Beamish v. THE HARTFORD/THE HARTFORD FINANCIAL

487 F. Supp. 2d 1196, 2007 U.S. Dist. LEXIS 31901, 2007 WL 1286184
CourtDistrict Court, W.D. Washington
DecidedMay 1, 2007
DocketC06-213Z
StatusPublished

This text of 487 F. Supp. 2d 1196 (Beamish v. THE HARTFORD/THE HARTFORD FINANCIAL) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Beamish v. THE HARTFORD/THE HARTFORD FINANCIAL, 487 F. Supp. 2d 1196, 2007 U.S. Dist. LEXIS 31901, 2007 WL 1286184 (W.D. Wash. 2007).

Opinion

ORDER

ZILLY, District Judge.

This matter comes before the Court on Defendants’ Motion for Summary Judgment, docket no. 14. The Court has reviewed the briefs and records filed herein, and being fully advised, now enters the following Order GRANTING Defendant’s Motion for Summary Judgment.

Background

1. The Terms of the Long Term Disability Plan.

Plaintiff Susan Beamish (Beamish) was formerly employed at Greenpoint Technologies, Inc. (Greenpoint) as the Senior Director of Finance. Administrative Record, docket no. 17, at 00168. This is a largely sedentary position. Id. at 00263. As of March 1, 2003, Greenpoint’s employees were covered by a long-term disability benefits plan (Plan) insured by CNA Group Life Assurance Company (CNA). Id. at 00001-39. There is no dispute that Beamish was a covered employee under the Plan.

The Plan defines “Disability” as an “Injury or Sickness which causes physical or mental impairment to such a degree of severity that You are: 1) continuously unable to perform the Material and Substantial Duties of Your Regular Employment; and 2) not Gainfully Employed.” Administrative Record, at 00012 (emphasis in original). “Material and Substantial *1198 Duties” is defined as “the necessary functions of Your Regular Occupation which cannot be reasonably omitted or altered.” Id. at 00021 (emphasis in original).

The Plan requires claimants to submit proof of disability in order to receive benefits, including “objective medical findings.” Id. at 00111. Under the Plan, objective medical findings include “tests, procedures, or clinical examinations standardly accepted in the practice of medicine for Your disabling condition(s).” Id. (emphasis in original). Under the Plan, Green-point delegated discretion to CNA to determine benefit eligibility and construe the Plan. Id. at 00118 (“With respect to making benefits decisions, the Plan Administrator has delegated sole discretionary authority to CNA Group Life Assurance Company to determine your eligibility for and entitlement to benefits under the Plan and to interpret the terms and provisions of any insurance policy issued in connection with the Plan.”).

2. Beamish’s Medical History.

After undergoing radiation therapy for breast cancer, Beamish developed recurrent chest pain. Id. at 00278. Beamish was treated with a variety of pain medications and therapy. Id. at 00278-79. On November 3, 2003, Beamish fell on her way to work, injuring her left knee. Id. at 00272. Her chest pain increased subsequent to this accident. Id. at 00279. On December 29, 2003, Beamish applied for short-term disability benefits under the Plan. An examination by Dr. Wesch in January 2003 described normal gait and station, normal strength and tone, stable joints, and a full range of motion with significant pain. Id. at 00186. On February 13, 2004, CNA approved the claim, retroactive to December 27, 2003. Id. at 00160. On March 4, 2004, CNA received Beamish’s application for long-term benefits. Id. at 00091. During its investigation into her claim, CNA consulted the notes and medical opinions of Beamish’s treating physicians, Drs. Wesch and Irving. Id. at 00088. Beamish complained of serious pain, which Dr. Irving treated with a drug regime. Id. at 00272. As of March 2004, Beamish’s routine pain medications included Methadone, Oxycodone, Neuron-tin, Zoloft, Amitriptyline and Tizanidine. Id. at 00474. Based on this information, CNA approved Beamish’s long term disability claim on April 8, 2004. Administrative Record, at 00088-89. Dr. Suzanne LaCross, a psychologist, began seeing Beamish in March 2004 to treat her depression arising from her chronic pain and inability to work.

The record also reflects that Beamish was seen by Dr. Heather Tagliarino as early as July 2, 2004. Id. at 00449. Dr. Tagliarino wrote a letter to Hartford Life and Accident Insurance Company (Hartford) 1 on August 17, 2004, stating that Beamish had been diagnosed with Complex Regional Pain Syndrome, which “markedly impacted Beamish’s] ability to sit or stand for prolonged periods of time, concentrate, or interact socially.” Id. at 00419. The letter concluded that it was unlikely Beamish could work in any capacity in the near future. Id.

Hartford continued to examine Beamish’s claims over the next several months. Hartford came to believe that support for Beamish’s disability rested entirely on her own subjective complaints to her doctors, and her doctors’ subsequent report of those subjective complaints. Hartford obtained the opinions of two consulting doctors to evaluate Beamish’s condition; Dr. David F. Zakin, a psychological consultant, and Dr. Robert Marks, a neurologist.

*1199 Dr. Zakin reviewed the submitted medical records of Beamish, an undated summary of interview for mental/nervous claims, a July 28, 2004 letter by Dr. La-Cross, and a July 16, 2004 claimant interview. Id. at 00270-74. Although Dr. Za-kin attempted to speak with Dr. LaCross, he was unable to do so. Id. at 00275. He concluded that there was insufficient evidence to conclude that Plaintiff was psychologically impaired: “Objective data regarding the claimant’s reported psychological impairment is lacking. No psychological testing has been conducted and in his monthly treatment notes, Dr. Irving does not make note of any impairment in attention or concentration.” Id. at 00274. Dr. Zakin summarized the conclusions of the treating physicians:

The records reviewed indicate that treating physicians have found the claimant to be disabled secondary to her experience of complex regional pain syndrome. The records reviewed also indicate that the medications taken for her complex regional pain syndrome ... may impact her energy level and cognitive state. However, there is no indication in the records reviewed that Ms. Beamish experiences any occupational impairment secondary to her psychological condition.

Id. at 00275. Dr. Zakin came to this conclusion because (1) Beamish’s depression began after she left work, (2) restrictions on her activities were due to physical, not psychological, limitations, (3) Dr. LaCross did not formally diagnosis Beamish with a psychological impairment, (4) Beamish received therapy biweekly instead of weekly, and (5) Dr. Irving’s notes made no mention of any impairment in mentation or cognition. Id. at 00275-76. In sum, Dr. Zakin concluded that “there is no indication that the claimant evidences any occupational impairment secondary to her psychological condition alone.” Id. at 00276.

Dr. Marks concluded that the evidence did not show that Beamish was physically impaired:

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487 F. Supp. 2d 1196, 2007 U.S. Dist. LEXIS 31901, 2007 WL 1286184, Counsel Stack Legal Research, https://law.counselstack.com/opinion/beamish-v-the-hartfordthe-hartford-financial-wawd-2007.