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Roden-Reynolds v. Metropolitan Life Insurance Co.

United States District Court, M.D. Pennsylvania

August 15, 2019

BRENDAN RODEN-REYNOLDS Plaintiff,
v.
METROPOLITAN LIFE INSURANCE COMPANY; TYCO ELECTRONICS CORPORATION; AND TYCO ELECTRONICS LONG TERM DISABILITY PLAN Defendant.

          MEMORANDUM

          SYLVIA H. RAMBO United States District Judge

         In this action arising under the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001-1461 (“ERISA”), Defendants Metropolitan Life Insurance Company (“MetLife”), Tyco Electronics Corporation (“TE”) and Tyco Electronics' Long Term Disability Plan (“the Plan”) (collectively, “Defendants”) have moved for summary judgment relating to MetLife's denial of Plaintiff Brendan Roden-Reynolds's (“Plaintiff”) claim for long-term disability benefits. The primary issue before the court is whether the plan administrator abused its discretion in denying Plaintiff's claim. For the reasons discussed below, the court will grant Defendants' motion for summary judgment.

         I. Background

         The Plan is an employee welfare benefit plan as defined by ERISA. MetLife is the administrator of the Plan and has discretionary authority, granted by The Plan, to interpret its terms and determine whether a covered individual is entitled to receive benefits. Plaintiff was previously employed as a software developer for TE and was a member of the plan.

         In pertinent part, the language of the Plan defines “Disabled or Disability” as follows:

         Disabled or Disability means that, due to Sickness or as the direct result of accidental injury:

         You are receiving Appropriate Care and Treatment and complying with the requirements of such treatment; and You are unable to earn:

1. during the Elimination Period and the next 24 months of Sickness or accidental injury, more than 80% of Your Predisability Earnings at Your Own Occupation from any employer in Your Local Economy; and
2. after such period, more than 60% of your Predisability Earnings from any employer in Your Local Economy at any gainful occupation for which You are reasonably qualified taking into account your training, education and experience.

         (Doc. 18-1, ¶ 3.) Specifically related to Plaintiff's disability, the benefits plan provides as follows:

For Disabilities Due to . . . Neuromuscular, Musculoskeletal or Soft Tissue Disorder . . .
Neuromuscular, musculoskeletal, or soft tissue disorder including, but not limited to, any disease or disorder of the spine or extremities and their surrounding soft tissue; including sprains and strains of joints and adjacent muscles, unless the Disability has objective evidence of:
• Seropositive Arthritis;
• Spinal Tumors, malignancy, or Vascular Malformations;
• Radiculopathies; • Myelopathies; • Traumatic Spinal Cord Necrosis; or
• Myopathies . . .

         We will limit Your Disability benefits to a combined lifetime maximum for any and all of the above equal to the lesser of:

• 24 months; or
• the Maximum Benefit Period.

(Id. at ¶ 4.) Lastly, the plan defines “Radiculopathies” as “disease of the peripheral nerve roots supported by objective clinical ...


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