Caplan v. CNA Financial Corp.

544 F. Supp. 2d 984, 2008 U.S. Dist. LEXIS 28290, 2008 WL 928656
CourtDistrict Court, N.D. California
DecidedApril 4, 2008
DocketC 06-5865 CW
StatusPublished
Cited by23 cases

This text of 544 F. Supp. 2d 984 (Caplan v. CNA Financial Corp.) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Caplan v. CNA Financial Corp., 544 F. Supp. 2d 984, 2008 U.S. Dist. LEXIS 28290, 2008 WL 928656 (N.D. Cal. 2008).

Opinion

ORDER GRANTING IN PART PLAINTIFF’S MOTION FOR JUDGMENT AND GRANTING IN PART DEFENDANTS’ CROSS-MOTION FOR JUDGMENT

CLAUDIA WILKEN, District Judge.

Plaintiff David Caplan moves for judgment on his claims for long-term disability benefits and injunctive relief under the Employee Retirement Income Security Act (ERISA). Defendants Hartford Life Group Insurance Company (Hartford) and CNA Long-Term Disability Plan cross-move for judgment on these claims. 1 The matter was heard on March 13, 2008. Having considered oral argument and all of the materials submitted by the parties, the Court grants each party’s motion in part. In addition, Plaintiffs claim for long-term disability benefits is remanded in part to Hartford for further proceedings.

FINDINGS OF FACT

I. Plaintiffs Employment

Plaintiff began working as a vocational case manager for CNA Financial Corporation in late 1999 or early 2000. In this position, he managed the cases of workers’ compensation claimants, reviewing and monitoring their eligibility for vocational rehabilitation. His duties involved sending notices, generating forms, talking to claimants or their attorneys while taking notes, writing position statements for workers’ compensation hearings and attending those hearings, and evaluating the ergonomics of workers’ jobsites.

Plaintiff initially conducted field visits for approximately one and one-half days per week. He spent the rest of his time at his desk, usually for eight hours each day. In 2003, a reduction in available field work caused Plaintiff to start spending more time at the computer. Plaintiffs workload also increased. As a result, Plaintiff began spending eight to eleven hours per day at the computer.

II. Plaintiffs Injury

In 1988, before he began working for CNA, Plaintiff injured his lumbar spine while trying to move a 600-pound motor. His injury ended his career as an electrician, and he continues to experience chronic lower back pain today. In 1998 — also before he began working for CNA — Plaintiff injured the ulnar nerve in his right arm. This injury continues to prevent Plaintiff from writing for long periods of time.

In 2003, Plaintiff injured his cervical spine as a result of performing large amounts of computer work. His injury caused him to experience pain and muscle spasms in his shoulders and upper back. At the same time, he began experiencing problems with his hands due to constant keyboarding.

Plaintiff attempted to use voice recognition software in order to reduce the amount of time he spent keyboarding, but the software was incompatible with his need to speak with people while taking notes, and did not allow him to work effectively within the specific programs he used. Additionally, even with the reduced amount of keyboarding, Plaintiffs back, neck and shoulder pain prevented him *987 from being able to spend a full day sitting at the computer in a static posture.

Plaintiff attempted to perform his normal duties, working through his pain and taking prescription painkillers such as Vi-codin and Tramadol. Eventually, however, the pain became too severe for him to continue working without accommodations. In February, 2004, at the advice of his doctor, Plaintiff was limited to three hours of typing a day. His employer attempted to accommodate this restriction by assigning him to more field visits. However, there was not enough field work to keep Plaintiff occupied full-time, and his productivity declined. In February, 2005, Plaintiffs supervisor advised him that she was no longer able to accommodate the reduced number of hours Plaintiff was billing. In addition, Plaintiff’s doctor had recently advised him to restrict himself to three hours of work each day. CNA was not able to grant Plaintiffs request for such an accommodation. Accordingly, Plaintiff was terminated on or about March 1, 2005.

III. The STD and LTD Plans

CNA maintains both a short-term disability plan (the STD Plan) and a long-term disability plan (the LTD Plan) for its employees. The STD Plan is self-insured by CNA, and the LTD Plan is insured by Hartford. Hartford is the claims administrator for both plans.

The STD Plan provides benefits for up to twenty-six weeks for employees who are temporarily disabled. An employee is considered disabled if he or she is “continuously unable to perform the Material and Substantial duties of the covered your [sic] Regular Occupation” and is “not working for wages in any occupation for which the Employee is or becomes qualified by education, training or experience.” Hassel-man Dec. Ex. 88 at STDPLAN0081-82. Alternatively, an employee may be considered disabled if “an Injury or Sickness is causing physical or mental impairment to such a degree of severity that [he or she is] unable to earn more than 80% of [his or her] Monthly Earnings in any occupation for which [he or she is] qualified by education, training or experience.” Id. at STDPLAN0082.

The LTD Plan provides benefits in the event that an employee’s disability extends beyond the twenty-six-week period covered by the STD Plan. For the first twelve months of LTD benefits, the Plan applies a definition of disability identical to the definition in the STD Plan. After the first twelve months of LTD benefits, however, the Plan applies a different definition of disability. Under this definition, an employee must be “continuously unable to engage in any occupation for which [he or she is] or become[s] qualified by education, training or experience,” and must not be “working for wages in any occupation for which [he or she] become[s] qualified by education, training or experience.” Id. at STDPLAN0089. Thus, for the first twelve months of benefits, an employee must merely show that he or she is unable to perform the duties of his or her own occupation, whereas after the first twelve months of benefits, the employee must show that he or she is unable to perform the duties of any suitable occupation. In addition, as with the STD Plan, the LTD Plan also provides an alternative definition of disability. Under this alternative definition, benefits are available if “an Injury or Sickness is causing physical or mental impairment to such a degree of severity that [an employee is] unable to earn more than 80% of [his or her] Monthly Earnings in any occupation for which [he or she is] qualified by education, training or experience.” Id.

IV. Plaintiffs Claim for STD Benefits

Just prior to his termination on March 1, 2005, Plaintiff applied for STD benefits *988 under the Plan. 2 He provided medical documentation to support his claim. This documentation included an August, 2004 report written by Dr. Robert E. Markison, an examining physician. The report addressed the injury to Plaintiffs upper extremities. Dr. Markison found that Plaintiff exhibited abnormal hyperextension of the ring and little fingers in his right hand, which was the “product of cumulative trauma-associated volar plate laxity without sublaxation of joints.” Macko Dec. Ex. B at AR0587. As a result, Plaintiffs hand function was impaired. Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
544 F. Supp. 2d 984, 2008 U.S. Dist. LEXIS 28290, 2008 WL 928656, Counsel Stack Legal Research, https://law.counselstack.com/opinion/caplan-v-cna-financial-corp-cand-2008.