Pikora v. Blue Cross & Blue Shield of Michigan

970 F. Supp. 591, 1997 U.S. Dist. LEXIS 6912, 1997 WL 399316
CourtDistrict Court, E.D. Michigan
DecidedMarch 31, 1997
Docket2:95-cv-71758
StatusPublished
Cited by3 cases

This text of 970 F. Supp. 591 (Pikora v. Blue Cross & Blue Shield of Michigan) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pikora v. Blue Cross & Blue Shield of Michigan, 970 F. Supp. 591, 1997 U.S. Dist. LEXIS 6912, 1997 WL 399316 (E.D. Mich. 1997).

Opinion

MEMORANDUM OPINION & ORDER RE PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT AND DEFENDANT’S MOTION FOR SUMMARY JUDGMENT

HOOD, District Judge..

I. FACTS

A. INTRODUCTION

This is an employment discrimination case. Plaintiff, Debra Pikora, is a 45 year-old woman who has suffered from migraine headaches since 1976. Stressful situations cause and aggravate her headaches. Treatment has not been successful. For the past several years, Ms. Pikora has also been diagnosed with major depression, a psychiatric disorder. The Plaintiff claims that this condition is casually linked to her migraines, and the level of stress she encountered in her employment with Defendant, Blue Cross and Blue Shield of Michigan.

The Plaintiff began working for the Defendant on either February 10, 1986 or July 23, 1988 (different facts suggest different dates). Plaintiff initially worked as an accounting supply clerk, a position she held for three years. She then applied for a position as a COB Processor II in Defendant’s Coordination of Benefits department. She assumed that position on September 30, 1989. Prior to her termination, she was a Customer Service Representative (CSR) at the National Service Center Department, a position which she assumed on March 16, 1991.

The National Customer Servicing Center (now known as the National Customer Operations Department), is one of seven customer service departments at the Metropolitan Service Center. The Defendant has quality and production standards for telephone CSR’s in all departments. Each telephone CSR is expected to:

1) handle at least 50 calls per day.
2) be plugged into the telephone system for and available to accept inbound telephone calls for 404 minutes during a work day. This includes time that the CSR is available on a call, in idle, or in wrap up. Failure to meet this standard may subject the CSR to discipline.
3) average only 45 seconds of wrap up time. Wrap time corresponds to the average time, in seconds, that it takes a CSR to make themselves available to receive another inbound call after they finish a call. During this 45 seconds between calls, a telephone CSR also is required to complete paperwork in the event it is necessary to forward a written inquiry to the written CSR station.
4) average on 350 seconds of talk time per telephone call. The 350 seconds include the amount of time a customer is kept on hold.
5) expected to meet a monthly standard of 97% accuracy on the calls processed. The accuracy component focuses on the information given to customers and the *593 level of service provided to a customer. Failure to meet this production standard can lead to the imposition of discipline on the employee.

Clearly, a large part of this job includes answering telephone calls. These calls originate from subscribers, providers, doctors and hospitals. It is also expected that a telephone CSR handle problems or complaints raised by customers. Sometimes these callers express irritation or anger.

The Plaintiff argues that several months after she assumed her position as a telephone CSR, she began having problems because of the stress caused by the excessive work on the telephones. She had frequent migraine headaches that caused her to be unable to do her job. Ms. Pikora states that this stress would cause the onset or exacerbation of a migraine. Sometimes she would have to lie down on a couch for a while, other times she would have to leave work early. Sometimes the severity of the headache would cause her to vomit.

Plaintiff’s Exhibit F indicates that, on February 9, 1993, the company’s doctor from the Detroit Industrial Clime recommended that the Plaintiff be excused from phone work when she is having headaches. However, the next day, the recommendation was changed to “may work without limitation” as Plaintiffs problem was “personal.” The Plaintiff alleges that this occurred as a result of the intervention of Defendant so that the company would not have to accommodate her disability.

The Plaintiff states that she requested a transfer to less stressful work, but that the Defendant either failed to follow through or denied her requests. Plaintiff claims she wanted to return to her old position as a COB Processor. The Defendant claims that the Plaintiff failed to follow proper procedure in seeking a transfer to a different position within the company. The Defendant states that the Plaintiff asked that she be transferred due to her headaches, not because of stress. Further, the Defendant states that she was advised by her supervisor, Theresa Collier, that she would have to apply for a position in another department pursuant to the collective bargaining agreement between the parties. In support of this procedure, the Defendant cites another employee, Susan Hicks, who wished to transfer out of her position as a CSR to one less stressful, and did so successfully by following company procedure.

On May 5, 1994, the Plaintiff went on Accident and Sickness (A & S) leave because of her migraines and the onset of major depression. Her psychological problems included thoughts of suicide. A & S leave is a program available to employees who have exhausted all of their available sick leave, and provides a benefit of 70% if base wages for a maximum of 26 weeks. The Plaintiff remained on A & S leave until October of 1994, when she was given permission by her doctor, Dr. Karen Rutkowski, to return to work on November 1, 1994 with medical restrictions. One of these restrictions was a directive that the Plaintiff not return to her current position in Customer Service. The Plaintiff took this letter to CoreSource, the third party administrator for the A & S program. It is the Defendant’s position that there were no jobs available that fit Plaintiff’s restrictions. The Plaintiff claims that there were numerous other available jobs that the Plaintiff was qualified to do. In fact, the Plaintiff argues that she performed well in her previous assignments before becoming a CSR.

It was at that time that the Defendant advised the Plaintiff that her only alternative was to apply for long term disability (LTD). Long term disability is a program administered by the National Employee Benefits Committee of the Blue Cross and Blue Shield Association which provides 60% of the employees’ monthly base salary beginning in January of the year that the employee goes on LTD, including primary social security benefits, if the employee is found to be disabled as defined by the plan. An employee is eligible to apply for LTD on the first day after the sixth month an employee is off work on an A & S leave. If the employee does not return to work after an A & S leave, that employees’ status is automatically switched to “pending LTD” status.

In order to apply for this program, the Plaintiff was required to apply for Social *594 Security. She was denied these benefits. The reason given was that there was a finding that the Plaintiff was able to work at Blue Cross and Blue Shield of Michigan with an accommodation.

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Cite This Page — Counsel Stack

Bluebook (online)
970 F. Supp. 591, 1997 U.S. Dist. LEXIS 6912, 1997 WL 399316, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pikora-v-blue-cross-blue-shield-of-michigan-mied-1997.