stands for too long, even while using
his cane, (4) this lower back pain causes him to avoid going
into the plants and warehouses because there are very few
places to sit and rest, (5) he could not use a wheelchair or
scooter to move about in the plants and warehouses due to the
irregular surfaces and levels, (6) “[t]he stairs and
irregular surfaces became a significant issue at both plants
[he] was responsible for, as there are offices and conference
rooms on two different floors of both, with no elevators,
” (7) when traversing the stairs, he would use both
hands to grab the railing while tying his cane to his belt
and dragging it behind him, (8) he frequently experienced
“stumbling and missteps” on the stairs (which
caused other employees to “express worry and
concern”), (9) he requested and received permission not
to attend the October 2012 Pratt controller meeting due to
his worsening mobility factors, (10) he missed some
doctors' visits over the past year due to work
emergencies and not because of “negligence or low
concern, ” (11) although he was able to delegate some
of his responsibilities to minimize the amount of walking he
has to do at work, he was not able to count on the delegation
to other employees to get consistent results and, thus,
“while computer work and desk work is indeed the
biggest slice of the day, time-wise, every plant controller
in the corrugated packaging manufacturing industry needs to
be capable of observing product and production within the
typical 150, 000 sf plant and/or warehouse, ” and (12)
“everyone that knows or deals with [him] . . . have no
question . . . that [he has] become disabled, and that [he]
needs rehabilitation now. This was not [his] idea or decision
or request, and if not for the intervention, [he] would still
be trying to hobble around pain or not.” Pl.'s
Facts at ¶ 42; Def.'s Resp. at ¶ 42; Admin. R.
the documents attached to the plaintiff's February 20,
2013 letter were office visit notes from Sana Hanafi, M.D.,
an internist. Admin. R. at 0352-0359; Pl.'s Facts at
¶ 21; Def.'s Resp. at ¶ 21. The notes reflect
that the plaintiff visited Dr. Hanafi for hypertension,
Hyperlipidemia, and obesity. Admin. R. at 0353, 0355. Dr.
Hanafi indicated that the plaintiff told her that “[h]e
works at plants in a company that manufactures boxes where
more than 60% of the time he has a desk job however has to go
on site and be on his feet, at times he has had
[f]alls.” Admin. R. at 0353. The plaintiff described to
Dr. Hanafi “right leg pain which is excruciating
burning and tingling pain from his right hip down to his
right knee, not associated with back pain however gets worse
about a scale of 10/10 when [w]eight-bearing.” Admin.
R. at 0353; Pl.'s Facts at ¶ 21; Def.'s Resp. at
¶ 21. In addition, the plaintiff “uses a cane to
compensate his weight and of course has gait dysfunction
which has been leading to multiple falls in the past.”
Admin. R. at 0353; Pl.'s Facts at ¶ 21; Def.'s
Resp. at ¶ 21.
Dr. Hanafi's physical examination of the plaintiff, she
noted that the plaintiff had “[l]imited range of motion
of the right hip joint and knee joint because of excruciating
pain. Patient moaning and seems to be in extreme pain while
trying to extend his right leg. Straight leg raising test in
sitting position is positive for sciatica at approximately 45
degrees.” Admin. R. at 0354; Pl.'s Facts at ¶
21; Def.'s Resp. at ¶ 21. In Dr. Hanafi's review
of symptoms, she noted that the plaintiff had a
“[n]ormal [m]ood” and was
“[c]ooperative.” Admin. R. at 0354.
Hanafi's assessment and diagnosis indicated that the
plaintiff had (1) obesity, (2) ambulatory dysfunction, (3)
pain of right leg, (4) juvenile osteochondrosis of hip and
pelvis, (5) essential hypertension, (6) sciatica of right
side, and (7) repeated falls. Admin. R. at 0355-0356;
Pl.'s Facts at ¶ 21; Def.'s Facts at ¶ 21.
Dr. Hanafi also noted past diagnoses of non-insulin dependent
diabetes mellitus, valvular heart disease, hypertension,
hyperlipidemia, ambulatory dysfunction: legg perthes disease,
and obesity. Admin. R. at 0354.
Hanafi had the plaintiff submit to an x-ray of his right hip
and right knee along with the examination. Admin. R. at 0355,
0358-0359. The x-ray of the plaintiff's right hip
revealed osteoarthritis with possible osteonecrosis of the
femoral head. Admin. R. at 0358; Pl.'s Facts at ¶
21; Def.'s Resp. at ¶ 21. The x-ray of the
plaintiff's right knee revealed “[n]ew dystrophic
calcification adjacent to the medial femoral
condyle.” Admin. R. at 0359; Pl.'s Facts at
¶ 21; Def.'s Resp. at ¶ 21.
addition to Dr. Hanafi's office visit notes and the x-ray
reports, the plaintiff also provided Liberty Life with
progress notes from a visit with Tracy D. Frombach, D.O., of
Commonwealth Orthopaedic Associates on February 13, 2013.
