Alexander v. Winthrop, Stimson, Putnam & Roberts Long Term Disability Coverage

497 F. Supp. 2d 429, 2007 U.S. Dist. LEXIS 51640, 2007 WL 2071865
CourtDistrict Court, E.D. New York
DecidedJuly 17, 2007
Docket04 CV 760(RJD)(KAM)
StatusPublished
Cited by6 cases

This text of 497 F. Supp. 2d 429 (Alexander v. Winthrop, Stimson, Putnam & Roberts Long Term Disability Coverage) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alexander v. Winthrop, Stimson, Putnam & Roberts Long Term Disability Coverage, 497 F. Supp. 2d 429, 2007 U.S. Dist. LEXIS 51640, 2007 WL 2071865 (E.D.N.Y. 2007).

Opinion

MEMORANDUM & ORDER

DEARIE, Chief Judge.

Plaintiff, formerly an employee of defendant law firm Winthrop, Stimson, Putnam and Roberts LLP (“Winthrop Stimson”), brings this action pursuant to the Employee Retirement Security Income Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq., and claims that defendants Winthrop Stimson and Prudential Insurance Company of America (“Prudential”) improperly denied her long-term disability benefits. Plaintiff moved for summary judgment, and defendants cross-moved for judgment on the administrative record. In a Memorandum & Order dated September 27, 2005, the Court denied both motions and invited the parties to submit final submissions addressing the facts. Both parties having done so, and upon a de novo review of the administrative record, the Court finds that plaintiff is totally disabled within the meaning of Winthrop Stimson’s long-term disability benefits plan and therefore is entitled to benefits.

BACKGROUND

The facts underlying this case are set out in detail in this Court’s Memorandum and Order of September 27, 2005. Accordingly, the Court now provides only a brief summary.

Plaintiff, now sixty years old, was employed continuously for thirty-three years, and worked at Winthrop Stimson as a legal secretary for at least nine years. 1 Pl.’s Rule 56.1 Stat’t ¶¶ 1-2. Beginning in 1994, plaintiff began experiencing lower back pain, which she claims made it increasingly difficult for her to perform her secretarial duties. Id. ¶¶3, 6. She was placed on disability leave from Winthrop Stimson on several occasions. Id. ¶ 6; PRU198. 2 By November 1997, according to plaintiff, she *433 was unable to return to work. Pl.’s Rule 56.1 Stat ¶ 6.

On February 9, 1998, plaintiff applied for benefits under Winthrop Stimson’s Long Term Disability Coverage plan (the “Plan”), which is underwritten by defendant Prudential. Defs.’ Rule 56.1 Stat’t ¶¶ 3, 6. On March 12,1998, Winthrop Stimson notified plaintiff by letter that “based upon [her] doctor’s determination that [she was] totally disabled ... it [was] not possible to continue to hold a position open for [her],” and that it had terminated her employment retroactive to February 26, 1998. Pl.’s Rule 56.1 Stat’t ¶ 12; PRU127. On May 19, 1998, Prudential approved the payment of benefits. Id. ¶ 15. Several months later, on January 28,1999, Prudential reversed this decision. Id. ¶ 21. Plaintiff appealed, but her appeal was unsuccessful. Prudential’s final denial of benefits issued on July 27, 1999. Id. ¶ 36.

While pursuing benefits under the Plan, plaintiff also applied for Social Security Disability insurance benefits. The attorneys who represented during this process were recommended to her and paid by Prudential. PRU278. Her application was denied, PRU275, but an Administrative Law Judge (“AL J”) reviewed the denial, and on July 13, 1999, without requiring a hearing, he issued a ruling in which he found that plaintiff was disabled and entitled to receive benefits. Pl.’s Rule 56.1 Stat’t ¶¶ 33-35; PRU151-61.

Plaintiff subsequently brought this ERISA action.

DISCUSSION

A. Standard of Review and Procedural Posture

Plaintiff challenges defendants’ denial of long-term disability benefits under Section 502(a)(1)(B) of ERISA, 29 U.S.C. § 1132(a) (1)(B), which empowers a participant in an employee benefit plan within the statute’s coverage to bring a civil action “to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan”; and under Section 502(a)(3) of ERISA, 29 U.S.C. § 1132(a)(3), which empowers a plan participant to bring a civil action “to enjoin any act or practice which violates any provision of this title or the terms of the plan, or ... to obtain other appropriate equitable relief ... to redress such violations or ... to enforce any provisions of this title or the terms of the plan.” See Am. Compl. ¶¶ 42, 50.

As the Court explained in its Memorandum & Order of September 27, 2005, Prudential did not have discretionary authority to determine plaintiffs eligibility for long-term disability benefits under the Plan. Thus the Court reviews Prudential’s denial of benefits de novo. See Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989) (“[W]e hold that a denial of benefits challenged under [29 U.S.C.] § 1132(a)(1)(B) is to be reviewed 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.”).

Plaintiffs motion for summary judgment having been denied, the Court proceeds based on an examination of the administrative record. See Muller v. First Unum Life Ins. Co., 341 F.3d 119, 124 (2d Cir.2003) (“[T]he decision on the motion for judgment on the administrative record, or the District Court’s de novo review of the parties’ submissions and resolution thereof, can best be understood as essentially a bench trial on the papers with the District Court acting as the finder of fact. Since there is no right to a jury trial under ERISA, this form of bench trial was en *434 tirely proper.”) (internal quotation marks and citation omitted).

Plaintiff bears the burden of proving her entitlement to benefits. See Slupinski v. First Unum Life Ins. Co., No. 99 Civ. 0616, 2005 WL 2385852, at *6, 2005 U.S. Dist. LEXIS 21601, at *18 (S.D.N.Y. Sept. 27, 2005) (“It is well established that plaintiff bears the burden of showing that he was entitled to long term disability benefits under his plan.”) (citing Maniatty v. Unumprovident Corp., 62 Fed.Appx. 413 (2d Cir.2003)); O’Sullivan v. Prudential Ins. Co. of Am., No. 00 Civ. 7915, 2002 WL 484847, at *8, 2002 U.S. Dist. LEXIS 5349, at *22 (S.D.N.Y. Mar. 29, 2002) (“The burden of establishing total disability ... rests with [plaintiff].”) (citing Barnable v. First Fortis Life Ins. Co., 44 F.Supp.2d 196, 204 (E.D.N.Y.1999)).

B. Plaintiffs Entitlement to Long-Term Disability Benefits

Under the terms of the Plan, plaintiff is “totally disabled” and entitled to benefits if she meets the following conditions:

(1) Due to Sickness or accidental Injury, both of these are true:

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Valentine v. Aetna Life Insurance
125 F. Supp. 3d 425 (E.D. New York, 2015)
Smith v. Cox Enterprises, Inc.
81 F. Supp. 3d 1366 (N.D. Georgia, 2015)
Barbu v. Life Insurance Co. of North America
35 F. Supp. 3d 274 (E.D. New York, 2014)
Prabhakar v. Life Insurance Co. of North America
996 F. Supp. 2d 124 (E.D. New York, 2013)
Niles v. American Airlines, Inc.
563 F. Supp. 2d 1208 (D. Kansas, 2008)
Niles v. American Airlines, Inc.
269 F. App'x 827 (Tenth Circuit, 2008)

Cite This Page — Counsel Stack

Bluebook (online)
497 F. Supp. 2d 429, 2007 U.S. Dist. LEXIS 51640, 2007 WL 2071865, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alexander-v-winthrop-stimson-putnam-roberts-long-term-disability-nyed-2007.