Chandler v. Raytheon Employees Disability Trust

53 F. Supp. 2d 84, 1999 U.S. Dist. LEXIS 9284, 1999 WL 412359
CourtDistrict Court, D. Massachusetts
DecidedJune 11, 1999
DocketCiv.A. 97-11383-PBS
StatusPublished
Cited by10 cases

This text of 53 F. Supp. 2d 84 (Chandler v. Raytheon Employees Disability Trust) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chandler v. Raytheon Employees Disability Trust, 53 F. Supp. 2d 84, 1999 U.S. Dist. LEXIS 9284, 1999 WL 412359 (D. Mass. 1999).

Opinion

MEMORANDUM ORDER

SARIS, District Judge.

INTRODUCTION

This action arises out of a dispute between plaintiff Elaine Chandler and defendants Raytheon Employees Disability *85 Trust (the “Trust”) and Metropolitan Life Insurance Company (“MetLife”) regarding Chandler’s eligibility to receive long-term disability benefits. Chandler brings suit pursuant to the Employee Retirement Income Security Act of 1974 (“ERISA”), § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B), to challenge the defendants’ decision that she is not “totally disabled” under the terms of the Raytheon Company Long Term Disability Plan (the “Plan”). The parties have filed cross-motions for summary judgment. After hearing, the plaintiffs motion for summary judgment is DENIED. The defendants’ motion is ALLOWED.

I. BACKGROUND

The Court treats the following facts as undisputed unless otherwise noted. 1

A. The Plan

The Raytheon Company Long Term Disability Plan is an “employee welfare benefit plan” as defined by ERISA. The purpose of the Plan is to provide participating Raytheon employees with long-term disability benefits in the event of full or total disability. The Plan is funded solely through the contributions of participating employees who pay into the Trust. Decisions on all claims for benefits are made by MetLife, the claims administrator. The Plan states:

The Plan Administrator and, with respect to claims administration, the Claims Administrator, shall have the exclusive right, in their sole discretion, to interpret the Plan and decide all matters arising thereunder, including the right to remedy possible ambiguities, inconsistencies, or omissions. All determinations of the Plan Administrator and Claims Administrator with respect to any matter within their assigned responsibilities hereunder shall be conclusive and binding on all persons unless it can be shown that the interpretation or determination was arbitrary and capricious.

(R. at 017.) The Plan further states:

The Claims Administrator is the fiduciary to whom the Plan grants full discretion, with the advice of counsel, to interpret the Plan; to determine whether a claimant is eligible for benefits; to decide the amount, form and timing of benefits; and to resolve any other matter under the Plan which is raised by a claimant or identified by the Claims Administrator. Ml questions arising from or in connection with the provisions of the Plan and its administration, not herein provided to be determined by the Board of Directors, shall be determined by the Claims Administrator, and any determination so made shall be conclusive and binding upon all persons affected thereby.

(R. at 020.) Participating employees are provided with a summary plan description that summarizes the Plan’s benefits.

The Plan has two phases of long-term disability benefits: the “Primary Benefit Period” (first phase) and the “Secondary Benefit Period” (second phase). Under the first phase, an eligible participant is entitled to full disability benefits if he or she “cannot perform the essential elements and substantially all of the duties of his or her job at Raytheon even with a reasonable accommodation.” (R. at 004.) Under the second phase, an eligible participant is entitled to total disability benefits if he or she “cannot do the essential elements and substantially all of the duties of his or her job at Raytheon even with reasonable ac *86 commodations; and cannot do any other job for which he or she is fit by education, training or experience.” (R. at 006.) An employee may receive full disability benefits for the first two years of disability, at the end of which payments terminate unless the employee qualifies for total disability benefits.

B. Primary Benefit Period

Elaine Chandler, currently sixty years old, was employed at the Raytheon Corporation’s Lowell facility from 1974 until April 12, 1993. While at Raytheon, Chandler worked in various jobs, the last of which was a missile test operator. Chandler has a high school education, with additional training as a dental assistant. In May of 1993, Chandler submitted a claim for long-term disability benefits, asserting that she suffered from acute back pain and an arthritic condition. On May 27, 1993, at the direction of MetLife, Chandler obtained an independent medical exam (“IME”) from Dr. Philip Salib, an orthopedic surgeon. Dr. Salib determined that the pain in Chandler’s lower back and right knee were essentially due to osteo-arthritic changes in both regions without nerve root irritation or a disc problem. He also determined that Chandler suffered from extreme obesity. Dr. Salib concluded that Chandler could do any kind of light work that did not require repeated bending over or lifting more than twenty pounds at a time. He told Chandler to avoid long periods of walking and stairs. Because Raytheon could not reasonably accommodate these restrictions, MetLife determined that Chandler was fully disabled and therefore entitled to long-term disability benefits in accordance with the Plan’s first phase. Payments to Chandler commenced on July 22,1993.

On December 14, 1993, at the direction of MetLife, a second IME was conducted by Dr. James F. Kiely, an orthopedic surgeon. After the exam and a review of Chandler’s medical information, Dr. Kiely found that Chandler could do light duty if it allowed for frequent changes in position with a minimum of walking and standing. Dr. Kiely concluded that Chandler was not able to lift anything over fifteen pounds and could not climb stairs or do any bending. Because Chandler still could not perform her job at Raytheon, even with reasonable accommodations, her long-term disability benefits continued.

C. Secondary Benefit Period

In order for benefits to continue after July 21, 1995, Chandler was required to show that she was “totally disabled” and that she could not do any job for which she was fit by education, training, or experience. On July 13, 1995, just before this more stringent definition was triggered, Chandler was once again examined by Dr. Salib at the direction of MetLife. For this examination, MetLife provided Dr. Salib with Chandler’s medical information, a summary of her education, training, and experience, and a description of Chandler’s job. After reviewing her records and conducting the examination, Dr. Salib concluded that Chandler could “do any kind of work that does not require lifting more than 30 pounds at a time or repeated bending over,” could “sit, stand or walk within short distances while at work,” and had “been able to drive distances that corresponded with those between her residence and work.” (R. at 244.)

MetLife then referred Chandler’s claim file to a vocational assessor for a determination whether Chandler had transferrable skills that would qualify her for other occupations based on her education, training, experience, and residual functional abilities. For this assessment, the vocational assessor was provided with Chandler’s medical information, work history, and education.

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Bluebook (online)
53 F. Supp. 2d 84, 1999 U.S. Dist. LEXIS 9284, 1999 WL 412359, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chandler-v-raytheon-employees-disability-trust-mad-1999.