Beauvais v. Citizens Financial Group, Inc.

418 F. Supp. 2d 22, 2006 U.S. Dist. LEXIS 9574, 2006 WL 563338
CourtDistrict Court, D. Rhode Island
DecidedMarch 8, 2006
DocketC.A. 04-403T
StatusPublished
Cited by4 cases

This text of 418 F. Supp. 2d 22 (Beauvais v. Citizens Financial Group, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Rhode Island primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Beauvais v. Citizens Financial Group, Inc., 418 F. Supp. 2d 22, 2006 U.S. Dist. LEXIS 9574, 2006 WL 563338 (D.R.I. 2006).

Opinion

*25 MEMORANDUM AND ORDER

TORRES, Chief Judge.

Maureen L. Beauvais (“Beauvais”) brought this action pursuant to the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132, against Citizens Financial Group, Inc. (“Citizens”) and Liberty Life Assurance Company of Boston (“Liberty”). Beauvais seeks benefits under disability plans adopted by Citizens and administered by Liberty.

The case is, now, before the Court for consideration of the parties’ cross motions for summary judgment; Beauvais’s request for attorney’s fees; and Liberty’s motion to strike an affidavit filed by Beau-vais in opposition to Liberty’s motion for summary judgment.

For the reasons hereinafter stated, Be-auvais’s motion for summary judgment and her request for a determination that she is entitled to an award of attorney’s fees are granted; the defendants’ motions for summary judgment are denied; and Liberty’s motion to strike is granted.

Background Facts

The Disability Plans

In 1987, Beauvais was hired by Citizens as a bank teller. By 2003, she had risen through the ranks to the position of Assistant Vice President in Citizens’ loan processing department.

Citizens provides both short term and long term disability benefits to its employees. The short term benefits are provided pursuant to a Short Term Disability Plan (“ST-Plan”) funded by Citizens and administered by Liberty. 1 Long term benefits are provided pursuant to a Long Term Disability Plan (“LT-Plan”) also administered by Liberty but, under which, benefits are paid through insurance purchased by Citizens from Liberty. Both plans reserve to the Plan Administrator discretion to construe the terms of the plan and determine an employee’s eligibility for benefits.

The ST-Plan defines “disability” as an employee’s inability to perform the “material and substantial duties” of the job that the employee was performing at the time the disability began, (AR 52-53), and it provides benefits for a maximum of 180 consecutive days of disability. (AR 50). In order to receive any further benefits, the employee must look to the LT-Plan which provides for up to 24 months of benefits while the employee is unable to perform the duties of her “own occupation” and, thereafter, while the employee is unable “to perform, with reasonable continuity, the material and substantial duties of any occupation.” (AR 7). Eligibility for long term benefits is contingent on the employee, first, having qualified for and exhausted the maximum 180 days of benefits under the ST-Plan.

The Alleged Disability

In November 2002, Beauvais began experiencing discomfort and swelling in her neck and an MRI done on December 16, 2002, revealed a nodule on her thyroid. On February 24, 2003, Beauvais underwent thyroid surgery performed by Dr. Greenberg and, the next day, Beauvais began receiving disability benefits under the ST-Plan.

Following her surgery, Beauvais was under the care of Dr. Razib Khaund, another orthopedic surgeon. On March 5, 2003, Beauvais saw Dr. Khaund and his office notes state that, while Beauvais was recovering well from the surgery, she was suffering from overall neck discomfort. The notes state that Beauvais “has a fair *26 amount of arthritic changes,” and that she would be out of work pending re-evaluation in 3-4 weeks. Two days later, Liberty requested those notes and asked Dr. Khaund to complete a Restrictions Form. (AR 319).

On March 12, 2003, Dr. Khaund submitted the Restrictions Form which stated that Beauvais was suffering from “cervical degenerative joint disease” and “cervical radiculitis.” 2 (AR 314). The Restrictions Form referred to the December 16, 2002 MRI and to an X-ray of Beauvais’s cervical spine taken in 2000. The Restrictions Form also stated that Beauvais was completely disabled, that she should avoid prolonged sitting or standing, and that she should remain out of work pending her next evaluation which was scheduled for four weeks later.

At Liberty’s request, Citizens completed a Physical Job Evaluation Form describing, in general terms, the tasks performed by an assistant vice presidentdoan processing manager and estimating the time spent each day sitting, standing and walking. (AR 321).

On April 7, 2003, Beauvais returned to work part-time but, four days later, she informed Liberty that she could not continue because of pain and swelling in her neck. (AR 97).

That prompted Liberty to request Dr. Khaund’s notes of an April 4, 2003 followup visit by Beauvais and to ask Dr. Khaund to complete a Functional Capacities Form and a Restrictions Form. Liberty did not request the cervical spine X-ray taken in 2000 or the.December 2002 MRI referred to in Dr. Khaund’s March 12, 2003 Restrictions Form. (AR 312).

On April 22, 2003, Dr. Khaund provided the requested information. His April 4, 2003 office notes describe Beauvais as suffering from “cervical DJD” (degenerative joint disease) and state that Beauvais’s neck “discomfort remains at a constant level.” (AR 308-309) They also state that an X-ray of Beauvais’s collar bone did not show any significant abnormalities. The Restrictions Form submitted by Dr. Khaund contains a diagnosis of “cervical DJD” and “cervical radiculitis” and states that Beauvais was being referred to a spine surgeon to consider a possible fusion of her cervical vertebrae. (AR 306). The Functional Capacities Form expressed Dr. Khaund’s opinion that Beauvais had only 1/3 normal capacity to perform a number of daily activities. (AR 307). Both the Restrictions Form and the Functional Capacities Form also refer to the December 2002 MRI which Dr. Khaund states revealed “degenerative changes.”

On May 12, 2003, Dr. Khaund submitted another Restrictions Form to Liberty together with his office notes from a May 2, 2003 visit. Once again, he stated that Beauvais could not sit for any amount of time or return to work. In fact, Dr. Khaund expressed skepticism as to whether Beauvais ever would be able to return to work, given the severity of the arthritis in her neck. (AR 296). A few weeks later, Beauvais saw Dr. Mallozzi, her primary care physician, complaining of vertigo and depression. (AR 232).

On June 11, 2003, Dr. Khaund saw Be-auvais again and recommended that she remain out of work for another eight weeks. Accordingly, Beauvais asked Liberty to extend the short term disability benefits she had been receiving. Liberty responded by requesting Dr. Khaund’s June 11, 2003 office notes, as well as another Restriction Form and it arranged for surveillance of Beauvais. 3

*27 The June 11, 2003 office notes provided by Dr. Khaund describe Beauvais’s complaints of intermittent numbness or tingling in her upper extremities. They also state that Beauvais had tried but was unable to work on her computer while wearing a collar because the collar was uncomfortable and that she had been seen by a rheumatologist as well as Dr. Mallozzi.

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

Related

Rhode Island Carpenters Annuity Fund v. Trevi Icos Corp.
533 F. Supp. 2d 246 (D. Rhode Island, 2008)
Curran v. Camden National Corp.
497 F. Supp. 2d 18 (D. Maine, 2007)
Desrosiers v. HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY
456 F. Supp. 2d 325 (D. Rhode Island, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
418 F. Supp. 2d 22, 2006 U.S. Dist. LEXIS 9574, 2006 WL 563338, Counsel Stack Legal Research, https://law.counselstack.com/opinion/beauvais-v-citizens-financial-group-inc-rid-2006.