Hufford v. Harris Corp.

322 F. Supp. 2d 1345, 2004 U.S. Dist. LEXIS 11184, 2004 WL 1427010
CourtDistrict Court, M.D. Florida
DecidedMay 18, 2004
Docket6:02CV1025-ORL-28DAB
StatusPublished
Cited by24 cases

This text of 322 F. Supp. 2d 1345 (Hufford v. Harris Corp.) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hufford v. Harris Corp., 322 F. Supp. 2d 1345, 2004 U.S. Dist. LEXIS 11184, 2004 WL 1427010 (M.D. Fla. 2004).

Opinion

ORDER

ANTOON, District Judge.

Plaintiff Kathleen Fenn Hufford, a former employee of Defendant Harris Corporation (“Harris”), has sued Harris claiming that her long-term disability benefits under the Harris Long-Term Disability Plan (“LTD Plan”) were improperly terminated. Plaintiff claims that she is totally disabled and as a result is unable to perform the duties of any occupation. The parties agree that the LTD Plan is governed by the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq., and that Harris is the Plan Administrator. Both parties have filed motions for summary judgment, 1 and both have *1348 stipulated that these motions will be dis-positive of the case because there are no disputed issues of material fact. (Joint Trial Br., Doc. 36, at 1). Because Harris’s termination decision was not arbitrary and capricious, summary judgment will be granted in favor of Harris.

I. Background

The Harris LTD Plan is funded entirely from employee contributions. (Wyse Aff., Doc. 25 ¶ 15). Harris pays no contributions into the LTD Plan, and its general assets are not subject to assessment with respect to Plan liabilities. (Doc. 25 ¶ 15). In accordance with the LTD Plan, Harris delegated to Kemper National Services (“Kemper”) the responsibility for making initial claims determinations and deciding initial appeals. (Doc. 25 ¶ 4). However, Harris’s Corporate Benefits Administrative Committee (“Committee”) remained responsible for final decisions on final appeals. (Doc. 25 ¶¶ 3-4). The Committee is comprised entirely of Harris employees who are not compensated for their participation. (Doc. 25 ¶ 3).

Plaintiff, a senior security coordinator for Harris, was injured in an automobile accident in 1995. Her injuries included two herniated discs in her cervical spine for which she subsequently underwent surgery. Plaintiff continued to work after the accident until she quit on March 26, 1998. Claiming that she could no longer work because of chronic back, neck, and arm pain; headaches; and thinking and memory difficulties, Plaintiff applied for and began receiving benefits under the LTD Plan retroactive to her last day of work. These benefits were paid on the grounds that Plaintiff could not perform the duties of her own occupation- — -the “own occupation” standard under the LTD Plan.

Plaintiff continued to receive benefits until Kemper terminated Plaintiffs benefits on March 1, 1999, stating that the medical documentation Kemper had received did not substantiate Plaintiffs claim that she was totally disabled from performing her own occupation. (Kemper Admin. R., Ex. A to Doc. 26, at 73-74) [hereinafter Kemper Admin. R.]. Plaintiff appealed the termination, submitting a letter from her treating neurologist, Gary Weiss, M.D., which described Plaintiffs injuries, her restrictions, and his opinion that she was “permanently [and] totally disabled from all work and work related activities.” (Kemper Admin. R. 77, 81-82). Plaintiff also provided Kemper with an MRI read by radiologist Marc Shapiro, M.D., and medical records from Dr. Weiss; Earnest E. Seiler III, M.D., her treating psychiatrist; and Scott M. Kaplan, Psy.D., her clinical psychologist. (Kemper Admin. R. 83-146).

In response, Kemper requested a review by one of its independent medical consultants (also known as a peer review physician). (Kemper Admin. R. 149-51, 152-55). Based on that review, which found that Plaintiff was not disabled from performing her own occupation (Kemper Admin. R. 155), Kemper upheld its termination of benefits on May 5, 1999. (Kem-per Admin. R. 156-58). In denying the appeal Kemper noted that the medical documentation Plaintiff provided failed to support the opinion of Plaintiffs treating physicians that she was unable to return to her prior position. (Kemper Admin. R. 157).

After her first appeal was denied, Plaintiff filed a second appeal with Kemper including her own description of the pain she was experiencing as well as her im *1349 paired mental functioning. (Kemper Admin. R. 167-68). She also included a report from Dr. Kaplan, her treating psychologist. (Kemper Admin. R. 161-66). After obtaining another peer review, which concluded Plaintiff was disabled under the terms of the LTD Plan (Kemper Admin.. R. 179-82), in August 1999 Kemper reversed its earlier decision and reinstated Plaintiffs benefits retroactively to the date that they were initially terminated. (Kem-per Admin. R. 183-84).

After two years of receiving benefits for being unable to perform her own occupation, under the terms of the LTD Plan Plaintiff had to be unable to perform any occupation in order to be considered disabled and continue receiving benefits — -the “any occupation” standard. (1995 Summary Plan Descriptions, Ex. B to Doc. 25, at 49). As required by the Harris LTD Plan, Kemper conducted periodic reviews to determine whether Plaintiff continued to be disabled. During its 2001 review, Kemper considered a report from Plaintiffs treating orthopedic surgeon, Richard A. Hynes, M.D., which Kemper believed suggested that Plaintiff might not be disabled. Dr. Hynes’s May 31, 2001 report stated:

I do agree [Plaintiff] is at maximum medical improvement and feel she has a fifteen percent permanent impairment of the whole person based on American Medical Association Guides to the Evaluation of Permanent Impairment.
Her prognosis is good, and we would expect with time any residual symptoms she may have will stabilize and she will be able to manage on a home exercise program and over-the-counter medications.

(Kemper Admin. R. 200). Kemper also reviewed an August 2001 report from Plaintiffs treating psychiatrist, Dr. Seiler, which Kemper believed not to constitute evidence that Plaintiff suffered from a mental or cognitive disability. (Kemper Admin. R. 201A-205). Having received this information from Plaintiffs treating doctors, Kemper requested reviews by two of its independent medical consultants.

After review of the file, these medical professionals determined that available medical evidence did not support Plaintiffs claim that she continued to suffer from a disability. Lawrence Blumberg, M.D., an orthopedic surgeon, concluded in a September 20, 2001 review that there was nothing in Plaintiffs medical record to indicate that she continued to be unable to perform her prior job as a security guard. (Harris Admin. R., Ex. D to Doc. 25, at 391-92) [hereinafter Harris Admin. RJ. In addition, psychologist Lawrence Ber-stein, Ph.D., reported to Kemper in Octo-. ber 2001 that from a “psychological perspective” the documentation provided did “not contain objective evidence of impairments in functioning, which would prevent [Plaintiff] from performing useful work at this time.” (Harris Admin. R. 393-94). After receiving these reports that Plaintiff was no longer disabled and reviewing Plaintiffs file, Kemper terminated Plaintiffs LTD benefit payments as of October 19, 2001. (Kemper Admin. R. 224-26).

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Bluebook (online)
322 F. Supp. 2d 1345, 2004 U.S. Dist. LEXIS 11184, 2004 WL 1427010, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hufford-v-harris-corp-flmd-2004.