Porter v. Smithkline Beecham Corp.

373 F. Supp. 2d 1306, 2005 U.S. Dist. LEXIS 17782, 2005 WL 1458031
CourtDistrict Court, M.D. Florida
DecidedMay 31, 2005
Docket8:04-cv-00403
StatusPublished

This text of 373 F. Supp. 2d 1306 (Porter v. Smithkline Beecham Corp.) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Porter v. Smithkline Beecham Corp., 373 F. Supp. 2d 1306, 2005 U.S. Dist. LEXIS 17782, 2005 WL 1458031 (M.D. Fla. 2005).

Opinion

ORDER

BUCKLEW, District Judge.

This cause comes before the Court on cross motions for summary judgment, Defendant SmithKline Beecham Corporation, d/b/a GlaxoSmithKline’s (“Defendant”) Motion for Summary Judgment (Doc. No. 30) and Rebecca Porter’s (“Plaintiff’) Motion for Summary Judgement. (Doc. No. 40). Plaintiff opposes Defendant’s motion. (Doc. No. 32). Defendant opposes Plaintiffs motion. (Doc. No. 45).

I. Background

On March 3, 2004, Plaintiff initiated this action pursuant to the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. (Doc. No. 1). Plaintiff seeks a judgment allowing her to recover long term disability benefits from May 31, 2001 to the date of the filing of this lawsuit, pre-judgment interest on each monthly payment from the date it became due until the date it is paid, attorney’s fees and costs incurred in this action, and a declaration that Plaintiffs same claim for benefits continues after the last date of benefits awarded by the Court without the need to file a new application. (Doc. No. 1 at 4-5).

Plaintiff worked for Defendant as a laboratory technician from December 18, 1978 until April 11, 1997. (R. 377). 1 Defendant offered all of its employees various benefits, including long term disability (“LTD”) benefits. The terms of the plan that applies to Plaintiff are contained in two parts, a Summary of the Plan Description dated December 1993 and an ERISA information Section dated May 1994. In accordance with the LTD plan, Defendant, as plan administrator, delegated to a third party the responsibility of being the claims administrator. The claims administrator was responsible for making the initial claims determinations and deciding the initial appeals. However, the plan stated that Defendant

reserves the absolute right to interpret the provisions of the ... welfare benefit plans, to make determinations of fact and eligibility for benefits, and to decide any dispute that may arise regarding the rights of employees, and their dependents or beneficiaries, under these plans.

(Doc. No. 30, Exhibit A).

In 1997, Plaintiff petitioned for LTD benefits complaining of fibromyalgia (chronic pain), asthma, and depression. On October 13, 1997, Hartford Life, the claims administrator at that time, approved Plaintiffs claim for LTD benefits. (R. 749-50). The LTD plan defines “Total Disability” as:

• During the first two years of LTD benefits — you are unable to perform the duties of your job
• After the first two years of LTD benefits — you are unable to perform any job for which you are reasonably qualified or may become qualified because of your education, training or experience.

(Doc. No. 30, Exhibit B)(emphasis added). Hartford Life stated that in order to qualify for benefits beyond the first two years *1309 (after October 3, 1999), Plaintiff must continue to satisfy the definition of “Total Disability” as defined in the plan. (R. 749).

On December 3, 1999, UnumProvident 2 (“Provident”) informed Plaintiff that the intial two years had passed and proof of her disability needed to be updated. (R. 603). In March 2000, Dr. Jerald Zakem, Plaintiffs physician, filled out a Physical Capacities form at Provident’s request. (R. 587). Dr. Zakem indicated that Plaintiff was capable of walking, standing, and driving for up to one hour at a time, and sitting for up to four hours at a time. Dr. Zakem also indicated that Plaintiff could frequently lift up to five pounds and occasionally lift up to ten pounds. (R. 587). However, Dr. Zakem stated that Plaintiff “cannot make 8 hr day.” (R. 589).

In October 2000, Michele Lawson, a registered nurse from GENEX Services, visited Plaintiff at her home as a representative of Provident. During the interview, Plaintiff told Nurse Lawson the extent of her medical condition and detailed her daily activities. (R. 499-505). Nurse Lawson wrote that Plaintiff usually started her day by feeding and watering her horses. Then she would walk her horses with a lead rope. Nurse Lawson reported that Plaintiff would ride into town with her mother to buy groceries or rent a video and folds laundry and helps clean the house. (R. 499 — 505).

On May 29, 2001, after two and a half years of receiving LTD benefits, Provident informed Plaintiff that she would not be paid LTD benefits beyond May 31, 2001. (R. 184-85). Provident based its decision on Dr. Zakem’s assessment of Plaintiffs physical abilities, Michele Lawson’s site visit to Plaintiffs home, and Provident’s own clinical staff review of Dr. Zakem’s medical notes. (R. 184-186). Provident concluded that there was “no clinical evidence to support the restriction and limitations ... [and] [t]he records do not preclude [her] from performing gainful employment.” (R. 185). Provident also stated that a Transferable Skills Analysis and Labor Market Survey was completed in May 2000, and several jobs were identified that met Plaintiffs restrictions and earning requirements. (R. 185). Provident informed Plaintiff that she could appeal this decision.

Plaintiff appealed the decision to Provident. Plaintiff provided a Functional Fi-bromyalgia Residual Functional Capacity Questionnaire filled out by Dr. Farrukh Zaidi on October 25, 2001. (R. 303-308). Dr. Zaidi concluded that Plaintiff had all 18 fibromyalgia tender points. (R. 303). He also concluded that Plaintiff was incapable of even low stress at work and could only continuously sit or stand for ten minutes at a time. (R. 306).

Provident conducted an internal clinical review that was performed by Pat Bran-ham, RN and Les Kertay, Ph.D. (R. 177-183). Pat Branham concluded that Dr. Zakem’s diagnosis was not consistent with an inability to work, and that Dr. Zaidi’s findings as stated on the Functional Capacity Questionnaire appeared inconsistent with Plaintiffs own description of her daily activities. (R. 179-180). Pat Branham noted in her report that Dr. Zakem had stated that “I feel that she could try to return to work on a four hour a day basis. There is the availability of a work conditioning program and I think she would do well with this.” (R. 179). Les Kertay concluded that Plaintiffs psychiatric condition and physical condition would not pre- *1310 elude her from performing a sedentary position. (R. 182).

On March 19, 2002, Provident upheld its previous decision denying Plaintiff LTD benefits. (R. 187). Provident did acknowledge that its Board Certified Internist and Rhumatologist found that Plaintiff might meet the criteria for fibromyalgia; however, Defendant’s internist noted that there was nothing objective in the file to prevent Plaintiff from performing the duties of her occupation. (R. 189).

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373 F. Supp. 2d 1306, 2005 U.S. Dist. LEXIS 17782, 2005 WL 1458031, Counsel Stack Legal Research, https://law.counselstack.com/opinion/porter-v-smithkline-beecham-corp-flmd-2005.