Admin. R. at 0351; Pl.'s Facts at ¶ 22; Def.'s
Facts at ¶ 22. Dr. Frombach's notes from her
examination of the plaintiff revealed impressions of (1)
morbid obesity, (2) weakness in the quadriceps, hamstring,
and hip flexor, (3) severe osteoarthritis of the right hip,
and (4) mild osteoarthritis changes of the right knee. Admin.
R. at 0351; Pl.'s Facts at ¶ 22; Def.'s Resp. at
¶ 22. Her physical examination notes showed that (1) the
plaintiff had “crepitus about the knee with flexion and
extension[, ]” (2) a McMurray's sign gave him
general discomfort, (3) he had “minimal range of motion
and internal and external rotation of the hip, ” giving
him discomfort through his quadriceps, and (4) he had
“weakness through the hip flexor and lifting the leg
off the table with approximately 4-/5 strength.” Admin.
R. at 0350; Pl.'s Facts at ¶ 22; Def.'s Resp. at
Frombach also reviewed the plaintiff's February 8, 2013
x-rays of his knee and hip. Admin. R. at 0350; Pl.'s
Facts at ¶ 22; Def.'s Resp. at ¶ 22. The x-ray
of the knee showed mild degenerative changes of the medial
femoral condyle, and the x-ray of the hip showed
“severe degenerative changes.” Admin. R. at 0350;
Pl.'s Facts at ¶ 22; Def.'s Resp. at ¶ 22.
her plan for the plaintiff, Dr. Frombach indicated that the
plaintiff would be sent to another doctor “for further
evaluation of his right hip severe degenerative changes and
prior history of Legg Calve Perthes disease for evaluation of
total hip replacement.” Admin. R. at 0351; Pl.'s
Facts at ¶ 22; Def.'s Resp. at ¶ 22. Dr.
Frombach did not feel that the plaintiff “needs full
disability” because he “can perform sedentary
work duties.” Admin. R. at 0351; Pl.'s Facts at
¶ 22; Def.'s Resp. at ¶ 22. In addition, Dr.
Frombach noted that the plaintiff had a handicap placard,
which she felt was appropriate for him, and he could continue
to walk with his four-prong cane. Admin. R. at 0351;
Pl.'s Facts at ¶ 22; Def.'s Resp. at ¶ 22.
Nonetheless, she indicated that “due to [the
plaintiff's] . . . osteoarthritis and obesity, [he]
should not walk for any long periods of time or any long
distances.” Admin. R. at 0351; Pl.'s Facts at
¶ 22; Def.'s Resp. at ¶ 22.
the receipt of this additional information from the plaintiff
and after receiving the February 7, 2013 job description from
Cutler, Liberty Life referred the plaintiff's file to
another of its nurse case managers for a file review.
Def.'s Facts at ¶ 11; Admin. R. at 0068-0069. On
February 26, 2013, Nurse Janet Green prepared notes to
summarize her review. Def.'s Facts at ¶ 12; Admin.
R. at 0068-0069. In the note, Nurse Green summarized the
records she reviewed and concluded that the plaintiff's
mobility and hip problems prevented him from walking and
standing on more than an occasional basis. Def.'s Facts
at ¶ 12; Admin. R. at 0068-0069. Soon thereafter,
Liberty Life reversed its initial decision denying the
plaintiff's STD benefits claim, and he ultimately
received STD benefits for the period of January 21, 2013,
through April 7, 2013, which was the maximum duration
applicable for such benefits under the Disability
Policy. Def.'s Facts at ¶ 13; Pl.'s
Facts at ¶ 8; Def.'s Resp. at ¶ 8; Admin. R. at
0067, 0068, 0074, 0148. The plaintiff's gross STD benefit
was $750.00 weekly. Pl.'s Facts at ¶ 8; Def.'s
Resp. at ¶ 8; Admin. R. at 0148.
Plaintiff's Application for LTD Benefits
before the expiration of the plaintiff's STD benefits,
Liberty Life began evaluating him to determine his
eligibility for LTD benefits under the Disability Policy.
Def.'s Facts at ¶ 14; Admin. R. at 0320-0321. As
part of this investigation, Liberty Life sent requests for
records to the plaintiff's treating physicians.
Def.'s Facts at ¶ 16; Admin. R. at 0300-0301, 0306.
response to Liberty Life's requests, it received records
from Dr. John Stelmach, an orthopedic surgeon who examined
the plaintiff in March 2013. Def.'s Facts at ¶ 16;
Pl.'s Facts at ¶ 23; Def.'s Resp. at ¶ 23;
Admin. R. at 0303-0304. Dr. Stelmach's March 20, 2013
office visit notes indicate that his impressions were that
the plaintiff had (1) severe osteoarthritis of the right hip,
and (2) “severe degenerative changes [due to]
flattening of the femoral head and increased femoral neck
angle questionable due to the prior Legg-Calve-Perthes
disease.” Pl.'s Facts at ¶ 23; Def.'s
Resp. at ¶ 23; Admin. R. at 0303-0304. Dr.
