Chaffin v. NiSource, Inc.

703 F. Supp. 2d 579, 2010 U.S. Dist. LEXIS 27411, 2010 WL 1253459
CourtDistrict Court, S.D. West Virginia
DecidedMarch 23, 2010
DocketCivil Action 3:08-0870
StatusPublished
Cited by1 cases

This text of 703 F. Supp. 2d 579 (Chaffin v. NiSource, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. West Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chaffin v. NiSource, Inc., 703 F. Supp. 2d 579, 2010 U.S. Dist. LEXIS 27411, 2010 WL 1253459 (S.D.W. Va. 2010).

Opinion

MEMORANDUM OPINION AND ORDER

ROBERT C. CHAMBERS, District Judge.

Pending before the Court are cross-motions for summary judgment filed on behalf of Plaintiff Rhonella Chaffin, Defendant NiSource Inc. d/b/a Columbia Gas Transmission Company, and NiSource Long-Term Disability Plan (hereinafter collectively referred to as NiSource), and Defendant The Prudential Insurance Company of America (hereinafter Prudential). For the following reasons, the Court rules: (1) Plaintiffs Motion for Summary Judgment on Count 1 is DENIED, but her alternative request to remand the benefit issue raised in Count 1 is GRANTED [Doc. No. 45]; (2) Plaintiffs Motion for Summary Judgment on Count 2 is DENIED as to Prudential, but GRANTED as to NiSource [Doc. No. 45]; (3) NiSource’s Motion for Summary Judgment on Count 1 is GRANTED, but DENIED as to Count 2 [Doc. No. 42]; and (4) Prudential’s Motion for Summary Judgment is DENIED as to Count 1, but GRANTED as to Count 2 [Doc. No. 40], The Court REMANDS the issue of benefits to Prudential for further consideration.

Plaintiff filed this action under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. §§ 1001-1461. In her Complaint, she alleges two causes of action. Plaintiff first alleges that she was wrongfully denied long-term disability benefits. Second, she claims that Defendants failed to provide her a copy of the Plan and the complete Administrative Record. Defendants assert both claims are without merit.

I.

BENEFITS CLAIM

Initially, the Court recognizes that Ni-Source and Prudential assert different reasons why they are entitled to summary judgment with respect to Plaintiffs claim for benefits. Prudential argues it is entitled to summary judgment upon the merits of Plaintiffs claim. On the other hand, NiSource asserts that it is an improper party with respect to this claim because it is undisputed that Prudential is vested with discretionary authority to administer claims. Citing Elie G. Ghattas Trust v. UnumProvident Life Ins., No. 1:03CV1614A (JCC), 2004 WL 2709715 (E.D.Va. Oct. 5, 2004) (stating “a claimant’s employer is not a proper defendant if the employer exercised no control over the administration of the plan, even if the employer was listed as plan administrator in the summary of benefits”); Williams v. UNUM Life Ins. Co. of Am., 250 F.Supp.2d 641, 645 (E.D.Va.2003) (finding where the employer “had delegated to ... [the insurer] responsibility for administering its short-term disability benefit plan[,]” the insurer is “a proper defendant”). 1 As *583 it appears that Prudential, rather than Ni-Source, is the proper defendant with respect to Plaintiffs claim for benefits in Count 1, the Court GRANTS NiSource’s Motion for Summary Judgment with respect to Count 1. For the reasons that follow, the Court DENIES Prudential’s Motion for Summary Judgment with respect to this Count, DENIES the like motion by Plaintiff, but GRANTS Plaintiffs alternative request that benefit issue be remanded for further consideration.

A.

Medical History

Plaintiff was employed by Columbia Gas Transmission Corporation, a division of Ni-Source, as a District Instrument Mechanic. On October 22, 2001, Plaintiff was involved in an automobile accident during the course of her employment. As a result of the accident, Plaintiff claims she sustained injuries to her shoulder, arm, and neck. Although Plaintiff was able to return to work immediately, she also began a course of regular treatment for her injuries.

On January 6, 2005, Plaintiff sustained a second on-the-job injury when she slipped on a wet rocky hillside and fell, striking her lower back against a rock and hitting her knee. The day after the accident, Plaintiff was seen by her family physician Marc A. Workman, M.D.’s assistant Jill Short who diagnosed her with low back pain, secondary to muscle strain and a contusion, and a knee sprain with contusion. Admin. R. at 260. X-rays taken of her knee and lumbar spine appeared normal. Id. at 268-71. Plaintiff was given an excuse to be off work for a week. Id. at 260. A week later, Plaintiff returned to Ms. Short complaining of considerable back pain and a grinding feeling in her knee. Examination revealed diffuse tenderness on palpation of the lumbar spine and tenderness over the lateral meniscus in her left knee. Id. at 261. She was ordered to remain off work, undergo an MRI of her spine, and was referred to physical therapy. Id. The MRI was negative.

At her next visit on January 27, 2005, Plaintiff continued to complain of back pain, but she said the pain in her knee was almost completely resolved. Id. at 262. She also reported that her shoulder was bothering her more since the fall. Dr. Workman directed Plaintiff to remain off work and continue with physical therapy. He also assessed her with chronic shoulder pain that should be followed up with Dr. Bolano. Id.

On February 11, 2005, Plaintiff was seen by one of Dr. Workman’s colleagues, Anna Patton, M.D., a family physician. At that visit, Plaintiff said she was having back pain and sharp stabbing pain in her knee. Dr. Patton recommended additional physical therapy and gave her an excuse to take an additional twelve weeks off from work. Id. at 263. Following several sessions of physical therapy, Dr. Patton saw Plaintiff again on February 25, 2005. Upon examination, Dr. Patton noted crepitation under Plaintiffs patella, tenderness along the medial aspect of her knee, and generalized tenderness to palpation at the SI joint in her back. Dr. Patton recommended she continue with physical therapy, but Dr. Patton did not feel she was ready for a work conditioning program. Id. at 264.

Plaintiff saw Dr. Patton again on March 15, 2005, and continued to complain of pain along the medial aspect of her knee. Id. at 266. Dr. Patton did not find edema or calf tenderness, but did note tenderness along the medial aspect and generalized tenderness to palpation at the SI joint in Plaintiffs back. Id. Dr. Patton recom *584 mended progression to a work conditioning program. Id.

On March 31, 2005, Plaintiff saw Dr. Workman. At that time, she told him that she had a lot of shoulder pain. Id. at 357. She also said her back pain was limiting her activities and she was having difficulty walking or working at home. Dr. Workman found no pretibial pitting edema and said Plaintiffs straight leg raise was negative. However, he said she did have diffuse tenderness along her lower lumbosacral region and a limited range of motion in her shoulder, especially with abduction. Id.

On May 9, 2005, Plaintiff had another MRI of her knee. Id. at 317-18. On May 11, 2005, Dr. Patton telephoned Plaintiff and explained that the MRI showed degenerative changes, but no evidence of a meniseal tear. Id. at 310. However, it did show a collection of cysts. Dr.

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Bluebook (online)
703 F. Supp. 2d 579, 2010 U.S. Dist. LEXIS 27411, 2010 WL 1253459, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chaffin-v-nisource-inc-wvsd-2010.