Husted v. Ford Motor Co.

847 F. Supp. 2d 1007, 2012 WL 203387, 2012 U.S. Dist. LEXIS 7988
CourtDistrict Court, S.D. Ohio
DecidedJanuary 24, 2012
DocketCase No. 1:11-cv-56
StatusPublished

This text of 847 F. Supp. 2d 1007 (Husted v. Ford Motor Co.) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Husted v. Ford Motor Co., 847 F. Supp. 2d 1007, 2012 WL 203387, 2012 U.S. Dist. LEXIS 7988 (S.D. Ohio 2012).

Opinion

DECISION AND ENTRY: (1) DENYING PLAINTIFF’S MOTION TO REVERSE THE ADMINISTRATIVE DECISION (Doc. 25); (2) GRANTING DEFENDANTS’ MOTION FOR JUDGMENT ON THE ADMINISTRATIVE RECORD (Doc. 37); AND (3) TERMINATING THIS CASE FROM THE DOCKET

TIMOTHY S. BLACK, District Judge.

This civil case is before the Court on the parties’ cross motions for judgment: (1) Plaintiffs motion to reverse the administrative decision (Doc. 25); (2) Defendants’ motion for judgment as a matter of law on the administrative record (Doe. 37); and (3) the parties’ responsive memoranda (Docs. 38, 41, 45).

I. PROCEDURAL HISTORY AND BACKGROUND FACTS

Plaintiff George L. Husted, III, brought this action against Defendants Ford Motor Company and Ford Motor Company Salaried Disability Plan (the “Plan”) under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(1)(B).

Plaintiff was hired in 1989 by Ford, where he worked as a manufacturing engineer for almost twenty years. (Doc. 29 at 16, 158-159). Plaintiff requested disability leave in 2007 due to pain in his lower back, a condition for which he had received medical treatment for several years. (Id. at 158-159, 185). His last day of work was January 19, 2007. (Id. at 185).

On January 26, 2007, Plaintiff filed a disability claim with the Plan’s claims processor, UniCare, due to alleged chronic back pain. (Doc. 29 at 14). To be eligible for disability benefits, Section 3 of the Plan states that an employee must be “an active employee with a disability.” (Id. at 359). A “disability” is a condition that renders the employee “Disabled” as defined in Section 2.09 of the Plan. (Id. at 355). Section 2.09 provides:

“Disabled” shall refer to an Employee who is unable to work due to an accident, illness, or pregnancy-related condition. “Disabled” shall not include any Employee who is unable to work because of Elective Surgery. “Disabled” under Short-term Benefits shall refer to an Employee who is unable to do his/her [1009]*1009job or any comparable job at the Company. “Disabled” under Long-term Benefits shall refer to an Employee who is unable to engage in regular employment or occupation with the Company.

(Id.)

On February 15, 2007, Plaintiff underwent surgery — specifically, an anterior lumbar fusion, performed by Dr. Michael Kramer. (Doc. 29 at 186-188). The surgery did not remedy the underlying condition, and in the months after his surgery, he continued to experience pain in both his lower back and legs. (Id. at 16-19).

In June 2007, an independent medial examination performed by a neurosurgeon, Dr. Stephen Eichert, confirmed that Plaintiff was experiencing “persistent back and bilateral leg pain.” (Doc. 29 at 158-159). Noting that Plaintiff’s job as an engineer involved “some physical labor” and “prolonged standing and walking daily,” Dr. Eichert concluded that Plaintiff was not ready to return to work. (Id.)

Plaintiffs physicians did not recommend further surgery; instead they prescribed a variety of pain medications and assigned Plaintiff to a pain management specialist. (Doc. 29 at 16-19, 140, 143-144). The disappointing outcome of the surgery and the continuing pain Plaintiff experienced took a psychological toll on him, and he was also treated for depression during this time. (Id. at 124).

A. The Ford Plan Denies Plaintiffs Benefits

Upon verification of Plaintiffs condition, his application for disability benefits was initially approved from January 30, 2007 to September 21, 2007. (Doc. 29 at 479). On October 5, 2007, UniCare informed Plaintiff that he failed to provide medical documentation to support continuing his disability benefits beyond September 21, 2007. (Id. at 62). Plaintiffs payments were suspended pending receipt of the requested documentation. (Id. at 479). The Plan’s consideration of his appeal took six months, during which time he was without disability benefits. On April 2, 2008, Uni-Care advised Plaintiff that the Plan would reverse its earlier decision and his benefits would be reinstated. (Id. at 90).

Prior to the commencement of Plaintiffs restored disability benefits, UniCare received a tip that Plaintiff owned and was operating a business known as A & G Builders, Inc., and therefore suspected that Plaintiff was working outside of Ford while claiming disability benefits. (Doc. 29 at 458). When UniCare first learned that Plaintiff appeared to be working, it did not immediately terminate his benefits. Rather, UniCare notified Plaintiff that it was in receipt of additional information that required further investigation. (Id. at 241). UniCare informed Plaintiff that his disability benefit payments would be suspended pending the results of the investigation. (Id.) Plaintiffs benefits were never reinstated. Defendants advised Plaintiff, by letter dated June 12, 2008, that it would not reinstate his benefits on the basis that he purportedly was “engaged in employment outside the Company.” (Id. at 265-267).

As part of its investigation, UniCare hired private investigators to acquire additional information regarding Plaintiffs role with A & G Builders, Inc. and any other business entities. On April 22, 2008, the private investigators prepared a report for UniCare detailing the results of an assets check and database search. (Doc. 29 at 207-220). The database search revealed that Plaintiff appeared to be actively working for at least three business entities: A & G Builders, Inc., Bello Homes, LLC, and the New Richmond Ice House. (Id. at 219).

[1010]*1010 1. Owner and Operator of A & G Builders, Inc.

According to information posted on A & G Builders, Inc.’s website, as of May 2008, the company was an “award winning Custom Home Builder, General Contractor and Real Estate Developer owned and operated by Angie and George Husted.” (Doc. 29 at 272). On the website, Plaintiff made numerous representations regarding the work he performed for this company, including:

• Angie and George [Husted] work together with professionals to customize each and every aspect of your project.

• Angie and George are proud of their design and build process and will work with an architect from existing plans.

• We put in extra effort in the design stage to make sure all the details have been thought out before we ever lift a hammer.

• Angie and George are personally involved with each construction project they take on.

• One on One direct communications and emails are tools Angie and George use to give A & G Builders and their customers a strong competitive advantage.

• Angie and George will work with you and your family through the entire process.

(Id. at 272-273).

Additionally, the website cited Plaintiffs particular skills and experience to distinguish A & G Builders, Inc. from other real estate construction and development companies:

• George Husted was born into this business, following in his parent’s footsteps.

• The Husted family has worked in Real Estate, and General Construction for nearly 60 + years.

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Bluebook (online)
847 F. Supp. 2d 1007, 2012 WL 203387, 2012 U.S. Dist. LEXIS 7988, Counsel Stack Legal Research, https://law.counselstack.com/opinion/husted-v-ford-motor-co-ohsd-2012.