Goodwin v. Liberty Life

2014 DNH 047
CourtDistrict Court, D. New Hampshire
DecidedMarch 4, 2014
Docket12-CV-414-JD
StatusPublished
Cited by1 cases

This text of 2014 DNH 047 (Goodwin v. Liberty Life) is published on Counsel Stack Legal Research, covering District Court, D. New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Goodwin v. Liberty Life, 2014 DNH 047 (D.N.H. 2014).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Wendy Goodwin v. Civil No. 12-cv-414-JD Liberty Life Assurance Co. Opinion No. 2014 DNH 047 of Boston d/b/a Liberty Mutual Group, Inc.

O R D E R

Wendy Goodwin brought suit under the Employee Retirement

Income Security Act ("ERISA"), 29 U.S.C. § 1001 et seq., seeking

to overturn the decision of Liberty Life Assurance Co. of Boston

("Liberty") to terminate her long term disability ("LTD")

benefits. The parties have both moved for judgment on the

administrative record. SeeL.R. 9.4(c).

Standard of Review

The standard of review in an ERISA case differs from that in

an ordinary civil case, where summary judgment is designed to screen out cases that raise no trialworthy issues. See, e.g.,

Orndorf v. Paul Revere Life Ins. Co., 404 F.3d 510, 517 (1st Cir.

2005). "In the ERISA context, summary judgment is merely a

vehicle for deciding the case," in lieu of a trial. Bard v.

Boston Shipping Ass'n, 471 F.3d 229, 235 (1st Cir. 2006). Rather

than consider affidavits and other evidence submitted by the

parties, the court reviews the denial of ERISA benefits based

"solely on the administrative record," and neither party is

entitled to factual inferences in its favor. IcL Thus, "in a very real sense, the district court sits more as an appellate tribunal than as a trial court" in deciding whether to uphold the administrative decision. Leahy v. Raytheon Co., 315 F.3d 11, 18 (1st Cir. 2002) .

Background1

Wendy Goodwin was employed by The Timberland Company

("Timberland") as a customer fulfillment database administrator, a sedentary job, since 1987. As a Timberland employee, Goodwin

was eligible for and participated in the company's long-term

disability insurance plan ("Plan"), offered through Liberty.

To receive benefits under the Plan, an employee must be

certified as disabled by Liberty. The Plan defines a disabled

employee as one who "as a result of Injury or Sickness, is unable

to perform the Material and Substantial Duties of . . . [the

employee's] occupation that [she] was performing when [her]

Disability . . . began."

On January 23, 2006, Goodwin had a CT scan of her abdomen and pelvis because of stomach pain. Following the scan, Goodwin

was examined by Dr. Peter Carter on two occasions in early

February of 2006. On or about February 15, 2006, Dr. Carter

performed surgery on Goodwin to repair a ventral incisional

^he parties' joint statement of material facts does not comply with Local Rule 9.4(b). The court will consider the parties' motions in the interest of avoiding unnecessary delay.

2 hernia.2 At a follow-up appointment on March 8, 2006, Dr. Carter

prescribed Ciprofloxacin, an antibiotic, because Goodwin appeared

to have a possible infection at the incision site. He also

prescribed pain medication.

Goodwin saw Dr. Carter on March 24 and April 7, 2006.

During the March 24 appointment. Dr. Carter noted that the

antibiotic was helping to treat the infection. During the April

7 appointment. Dr. Carter noted that the incision had healed adeguately, but that Goodwin had a "mild keloid formation" and a

"moderate amount of discomfort." Dr. Carter advised Goodwin to

return to work but to remain on "light duty for this next

month."3

Goodwin saw Dr. Carter again on May 3, 2006. Dr. Carter

noted that Goodwin continued to have discomfort, mostly while

sitting, in the area of the incision. He ordered an ultrasound

of Goodwin's stomach and a pain consultation.

Goodwin saw Dr. Christopher Delorie for the pain

consultation on May 10, 2006. Dr. Delorie noted that the "area along the scar seems boggy and inflammed [sic]." He prescribed

Tramadol for Goodwin's pain. Dr. Delorie also noted that the

"next option would be . . . infiltration of the scar and deeper

tissues with local and steroid."

2Goodwin also told Dr. Carter that she had surgery in 2004 to repair an umbilical hernia.

3It is unclear whether Goodwin returned to work at that point or at any point prior to early October of 2006.

3 Goodwin saw Dr. Carter on May 17, 2006, to discuss the

results of the ultrasound. According to Dr. Carter, the

ultrasound showed a "collection of fluid" in Goodwin's abdomen.

Dr. Carter prescribed codeine for Goodwin, and referred her back

to Dr. Delorie for "some injections to soften up the scar

tissue." Goodwin saw Dr. Delorie on May 23, 2006, and received a

nerve block injection to ease her pain.

On May 31, 2006, Goodwin saw Dr. William Gilbert of Kittery

Family Practice. Dr. Goodwin wrote Goodwin prescriptions for two

pain medications: Gabapentin and Darvocet (also known as

propoxyphene napsylate). Over the next several months, Goodwin

received and filled renewed prescriptions for these medications

from Dr. Gilbert.

Goodwin saw Dr. Carter on July 18, 2006. Dr. Carter did not

think that Goodwin's pain was being caused by the collection of

fluid shown on the ultrasound. He thought Goodwin may be having

a reaction to the suture used to close the incision from her

previous operation. On August 8, 2006, Goodwin underwent a

"[d]ebridement of scar tissue, excision of Prolene suture, evacuation of seroma . . . . [and] repair of small incisional

hernia."

Goodwin saw Dr. Carter on August 24, 2006, to examine her

for a "possible wound infection" after her August 8 procedure.

Dr. Carter thought that Goodwin was having a "superficial

reaction to the suture material" and noted that he was "at a loss

4 as to why [Goodwin] has so much discomfort." Dr. Carter

prescribed Darvocet for Goodwin's pain.

Goodwin saw Dr. Carter again on September 7, 2006. Dr.

Carter noted that he had never had a "patient with this much

chronic pain for the entire duration of my career, so I am

perplexed regarding what could be contributing to her

discomfort." Dr. Carter also expressed concern "about the amount

of Darvocet and Tylenol [Goodwin] has been taking." Dr. Carter

wrote Goodwin a prescription for Tramadol.

Goodwin next saw Dr. Carter on September 28, 2006. Dr.

Carter encouraged Goodwin to return to work. He directed her to

see him again in one month, at which point "the inflammation

should subside, and she should feel better." He also wrote her a

prescription for Hydrocodone, a pain medication. It does not

appear that Goodwin saw Dr. Carter the following month or at any

point after the September 28 appointment.

Goodwin returned to work in early October 2006. Around this

time. Dr. Gilbert wrote Goodwin prescriptions for two pain

medications: Cymbalta (also known as Duloxetine) and Lidoderm patches. Goodwin also reguested, and apparently received, a new

prescription for Darvocet from Dr. Frederick Thaler of Kittery

Family Practice. Goodwin stopped going to work in late October

or early November 2006.

Shortly after Goodwin stopped going to work, she completed a

Disability Claim Form for LTD benefits. On the form, she

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