Molodetskiy v. Nortel Networks Short-Term & Long-Term Disability Plan

594 F. Supp. 2d 870, 2009 U.S. Dist. LEXIS 4034, 2009 WL 128363
CourtDistrict Court, M.D. Tennessee
DecidedJanuary 20, 2009
Docket3:07-1046
StatusPublished

This text of 594 F. Supp. 2d 870 (Molodetskiy v. Nortel Networks Short-Term & Long-Term Disability Plan) is published on Counsel Stack Legal Research, covering District Court, M.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Molodetskiy v. Nortel Networks Short-Term & Long-Term Disability Plan, 594 F. Supp. 2d 870, 2009 U.S. Dist. LEXIS 4034, 2009 WL 128363 (M.D. Tenn. 2009).

Opinion

MEMORANDUM

ROBERT L. ECHOLS, District Judge.

Plaintiff Pavel Molodetskiy brings this action under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132, seeking judicial review of the decision made by Defendant Nortel Networks Inc. Short-Term Disability Plan and Long-Term Disability Plan (“the Plan”) to terminate Plaintiffs long-term disability benefits. The Plan is self-funded by Nor-tel Networks, a Tennessee corporation, through an ERISA trust, but the Plan is administered by Prudential. Plaintiff filed a Motion for Judgment on the ERISA Record (Docket Entry No. 14), to which the Plan filed a response in opposition (Docket Entry No. 19), Plaintiff filed a reply (Docket Entry No. 23), and the Plan filed a surreply (Docket Entry No. 26). The Plan also filed its own Motion For Judgment On The Administrative Record (Docket Entry No. 16), to which Plaintiff filed a response in opposition (Docket Entry No. 18).

I. FACTS

Plaintiff is a Ukrainian-born California resident who has a college degree and lives with his parents. He began work with Nortel Networks, Inc. as a systems design engineer in March 2001. (AR 50, 344, 347.) Plaintiff was a member of a computer hardware diagnostic team and attended numerous meetings. (AR 130-132.) He worked at multiple computer workstations on a random schedule when time slots were available, including late evenings, early mornings and weekends. Plaintiff worked with manufacturing and hardware engineers at other locations, he trained manufacturing staff to use diagnostic software (mostly in Asia), and he worked with customers. He was required to sit or stand and type in often very uncomfortable positions. His job required him to work 40 to 50 hours a week and it involved overtime, stress, responsibility and teamwork. (AR 54.)

As a Nortel Networks employee, Plaintiff was covered under the company’s group disability plan. The Plan defined “disability” as follows:

You are entitled to benefits from the LTD Plan only if you are considered “Totally Disabled.” You are considered Totally Disabled initially when the Claims Administrator determines that *873 you are unable to perform the essential functions of your job and this finding is supported by documentation from your Physician. This means that you cannot perform the work you were normally performing at the time of your disability, with or without reasonable accommodations, due to the limitations resulting from your Illness or Injury....
The proof that your Physician submits must be written proof of objective clinical documentation (i.e., lab tests, x-rays, medical reports, etc.) of your Total Disability. The Claims Administrator will approve or deny your Claim for LTD benefits at its discretion. Independent Medical Evaluations (IMEs) may also be required (either additional physical examinations and medical testing or file reviews of existing medical records), at the Company’s expense, in order to arrive at this final determination. Your benefit will be denied if you do not provide such objective proof of your Claim within the required timeframe. During the first 18 months of a covered Total Disability (from the first day of STD), you will be considered unable to work if you cannot perform the work you were normally performing at the time of your disability, with or without reasonable accommodations, due to the limitations resulting from your Illness or Injury.
After the first 18 months of covered Total Disability (from the first day of STD), you will be considered unable to work if you are unable to perform any reasonable occupation. A “reasonable occupation” is any job you are or could become qualified to do with your education, training, or experience.
Disabilities due to an Illness or Injury that, as determined by the Claims Administrator, are primarily based on self-reported symptoms, have a limited pay period during your lifetime. The pay period limitations are at the discretion of the Claims Administrator. If objective medical and clinical evidence is not submitted or changes in the treatment plan or more aggressive treatment is not commenced within a reasonable period, the benefit will be terminated.

(AR 20.) The Plan also included a 24-month behavioral illness limitation and provided for a written appeal of a denial of short-term or long-term benefits within 180 days of the denial of the claim. The Plan permitted a claimant to provide additional information relevant to the claim. Further,

[a] full review of the information in the Claim file and any new information submitted to support the appeal will be conducted by the Prudential Appeals Review Unit. The Claim decision will be made by a member of the Prudential Claims Management Team. The Prudential Appeals Review Unit and Claims Management Team members are made up of individuals not involved in the initial benefit determination. This review will not give any deference to the initial benefit determination.

(AR 31.) If not satisfied with the outcome of the first-level appeal, the Plan permitted the claimant to request within sixty days a second-level appeal from the Employee Benefits Committee. (Id.)

During employment with Nortel Networks, Plaintiff suffered low back pain radiating into his legs. His medical treatment included epidural steroid injections, physical therapy, and referral to a pain clinic in 2002. (Id.) On November 4, 2003, when Plaintiff was 31 years old, he was again seen by his physiatrist, Dr. Millard, complaining of increasing low back pain radiating into the right leg and increasing arm pain extending into his fingers. (AR 133.) Plaintiff attributed his increased *874 pain to an automobile accident on August 12, 2003; Plaintiffs vehicle was struck from behind. (Id.) Plaintiff told Dr. Millard he had tried chiropractic treatments that seemed to help temporarily, but he had not had any physical therapy or an MRI. Clinical examination revealed decreased cervical lordosis. 1 Cervical forward flexion and extension and bilateral extension/rotation provoked neck pain. Neurological examination was normal in the bilateral upper extremeties, but Tinel sign was present over the ulnar nerve at the elbow, with reproduction of fourth and fifth digit paresthesias. 2 (AR 134.) Dr. Millard’s impression was C4 through C6 discogenic/mechanical pain; possible C7 radiculitis 3 ; ulnar neuritis 4 at the elbow, bilaterally. (Id.) Dr. Millard recommended an MRI of the cervical spine and a repeat MRI of the lumbar spine and started Plaintiff on physical therapy.

Plaintiff stopped working on November 13, 2003. Plaintiff attended physical therapy sessions until December 22, 2003, when he ended the sessions before treatment was completed. Plaintiff felt the treatments did not help him.

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Bluebook (online)
594 F. Supp. 2d 870, 2009 U.S. Dist. LEXIS 4034, 2009 WL 128363, Counsel Stack Legal Research, https://law.counselstack.com/opinion/molodetskiy-v-nortel-networks-short-term-long-term-disability-plan-tnmd-2009.