Armstrong v. Liberty Mutual Life Assurance Co.

273 F. Supp. 2d 395, 2003 U.S. Dist. LEXIS 12290
CourtDistrict Court, S.D. New York
DecidedJune 30, 2003
DocketNo. 02 CIV. 2450(CM)
StatusPublished
Cited by2 cases

This text of 273 F. Supp. 2d 395 (Armstrong v. Liberty Mutual Life Assurance Co.) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Armstrong v. Liberty Mutual Life Assurance Co., 273 F. Supp. 2d 395, 2003 U.S. Dist. LEXIS 12290 (S.D.N.Y. 2003).

Opinion

MEMORANDUM DECISION AND ORDER

MCMAHON, District Judge.

Plaintiff William Armstrong brings this action against defendants Liberty Life Assurance Company of Boston (“Liberty”); Liberty Mutual Insurance Company (“Liberty Mutual”); Liberty Mutual Group, Inc.; and Liberty Mutual Insurance Company Group Long Term Disability Income Plan, challenging Liberty’s determination that he is no longer eligible for long-term disability benefits.1 Before the Court are the parties’ cross-motions for summary judgment.

For the following reasons, the defendants’ motion is granted in part and denied in part. Plaintiffs motion is denied.

FACTS

Liberty Mutual hired Armstrong in 1977, and he eventually worked there as an Executive Sales Representative. [000682],2 In September of 1990, Armstrong began to suffer severe pain in his back and legs after pushing a tree-trunk. [000240; 000264]. He was hospitalized and advised of bedrest. When the pain persisted, he visited Dr. Richard J. Radna, a neurosurgeon. Dr. Radna performed lumbar surgery on Armstrong. Id.

Armstrong’s condition improved after his surgery, but he continued to suffer from discomfort in his lumbar area, pain in his left thigh, spasms in his left calf, and achiness of his left foot upon walking. [000240; 000171]. Armstrong visited Dr. L. Stephan Kranzler on May 19,1992.’ Dr. Kranzler recommended a course of tests, including an MRI and EMG nerve conduction studies. [000171-000173]. Plaintiff had an MRI on May 28, 1992, which found some scarring and a “small, focal, left-sided L4-5 herniation partially obliterating the left epidural recess.” [000175].

As of August 31, 1992, plaintiff was unable to continue work due to pain. [001094]. Dr. Kranzler scheduled Arm[398]*398strong for a steroid injection on September 22, 1992. [000178-000179]. Dr. Kranzler advised that plaintiff could return to work on November 1, 1992 but should not drive more than a half hour per day or engage in any heavy lifting. [000181].

Armstrong met with a Rehabilitation Specialist from Comprehensive Rehabilitation Associates, Inc (“Comprehensive Rehabilitation”) on December 9, 1992. [000184]. The Rehabilitation Specialist’s report noted Armstrong’s eagerness to go back to work, which he did on December 23, 1992. [001097]. Comprehensive Rehabilitation monitored plaintiffs return to work, and plaintiff reported that he experienced discomfort but it was not severe. [000196]. Comprehensive Rehabilitation closed plaintiffs file on January 14, 1993 after concluding that Armstrong had adjusted well to his return to work. Id.

On January 1, 1994, Armstrong awoke with severe pain and numbness in his right arm. [000240]. Armstrong visited Dr. Louis D. Nunez, who determined that plaintiff would probably need neck surgery and referred him to Dr. Radna (who had performed plaintiffs lumbar surgery in 1990). [000199],

Liberty received notice that Armstrong would be absent from work beginning on January 3, 1994. [000782], Liberty asked Armstrong to supply information about his condition in anticipation that Armstrong would make a claim for short-term disability benefits. Id. Dr. Nunez reported to Liberty that Armstrong was totally disabled for any occupation. [000199]. Plaintiff received short-term disability benefits for the maximum term of twenty six weeks' — from January 3 until July 2, 1994. At that time, plaintiffs claim became a long-term disability claim and he continued to receive disability payments. [000757],

Dr. Radna continued to treat plaintiff over that period of time. Dr. Radna determined that plaintiffs cervical spine showed severe cord compression due to a herniated disc, and on February 24, 1994 he performed an anterior cervical discecto-my on plaintiff. [000203; 000210]. During periodic visits over the next several months, plaintiff reported that he felt considerable relief of cervical and radicular pain but still suffered some cervical spasms and discomfort in his right hand. [000215; 000217; 000226; 000229].

On August 25, 1994 Dr. Radna sent a note to Liberty indicating that plaintiff was “neurosurgically cleared for full time duties, excluding long distance travel.” [000742], Armstrong returned to work from August 29 through September 27, 1994, when he reported that he was unable to continue work due to pain. [000734; 000729]. In the form that he filled out in support of his claim for long-term disability benefits, Armstrong described his injury as two herniated disks in his neck and reported that he had suffered persistent pain in his neck since the discs were removed on February 24,1994. [000729].

Plaintiff continued to see Dr. Radna as well as other doctors. On June 27, 1995, for example, Dr. Radna found evidence of “moderate bilateral para-vertebral spasm in the cervical region, with mildly diminished range of motion.” [000254], And on November 28, 1995, Dr. Radna’s diagnosis continued as persistent cervical and lumbo-sacral pain syndrome following decompres-sive surgery of the cervical and lumbo-sacral regions. [000261-000262],

At Liberty’s request, Armstrong underwent a Neurosurgical Consultation by Dr. Hugh S. Wisoff on December 21, 1995. [000264]. As a part of his consultation, Dr. Wisoff filled out a physical capacities form in which he stated that Armstrong was capable of sitting, walking, and standing for 90%, 20%, and 30%, respectively, of an eight hour day. He also noted that [399]*399plaintiff was incapable of carrying, driving, traveling, or typing. [000268].

Based on Dr. Wisoffs evaluation, Liberty arranged a “transferable skill analysis” for Armstrong. [000959]. Plaintiff met with Neil Krouse, a vocational rehabilitation counselor. On January 17, 1996, Krouse issued a “Labor Market Survey.” [000948]. Based on the survey, Liberty determined that there were occupations that plaintiff was capable of performing. As a result, Liberty advised Armstrong on February 29, 1996 that he was no longer eligible for long-term disability benefits. [000945].

Armstrong appealed Liberty’s determination. [000939]. Plaintiff submitted a physical capacities evaluation from Dr. Radna and a radiological report from Dr. Arthur H. Groten. Dr. Radna’s evaluation indicated that plaintiff could only sit, stand, or walk for a period of fifteen minutes; could occasionally lift or carry items up to five pounds; and could occasionally bend, squat, crawl, and reach above shoulder level. [001011-001016]. Dr. Groten reported “[degenerative and post-operative findings involving the lower cervical spine.” [001001]. Upon considering this additional information, Liberty reopened Armstrong’s claim and continued his benefits. [000926].

In April of 1996, the Social Security Administration awarded Armstrong Social Security Disability Benefits. [000915— 000918]. The award was retroactive from June 1, 1994, and plaintiffs policy with Liberty provided for a reduction of long-term disability benefits in the amount of Social Security benefits. Armstrong submitted a check to Liberty for reimbursement in the proper amount. [000885-000888].

Liberty continued to pay plaintiff long-term disability benefits and periodically sought reports and recommendations pertaining to Armstrong’s condition. In December of 1997, Liberty asked Armstrong to have Dr. Radna complete a Physical Capacities Form, Restrictions Form, and Attending Physician’s Statement. [000875]. Liberty received the completed forms on February 28, 1998. Dr.

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