Linda Salter v. Continental Casualty Co.

132 F. App'x 337
CourtCourt of Appeals for the Eleventh Circuit
DecidedMay 25, 2005
Docket04-16246; D.C. Docket 03-00221-CV-DF-5
StatusUnpublished

This text of 132 F. App'x 337 (Linda Salter v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Linda Salter v. Continental Casualty Co., 132 F. App'x 337 (11th Cir. 2005).

Opinion

PER CURIAM.

Plaintiff-appellant Linda Salter, a registered nurse who was seeking to recover *338 long term disability benefits under an insurance policy issued by Defendant-appellee Continental Casualty Company (“Continental”), appeals the district court’s grant of summary judgment in favor of Continental. Salter argues that summary judgment was improperly granted because she adduced sufficient evidence to raise a genuine issue of fact as to whether she was totally disabled as defined by the insurance policy. We AFFIRM.

I. BACKGROUND

As of 1996, Salter was employed as a nurse at Northside Hospital in Macon, Georgia. During the time of her employment, the hospital was owned by Quorum Health Group, Inc., which offered an employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”). The benefit plan, which Salter opted to join, included disability insurance in the event a worker became disabled and was unable to perform his or her job function. The disability insurance contained an initial “elimination period,” during which no benefits would be paid for 150 days following a worker’s disablement. If the worker remained disabled after the expiration of the elimination period, he or she could qualify to receive twenty-four months of benefit payments. To qualify for these payments, the worker had to demonstrate “total disability,” which, as defined by the policy, meant that the worker: (1) was “continuously unable to perform the substantial and material duties of [his or her] own occupation”; (2) was “under the regular care of a licensed physician”; and (3) was “not gainfully employed in any occupation for which [he or she was or became] qualified by education, training, or experience.” R2-55 at 3. The policy also provided for additional benefit payments after the expiration of the twenty-four month period. To qualify for these payments, the worker had to satisfy a stricter standard for “total disability,” namely that the worker: (1) was “continuously unable to engage in any occupation for which he [or she was or became] qualified by education, training, or experience”; and (2) was “under the care of a regular physician.” Id. at 4.

Salter became disabled on 24 September 1996 and was unable to perform her job functions due to back pain and loss of control of her legs. During the 150-day elimination period, Salter underwent surgery to correct certain cervical, thoracic, and lumbar disc protrusions which were causing the pain in her back and legs. Although the neurosurgeon who performed the surgery, Dr. Peter Holliday, indicated in December 1996 that Salter was recovering well from the surgery, he stated that Salter would not be able to return to work until at least June 1997. As a result, after the expiration of the elimination period, Salter began to receive benefit payments on 21 February 1997 because she was able to demonstrate that she was totally disabled as defined by the policy. She continued to receive disability payments based on the post-elimination-period definition of “total disability” until 20 February 1999.

After the expiration of the twenty-four month benefit period provided by the disability policy in February 1999, Continental continued to pay Salter disability benefits. On 29 April 1999, however, Holliday released an Attending Physician Statement (“APS”) in which he cleared Salter to perform light duty work. Holliday imposed the specific restrictions that Salter should alternate standing for one hour with sitting for one hour, should not lift more than twenty pounds, should not twist her lower back, and should not work with her arms above her shoulders. Based on Holliday’s APS, Continental sent a letter *339 to Salter that indicated she was capable of performing light duty work and, based on vocational assessment reports that had been previously compiled for Salter, suggested three job positions that Salter could fulfil. Moreover, based on the APS and the vocational assessments, Continental indicated that it would discontinue Salter’s disability payments on 20 May 1999. Salter appealed to Continental to have her benefits restored, but her appeals were unsuccessful. Accordingly, she filed suit in Georgia state court in June 2003 and alleged that she was wrongfully denied disability benefits. Continental subsequently removed the action to federal court.

Following discovery, both Continental and Salter moved for summary judgment, and the district court granted summary judgment in favor of Continental. In making its determination, the district court found that Holliday’s APS and the vocational assessments offered by Continental demonstrated that Salter was not “totally disabled” from performing any occupation as required for the receipt of benefits at this stage under the policy. Because Salter presented no evidence to raise a genuine issue of fact as to this conclusion, the district court found that summary judgment was warranted. On appeal, Salter argues that the district court erred because she had presented sufficient evidence to create a question of fact as to her disability. Particularly, she cites Continental’s payment of benefits beyond February 1999 and the strict limitations imposed by Holliday in his APS as evidence that she was totally disabled from performing any occupation. In addition, she faults the district court for relying on the vocational assessments because they lacked credibility.

II. DISCUSSION

We review de novo the district court’s grant of summary judgment in a case involving a claim for benefits governed by ERISA. See Williams v. BellSouth Telecomms., Inc., 373 F.3d 1132, 1138 (11th Cir.2004). In making this inquiry, “[w]e view all evidence and factual inferences reasonably drawn from the evidence in the light most favorable to the non-moving party.” See Burton v. Tampa Hous. Auth., 271 F.3d 1274, 1277 (11th Cir.2001). Summary judgment is appropriate “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Fed. R.Civ.P. 56(c); see Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 2553, 91 L.Ed.2d 265 (1986). Once the moving party has properly supported its motion for summary judgment, the burden shifts to the nonmoving party to come forward with specific facts showing that there is a genuine issue for trial. See Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 106 S.Ct. 1348, 1356, 89 L.Ed.2d 538 (1986) (citation omitted).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Connie Burton v. Tampa Housing Authority
271 F.3d 1274 (Eleventh Circuit, 2001)
William M. Shaw v. Connecticut General Life
353 F.3d 1276 (Eleventh Circuit, 2003)
Marcia Williams v. BellSouth Telecommunications
373 F.3d 1132 (Eleventh Circuit, 2004)

Cite This Page — Counsel Stack

Bluebook (online)
132 F. App'x 337, Counsel Stack Legal Research, https://law.counselstack.com/opinion/linda-salter-v-continental-casualty-co-ca11-2005.