Copenhaver v. Baxter International, Inc.

CourtDistrict Court, D. Idaho
DecidedJuly 27, 2020
Docket1:19-cv-00079
StatusUnknown

This text of Copenhaver v. Baxter International, Inc. (Copenhaver v. Baxter International, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Idaho primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Copenhaver v. Baxter International, Inc., (D. Idaho 2020).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF IDAHO

ERIC J. COPENHAVER, an individual, Case No. 1:19-cv-00079-CWD Plaintiff, MEMORANDUM DECISION AND v. ORDER

BAXTER INTERNATIONAL, INC., a corporation, BAXTER HEALTHCARE CORPORATION, a company, LIBERTY LIFE ASSURANCE COMPANY OF BOSTON, a company, JOHN DOE I-X,,

Defendants.

INTRODUCTION The Court has before it cross-motions for summary judgment relating to Defendants’ discontinuation of short term disability benefit payments. Eric Copenhaver filed this action alleging a violation of Section 502 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1132, and a violation of the Americans with Disabilities Act, 42 U.S.C. § 12111. However, the motions are limited to the ERISA claim. Copenhaver seeks to recover short-term disability benefits, which Defendants refused to extend on the grounds Copenhaver no longer met the definition of disability within the meaning of the Baxter Short-Term Disability Plan. The Court heard oral argument on June 4, 2020, and took the matter under advisement. For the reasons explained below, the Court will grant Plaintiff’s Partial

Motion for Summary Judgment and deny Defendants’ Motion for Summary Judgment. BACKGROUND Copenhaver worked for Baxter International, Inc. (“Baxter”) in the position of Service Specialist. The position required Copenhaver to, among other duties, deliver and pick up products for kidney dialysis patients and dialysis clinics utilizing a Class B CDL vehicle. AR 138.1 According to the job description, the position required the ability to

drive a CDL vehicle, and the physical capability to hand carry stock. This involved heavy physical work with frequent lifting, and the ability to carry objects weighing 25-37 pounds or more on a repetitive basis, as follows: An average delivery consists of 30 cases, at 824 pounds. Each case is lifted from the floor of the truck, or stack, (possibly chest high), and placed on a hand truck, wheeled into a patient’s home, then lifted off the hand truck and placed on the floor, or lifted onto an existing stack. In a warehouse 15%. In truck driving 40%. In patients home making deliveries 45%. Hazards include…Pushing and pulling a hand truck loaded (total weight of 165-200 lbs). Some are deadlifts up stairs, into basements, attics, or into a garage. Often requires pulling out an aluminum ramp or liftgate from the truck. Manual lifting of cartons.

AR 138-139. The job requirements included also the ability to pass a physical agility test. AR 139.

1 The Administrative Record is filed at Docket 23, Exhibit A. Rather than docket numbers, the Court will refer to the administrative record page numbers. While at Baxter, Copenhaver participated in Baxter’s welfare benefit plan, which provided both short term and long term disability benefits administered as The Baxter

Short-Term Disability Plan (the STD Plan) and The Baxter Long-Term Disability Plan (the LTD Plan). AR 88 – 131.2 Baxter is the sponsor of both Plans. AR 128. Liberty Life Assurance Company (“Liberty”) is the Plan carrier and claims administrator. AR 129. The plan carrier makes decisions regarding a claimant’s eligibility for STD and LTD benefits. AR 102. Upon filing a claim under the STD Plan, the plan carrier reviews the claim, requests information that may be needed, and advises the employee claimant if the

claim for benefits is approved or denied. AR 118. The STD Plan is self-insured, meaning benefits are paid by Baxter from Baxter’s general assets. AR 102. The plan carrier (Liberty) insures the LTD Plan and makes all payments from the Plan, while Baxter pays premiums to the plan carrier for LTD coverage elected by its employees. AR 102. The STD Plan will pay benefits, up to 28 weeks, provided the employee continues

to meet the definition of total or partial disability. AR 95. The STD Plan defines disability as follows: To be considered disabled under the STD Plan because of an injury, illness, or pregnancy, you must: • be continuously unable to perform the substantial and material duties of your current job on a full time basis (your regular pre-disability work schedule); and • be under the regular care of a licensed physician (other than a family member or yourself, if you are a physician).

2 The Baxter Short-Term Disability Plan and The Baxter Long-Term Disability Plan are component parts of a larger plan whose official name is the Baxter International Inc. and Subsidiaries Welfare Benefit Plan for Active Employees (the “Welfare Benefit Plan”). AR 129. The Welfare Benefit Plan is subject to ERISA. AR 130. To be eligible for STD benefits, you must file a completed telephonic or internet claim. Your physician also must provide substantial objective medical information or clinical findings with your medical treatment to support the disabling condition.

AR 103. An injury is defined as “any accidental bodily injury that results (directly and independently of all other causes) in a disability.” AR 103. Additional provisions contained within the STD Plan inform the claimant that the plan will pay “benefits only if you are under the care of a licensed physician (other than a family member or yourself, if you are a physician). In addition, the plan carrier may require independent medical examinations or testing as evidence of your disability. The STD Plan may pay for the expense associated with these required examinations or testing.” AR 104. Coverage under the STD Plan ends the day the claimant no longer meets the eligibility criteria. AR 123. Benefits will also end if: You are no longer able to provide sufficient medical evidence of your disability; . . . . You refuse to follow your treatment plan or a rehabilitation program; . . . . You cease to be under the care of a licensed physician (other than a family member or yourself, if you are physician) . . . .

AR 105. On July 22, 2017, Copenhaver submitted a claim for short term disability benefits for chronic pain in his shoulders limiting his range of motion, and impairing his ability to lift and carry. AR 91, 407, 595. On July 26, 2017, Liberty acknowledged receipt of Copenhaver’s application. Thereafter, Liberty contacted Copenhaver’s physicians, and obtained information about Copenhaver’s medical condition and prognosis. AR 595.

Based upon the medical information received, Liberty approved Copenhaver’s request for STD benefits, and he began receiving benefits as of August 1, 2017. AR 132. Liberty extended benefits through December 4, 2017, at which time Liberty denied further extension of Copenhaver’s STD benefits on the grounds he no longer met the definition of disability under the terms of the Plan. AR 487, 397 - 400. Copenhaver appealed the termination of benefits decision on January 25, 2018, and on March 9, 2018, Liberty

affirmed its denial of continued benefits. AR 407 – 411. Copenhaver filed a second level appeal on June 21, 2018. AR 132. Baxter denied the appeal on September 20, 2018. AR 132 – 137. This suit followed. A. Copenhaver’s Medical Condition In granting STD benefits through December 4, 2017, Liberty relied upon medical

records obtained from Copenhaver’s treating providers. On August 29, 2017, Liberty approved benefits through September 30, 2017, “based upon your inability to perform your job.” AR 533. Liberty at that time had received treatment records from FNP Jeff Robbins of Primary Health; PA Cline; Dr. Strickland, a chiropractor; and Dr. Hessing, an orthopedist, which records are summarized below.

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