Conley v. Pitney Bowes, Inc.

978 F. Supp. 892, 1997 WL 580533
CourtDistrict Court, E.D. Missouri
DecidedOctober 6, 1997
Docket1:92CV25-DJS
StatusPublished
Cited by3 cases

This text of 978 F. Supp. 892 (Conley v. Pitney Bowes, Inc.) is published on Counsel Stack Legal Research, covering District Court, E.D. Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Conley v. Pitney Bowes, Inc., 978 F. Supp. 892, 1997 WL 580533 (E.D. Mo. 1997).

Opinion

978 F.Supp. 892 (1997)

Donald E. CONLEY, Plaintiff,
v.
PITNEY BOWES, INC., Pitney Bowes Long Term Disability Plan, George B. Harvey, Carmine F. Adimando, and Allan A. Crystal, as Trustees of Pitney Bowes Long Term Disability Plan, Defendants,
and
Pitney Bowes Group Life Insurance Plan, Pitney Bowes Retirement Plan, Pitney Bowes Major Medical Expense Plan and Pitney Bowes Dental Expense Plan, Defendant Parties-in-Interest.

No. 1:92CV25-DJS.

United States District Court, E.D. Missouri, Southeastern Division.

July 30, 1997.
Order Denying Stay October 6, 1997.

*893 S. Sheldon Weinhaus, Weinhaus and Dobson, St. Louis, MO, for Plaintiff.

Clark H. Cole, Keith A. Rabenberg, Armstrong and Teasdale, St. Louis, MO, for Defendants.

MEMORANDUM OPINION

STOHR, District Judge.

Plaintiff brings the instant action under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq. As indicated in its order of January 24, 1997, the Court construes the second amended complaint as asserting, in Count I, a claim for benefits under the defendant Long Term Disability Plan ("the Plan") pursuant to 29 U.S.C. § 1132(a)(1)(B), and in Count III, a claim of interference with protected rights pursuant to § 1140. The breach of fiduciary duty claim asserted in Count II has been dismissed for failure to state a claim upon which relief might be granted. See Order and Partial Dismissal dated January 24, 1997.

*894 The remaining claims were tried to the Court sitting without a jury on February 4, 5 and 6, 1997. Having considered the pleadings, the testimony of the witnesses, the documents in evidence, and the stipulations of the parties, and being fully advised in the premises, the Court here sets forth its findings of relevant fact and conclusions of law, in accordance with Fed.R.Civ.P. 52(a).

Findings of Fact

1. In September 1989, plaintiff lived in Poplar Bluff, Missouri, and worked for defendant Pitney Bowes, Inc. ("Pitney Bowes") as a customer service representative who sold and serviced business machines over a five-county area.

2. Plaintiff was then covered by the defendant Long Term Disability Plan, an ERISA-governed employee benefit plan sponsored and administered by Pitney Bowes.

3. At all times relevant to this action, the medical staff of the Disability Department which handled plaintiff's claim for disability benefits under the Plan consisted of a Dr. Julian Levine, Medical Director, and Jane Millar, a registered nurse.

4. Helene Gardner served as "Long Term Disability Administrator" or "LTD Administrator." The summary of Pitney Bowes' various employee benefit plans lists Pitney Bowes, Inc. as the plan administrator as that term is used in the Plan itself.

5. Dr. Levine and Ms. Millar reviewed medical information submitted pertinent to disability claims, and made initial determinations of eligibility for benefits, subject to appeal to the Employee Benefits Committee.

6. On September 26, 1989, while driving to a service call, plaintiff's automobile was rear-ended by another car.

7. Afterward plaintiff drove himself to a clinic or hospital in Poplar Bluff, where x-rays were taken and pain medication was given.

8. Plaintiff saw his personal physician, Dr. Elliott, several days after the accident on September 29, 1989. On that date, Dr. Elliott completed a Pitney Bowes form entitled "Attending Physician's Statement of Disability" indicating a diagnosis of back and cervical degenerative joint disease with acute strain, and that plaintiff was temporarily disabled for all types of work. Dr. Elliott ordered x-rays to be taken and referred plaintiff to physical therapy.

9. At a later visit, Dr. Elliott referred plaintiff to a neurosurgeon from Memphis, Tennessee, a Dr. Donahue.

10. Dr. Donahue deemed the results of an MRI (magnetic resonance imaging) not to explain or support the subjective symptoms reported by plaintiff, and ordered a myelogram, a more invasive test involving the injection of dye into the areas surrounding the spinal column. Plaintiff cancelled the myelogram, because he was unwilling to undertake the drive to and from Memphis and because in his past experience a myelogram had caused a severe headache.

11. Plaintiff's prior medical history included a spinal fusion in the mid-1970's and a laminectomy, from which plaintiff claims to have made a complete recovery.

12. Jan Thompson, a registered nurse employed by ConServCo, met with plaintiff and his wife on November 22, 1989, after plaintiff's workers' compensation file was referred to ConServCo, a disability and medical cost management service, by Travelers Insurance Company, Pitney Bowes' workers' compensation carrier.

13. Jane Millar of the Disability Department maintained regular contact with Jan Thompson at ConServCo, and thereby obtained medical reports and other information provided to Thompson. This information was relied upon by the Plan in making its determination that plaintiff was not totally disabled.

14. Unless otherwise noted herein, the medical information and reports described or referred to in these findings were part of the Disability Department file and were considered in the making of the Plan's determination of plaintiff's claim.

15. Thompson's report of the November 22, 1989 meeting notes that plaintiff's personal physician, Dr. Elliott, had referred plaintiff to Dr. Donahue, and that Dr. Donahue *895 had performed an MRI and recommended an outpatient myelogram, which plaintiff declined on the ground that he could not tolerate the 4½ hour return car trip from Memphis afterward.

16. Thompson's November 22, 1989 report also describes Dr. Elliott's treatment of plaintiff, including physical therapy, Anaprox, Vitamin B-6 and Vicodin as necessary for pain.

17. At that time, Thompson scheduled an appointment for plaintiff with a Dr. Adams on December 19, 1989, for a second opinion concerning plaintiff's injury and condition.

18. Upon Dr. Adams' recommendation, plaintiff did undergo a myelogram and CT scan, the results of which suggested to Dr. Adams as of January 5, 1990 that plaintiff might have a herniated disc or problems relating to scar tissue from his previous back surgery, and that surgery — decompression and discectomy — might ultimately be warranted if further physical therapy did not result in improvement.

19. At a later visit on January 29, 1990, Dr. Adams' recommended and discussed surgery with plaintiff.

20. Relative to his workers' compensation claim, ConServCo referred plaintiff to a neurologist, Daniel Phillips, M.D., for evaluation. Dr. Phillips' initial written report to ConServCo, dated February 26, 1990, indicated a largely normal examination and no objective medical findings consistent with plaintiff's reports of pain.

21. On March 8, 1990, after reviewing a myelogram and CT scan of plaintiff, Dr. Phillips noted a significant disc bulge, though not a herniated disc, and generally concurred with Dr. Adams' recommendation that surgery be considered, although he observed that the disc problem would not, account for all of plaintiff's complaints, such as urinary urgency, difficulty maintaining an erection, and interscapular symptoms.

22. Dr.

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