Stelmach's treatment plan was as follows:
At this point due to his weight and not being a surgical
candidate, he will need to lose another 50-100 lbs to get
closer to a more appropriate BMI. He definitely is in need of
a total hip replacement. When he gets closer to a more
appropriate weight and he can be medically cleared we will do
the total hip replacement. At this point the patient is
probably not able to perform his work duties due to the risks
of falling and ambulatory dysfunction when he walks. He seems
to be pretty unstable on his leg and his four prong [cane]
will help him with this, but due to the osteoarthritis and
obesity it is appropriate to say that the patient will not be
able to walk on a regular basis.
Pl.'s Facts at ¶ 23; Def.'s Resp. at ¶ 23;
Admin. R. at 0303-0304.
Life also forwarded Dr. Stelmach a letter dated March 28,
2013, and a “restrictions form.” In the
letter, Liberty Life asked whether the plaintiff could
perform sedentary or light capacity work and provided
definitions and characteristics of both forms of
work. Def.'s Facts at ¶ 16; Pl.'s
Facts at ¶¶ 24, 25; Def.'s Resp. at
¶¶ 24, 25; Admin. R. at 0302. Dr. Stelmach returned
the letter to Liberty Life on March 29, 2013, and he
indicated his opinion that the plaintiff “is unable to
work [at] this time.” Def.'s Facts at ¶ 16;
Pl.'s Facts at ¶ 26; Def.'s Resp. at ¶ 26;
Admin. R. at 0300. On the same date, Dr. Stelmach returned
the restrictions form to Liberty Life where he also indicated
his opinion that the plaintiff was capable of “no work
[at] this time.” Pl.'s Facts at ¶ 26;
Def.'s Resp. at ¶ 26; Def.'s Facts at ¶ 16;
Admin. R. at 0302.
plaintiff also completed a Liberty Life activities
questionnaire in support of his claim for benefits. Pl.'s
Facts at ¶ 43; Def.'s Resp. at ¶ 43; Admin. R.
at 0278-0280. In the questionnaire, the plaintiff indicated
that he (1) could sit for 15 consecutive minutes, (2) could
stand for 1.5 consecutive minutes with cane support, but was
limited by back pain and arm fatigue, (3) could walk for 2
minutes with cane support, but possibly for longer if he
leaned his weight onto a shopping cart, (4) did not stand or
walk without support, (5) sat, laid, or slept for 22 hours a
day, (6) stood (with cane support) approximately 20 minutes a
day, and (7) walked (with a cane, bracing, or shopping cart)
for approximately 90 minutes a day, (8) cannot sleep in a
flat bed, so he uses a recliner to sleep, (9) experiences
fatigue when he uses a normal or desk chair, (10) can sit in
a car with a reclining seat for about a maximum of one hour,
(11) had a handicapped placard, but had to come back to a
location if a handicapped spot was unavailable or not within
a “couple minutes of a shopping cart” (where he
would use his cane to get to the cart), (12) can do
approximately 20 minutes of shopping if he has a shopping
cart, but could not go into a store that did not have or
allow shopping carts, and (13) was unable to travel or take
vacations due to mobility issues and the need for a recliner
to sleep. Pl.'s Facts at ¶ 43; Def.'s Resp. at
¶ 43; Admin. R. at 0278-0279. The plaintiff also stated
that his lack of mobility kept him from getting out into the
“typical 150, 000 [square foot] production plant and
warehouses, to attend to job cost duties and inventory
duties, and troubleshoot production reporting.”
Pl.'s Facts at ¶ 44; Def.'s Resp. at ¶ 44;
Admin. R. at 0280. The plaintiff stated that he needed this
type of mobility, which “include[ed] being able to get
between loads and units.” Pl.'s Facts at ¶ 44;
Def.'s Resp. at ¶ 44; Admin. R. at 0280.
with requesting and receiving records from the
plaintiff's treating physicians as part of its
investigation, Liberty Life sent an email to Pratt Industries
requesting clarification of the physical requirements of the
plaintiff's job because Cutler had submitted differing
physical job evaluation information. Def.'s Facts at
¶ 17; Admin. R. at 0316. In the email, Liberty Life
indicated that it needed clarification and an accurate
description of the plaintiff's job demands as part of its
LTD benefits evaluation and so its vocational specialist
could evaluate how the plaintiff's occupation is
performed in the national economy. Def.'s Facts at ¶
17; Admin. R. at 0316. In response to this email, Pratt
Industries sent an email stating that the information
provided by Cutler on February 7, 2013, was more accurate and
should be used. Def.'s Facts at ¶ 17; Admin. R. at
receiving Dr. Stelmach's medical records and the
clarification from Pratt Industries about the plaintiff's
job duties, Liberty Life requested its vocational
rehabilitation department to complete a vocational report
summarizing the principal duties of the plaintiff's
controller occupation as it is performed in the national
economy. Def.'s Facts at ¶ 18; Admin. R. at 0294. On
April 8, 2013, Bernadette Cook (“Cook”), a senior
vocational case manager, prepared a report in response to
Liberty Life's request. Def.'s Facts at ¶ 18;
Admin. R. at 0238-0240.
Cook's report, she summarized the principal duties
associated with the plaintiff's controller position,
including the information provided by Pratt Industries.
Def.'s Facts at ¶ 19; Admin. R. at 0238. She did not
speak to the plaintiff. ...