Graeber v. Hewlett Packard Co. Employee Benefits Organization Income Protection Plan

421 F. Supp. 2d 1246, 2006 U.S. Dist. LEXIS 16145, 2006 WL 709049
CourtDistrict Court, N.D. California
DecidedMarch 16, 2006
DocketC 05-01124 CRB
StatusPublished
Cited by3 cases

This text of 421 F. Supp. 2d 1246 (Graeber v. Hewlett Packard Co. Employee Benefits Organization Income Protection Plan) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Graeber v. Hewlett Packard Co. Employee Benefits Organization Income Protection Plan, 421 F. Supp. 2d 1246, 2006 U.S. Dist. LEXIS 16145, 2006 WL 709049 (N.D. Cal. 2006).

Opinion

MEMORANDUM AND ORDER

BREYER, District Judge.

This ERISA lawsuit challenges the termination of plaintiffs long-term disability benefits.

BACKGROUND

A. The ERISA Plan

This is a dispute about coverage under the Agilent Technologies, Inc. Disability Plan (“the Plan”). The Plan provides that

[t]he Company is the named fiduciary which has the discretionary authority to act with respect to any appeal from a denial of benefits. The Company’s discretionary authority includes the authority to determine eligibility for benefits and to construe the terms of the Plan. The Claims Administrator shall administer the review of denied claims on the Company’s behalf and make the decision on review.

Plan § 8(a), Administrative Record (“AR”) at 25. The Plan, in turn, gives the Claims Administrator discretion in reviewing denied claims:

*1249 [t]he Claims Administrator will make the decision on review in conformance with section 503 of ERISA and the regulations thereunder and procedures it has developed in the normal course of its business. The Claims Administrator shall have the discretionary power to construe the language of the Plan and make the decision on review on behalf of the Company.

Id. § 8(c)(iii), AR at 26.

The Plan provides benefits to Plan Members who become “Totally Disabled” as follows:

(I) During the first fifty-two (52) weeks following the onset of the injury or sickness, the Member is continually unable to perform each and every duty of his or her Usual Occupation; and
(ii) After the initial fifty-two (52) week period, the Member is continuously unable to perform any occupation for which he or she is or may become qualified by reason of his or her education, training or experience.

Id. § 2(s), AR at 8 (emphasis added). Thus, after one year of disability the Plan Member may receive benefits only if he cannot perform any occupation, not just his own occupation. Totally disabled includes disability resulting from a mental disorder only if the employee is confined to a hospital for a prolonged period of time. Id. § 2(s)(A), AR at 9. Benefits cease whenever the Claims Administrator determines that the employee is no longer Totally Disabled. Id. § 5(c)(1), AR at 15.

The Plan also provides for “Transitional Return to Work” during the first year (the first 52-week period). The Member may return to work at Agilent or one of its subsidiaries on a part-time basis and receive partial disability benefits provided the employee works at least 20 hours a week. Such work does not make the Member ineligible to receive benefits as “Totally Disabled,” but only for the first year. Id. § 2(m), (t), § 5(g), AR at 7, 11, 20.

B. The Administration of Plaintiff’s Claim

Plaintiff was an electrical engineer at Hewlett Packard and later Agilent (after Hewlett Packard created the Agilent spin off). On April 25, 2000, plaintiff applied for benefits under the Plan. He reported pain in his neck, arms, shoulder and wrists when using the computer. His physician, Dr. Dubinsky, diagnosed plaintiff with bra-chial neuritis, severe pain, and anxiety and depression due to chronic pain. Although plaintiff was working at the time, Dr. Du-binsky recommended that plaintiff not work for four weeks. The claims administrator' — Voluntary Plan Associates (“VPA”) — approved a four-week total disability leave.

Plaintiff returned to work briefly with accommodations; however, in September 2000 Dr. Dubinsky recommended that plaintiff stay home for one week “to rest up and calm his flare.” Soon thereafter she recommended that he be off work until December 1, 2000 because his work restrictions could not be accommodated. VPA approved his claim and the Plan paid him benefits. Dr. Dubinsky recommended that the leave be extended another four months, but also encouraged plaintiff to return to work; for example, she encouraged him to take a position Agilent had offered him that did not involve the use of his hands.

Plaintiff returned to work in early 2001 with accommodations, including working only six hours a day, four days a week. On March 19, 2001, he submitted a claim to the Plan for long-term disability benefits. He claimed brachial neuritis, severe pain, anxiety and depression due to chron *1250 ic pain, and the inability to set boundaries at work.

Plaintiffs eligibility for benefits for being disabled from his own occupation expired in April 2001; thus, in order to receive long-term disability benefits plaintiff had to be totally disabled from working in any occupation. VPA initially denied plaintiffs claim for benefits. Plaintiff appealed. As plaintiff was scheduled to have various surgeries to improve his carpal tunnel syndrome, VPA eventually approved his disability claim through March 1, 2002, to give him time to recover from his surgeries (this approval came after VPA stopped benefits on a couple of occasions). Plaintiff had surgery in May, August and October 2001.

Plaintiffs surgeon cleared plaintiff for return to work in January 2002, with no work restrictions. Dr. Dubinsky reported that plaintiff could return to work in March 2002, with certain restrictions, but in a January 2002 progress report she noted that returning to work in February “is within reach.” She noted further that “[a]t this point, the stumbling block seems to be returning Mr. Graeber to work when he is in significant pain from the drive there.” Dr. Dubinsky’s restrictions included a 5 to 10 minute break from sitting every hour, no computer use greater than 5 minutes at a time and only 15-20 minutes per hour, voice activation, ergonomic computer and equipment, and no more than 20 hours of work a week, seven hours at a time.

VPA had retained CorVel Corporation to review plaintiffs claim. In October 2001, CorVel determined that there were no occupations that plaintiff could perform, primarily due to his computer restrictions. CorVel based its finding on the restrictions and limitations set forth in Dr. Dubinsky’s Work Status Report/Back To Work Release dated December 12, 2000. In that report Dr. Dubinsky restricted plaintiff from using a computer for more than five minutes at a time, and not more than one hour total a day.

In February 2002, after plaintiff had had his surgeries, CorVel did another assessment. CorVel determined plaintiffs restrictions and limitations based on Dr. Du-binsky’s Work Status Report/Back To Work Release dated January 14, 2002. With respect to computer use, CorVel assumed that plaintiff should not use the computer more than five minutes at a time with a maximum of 15-20 minutes per hour. Plaintiffs required accommodations included “voice activation” and ergonomic keyboard, mouse and chair. AR 217. CorVel concluded that in light of the updated information, plaintiff could perform certain engineering positions. CorVel explained its changed recommendation as follows:

Given Mr.

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Related

Karen McClain v. Eaton Corp. Disability Plan
740 F.3d 1059 (Sixth Circuit, 2014)
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650 F. Supp. 2d 500 (W.D. Virginia, 2009)

Cite This Page — Counsel Stack

Bluebook (online)
421 F. Supp. 2d 1246, 2006 U.S. Dist. LEXIS 16145, 2006 WL 709049, Counsel Stack Legal Research, https://law.counselstack.com/opinion/graeber-v-hewlett-packard-co-employee-benefits-organization-income-cand-2006.