Murphy v. Deloitte & Touche Group Insurance Plan

619 F.3d 1151, 77 Fed. R. Serv. 3d 590, 49 Employee Benefits Cas. (BNA) 2345, 2010 U.S. App. LEXIS 18752, 2010 WL 3489673
CourtCourt of Appeals for the Tenth Circuit
DecidedSeptember 8, 2010
Docket09-2028
StatusPublished
Cited by126 cases

This text of 619 F.3d 1151 (Murphy v. Deloitte & Touche Group Insurance Plan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Murphy v. Deloitte & Touche Group Insurance Plan, 619 F.3d 1151, 77 Fed. R. Serv. 3d 590, 49 Employee Benefits Cas. (BNA) 2345, 2010 U.S. App. LEXIS 18752, 2010 WL 3489673 (10th Cir. 2010).

Opinion

EBEL, Circuit Judge.

Plaintiff-Appellant Aileen Murphy was a participant in the Deloitte & Touche Group Insurance Plan (“the Plan”), an insurance plan governed by the Employee Retirement Income Security Act (“ERISA”). Metropolitan Life Insurance Company (“MetLife”) both insured and administered the Plan; thus, it operated under an inherent dual role conflict of interest, see Weber v. GE Group Life Assurance Co., 541 F.3d 1002, 1011 (10th Cir.2008). While a participant in the Plan, Ms. Murphy filed a claim for long-term disability benefits, which MetLife ultimately denied.

Ms. Murphy then sought judicial review of MetLife’s decision pursuant to 29 U.S.C. § 1132(a)(1)(B) and all parties agreed to proceed before a magistrate judge. Soon after filing her action, Ms. Murphy moved for discovery regarding MetLife’s dual role conflict of interest. The magistrate judge denied Ms. Murphy’s discovery request because the conflict of interest was apparent on the face of the administrative record, which rendered discovery on that issue unnecessary. Then, upon receiving motions for summary judgment from both sides, the magistrate judge granted summary judgment in favor of the Plan and MetLife.

On appeal, Ms. Murphy challenges the magistrate judge’s denial of her discovery request and its grant of summary judgment for the defendants. Exercising jurisdiction pursuant to 28 U.S.C. § 1291, we VACATE the magistrate judge’s discovery and summary judgment orders and REMAND for further proceedings consistent with this opinion.

BACKGROUND

Ms. Murphy worked as a Tax Firm Director for Deloitte & Touche. Her position entailed travel, significant interaction and coordination with others, negotiations with the Internal Revenue Service and clients, advising clients on complex matters, preparation of proposals, and leading client meetings.

While at Deloitte & Touche, Ms. Murphy participated in the Plan, which was governed by ERISA and provided long-term disability benefits for plan participants. All parties agree that to receive long-term disability benefits Ms. Murphy had to satisfy the Plan’s definition of “Total Disability” or “Totally Disabled”:

[D]ue to an injury or Sickness, you:
1. are completely and continuously unable to perform each of the material duties of your regular job; and
2. require the regular care and attendance of a Doctor.
However, after the first 24 months of benefit payments, you must also be completely unable to perform the duties of any gainful work or service for which you are reasonably qualified taking into consideration your training, education, experience, and past earnings.

(ApltApp. v.2 at 152.) The Plan requires that the claimant furnish “[wjritten proof of a claim” that “describe[s] the event, the nature, and the extent of the cause for which a claim is made.” (Id. at 157.) To receive disability benefits, the furnished proof must “be satisfactory” to the Plan, and the Plan reserves the right to have the claimant examined by doctors of its choice. (Id.)

In August 2006, Ms. Murphy first submitted a claim for long-term disability ben *1155 efits under the Plan. Her primary care physician, Dr. Frances Chavez, provided Ms. Murphy with two letters supporting her disability claim. In a June 2006 letter, Dr. Chavez diagnosed Ms. Murphy with “ataxic gait” and “blurred vision” and described her symptoms to include “loss of balance, parasthesias, difficulty with speech, malaise, memory loss, [and] blurry vision.” (Id. at 344.) Dr. Chavez also described Ms. Murphy as “unable to communicate clearly” and struggling to recall and focus with numbers. (Id.)

In a subsequent letter dated August 2006, Dr. Chavez revised her diagnosis, but explicitly restated her conclusion that Ms. Murphy could not perform any “aspect of [her] job duties.” (Id. at 393.) Dr. Chavez now diagnosed Ms. Murphy as suffering from “[l]umbar spinal stenosis” and “[m]emory [disturbance.” (Id. at 392.) She described her symptoms to include “back pain, leg pain, extreme fatigue, balance [and] vision problems” as well as memory problems, greatly diminished focus and attention, and adversely affected cognitive disabilities. (Id.) Dr. Chavez noted that she had prescribed Ms. Murphy Oxycontin and that her “back [and] leg pain [were] currently responding to [the] painkillers.” (Id. at 392-93.)

Ms. Murphy also submitted reports, letters, or notes from a psychiatrist, Dr. Mus-tafa Ziyalan, a neurologist, Dr. Elizabeth Lakind, and an orthopedic surgeon, Dr. Claude Gelinas. Dr. Ziyalan noted that Ms. Murphy had been hospitalized in 2005 for suicidal ideation and diagnosed with Major Depressive Disorder and Panic Disorder, but describes her depression as “recurrent, in full remission.” Id. at 391. Dr. Lakind explained that Ms. Murphy suffered from a “lumbar spine disease,” but that Ms. Murphy was “now on pain medications with good benefit.” Id. at 396. Dr. Lakind also noted that in June 2006 Ms. Murphy had undergone a cranial MRI, an EEG, and a Brain SPECT and each produced normal results, but a cervical MRI raised some concerns with her spinal discs. Finally, Dr. Gelinas also diagnosed Ms. Murphy as suffering from “[j]unetional stenosis and degenerative disc disease” in her spine, and he described her as suffering from antalgic gait that significantly limited her range of motion. (Id. at 407.)

Despite this information, MetLife denied Ms. Murphy’s claim in September 2006. It “found no clinical evidence to substantiate [the] restrictions and limitations” described by Dr. Chavez and “no objective clinical evidence or documentation to support [Ms. Murphy’s] subjective complaints.” (Id. at 349-50.) MetLife noted that Ms. Murphy informed it over the phone that Oxycontin controlled her pain, she no longer used a walker, and she had left her job because cognitive problems impaired her performance. MetLife further noted that Ms. Murphy’s EEG produced normal results, she declined to have surgery to address her back pain, and she failed to have follow-up tests to rule out an otologic cause as the source of some of her problems, which an Ear, Nose, and Throat specialist suggested as a possibility. Therefore, MetLife found “no medical documentation to substantiate restrictions and limitations or a level of impairment of such severity” that Ms. Murphy was “preclude[d] ... from performing [her] sedentary job.” (Id. at 350.)

Ms. Murphy appealed MetLife’s decision and supplemented the administrative record with a variety of information. Dr. Chavez provided additional information confirming Ms. Murphy’s disability, and she expanded her diagnosis to include ataxic gait, blurred vision, lumbar spinal stenosis, memory disturbance, Major Depressive Disorder, and Anxiety Disorder.

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Bluebook (online)
619 F.3d 1151, 77 Fed. R. Serv. 3d 590, 49 Employee Benefits Cas. (BNA) 2345, 2010 U.S. App. LEXIS 18752, 2010 WL 3489673, Counsel Stack Legal Research, https://law.counselstack.com/opinion/murphy-v-deloitte-touche-group-insurance-plan-ca10-2010.