Richards v. AT&T Mobility

2011 DNH 027
CourtDistrict Court, D. New Hampshire
DecidedFebruary 16, 2011
DocketCV-10-92-PB
StatusPublished

This text of 2011 DNH 027 (Richards v. AT&T Mobility) is published on Counsel Stack Legal Research, covering District Court, D. New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Richards v. AT&T Mobility, 2011 DNH 027 (D.N.H. 2011).

Opinion

Richards v . AT&T Mobility CV-10-92-PB 2/16/11

UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF NEW HAMPSHIRE

Deanna Richards

v. Case N o . 10-cv-92-PB Opinion N o . 2011 DNH 027 AT&T Mobility Disability Benefits Program

MEMORANDUM AND ORDER

Deanna Richards, a former participant in the AT&T Mobility

Disability Benefits Program, brings an Employee Retirement

Income Security Act (“ERISA”) action against the Program seeking

to recover long-term disability benefits allegedly owed her.

Both Richards and the Program have moved for judgment on the

administrative record. For the reasons set forth below, I grant

the Program’s motion and deny Richards’ motion.

I . BACKGROUND1

A. The Program

The AT&T Mobility Disability Benefits Program (“Program”)

is a component program under AT&T Benefit Plan N o . 1 . The Plan

1 The background facts are drawn primarily from the parties’ Joint Statement of Material Facts (Doc. N o . 1 0 ) . Sponsor and Plan Administrator, as defined by ERISA, 29 U.S.C. §

1001 et seq, is AT&T Inc. The Claims Administrator is AT&T

Integrated Disability Service Center, a division of Sedgwick

Claims Management Services, Inc. In its role as Plan Sponsor,

AT&T delegated to the Claims Administrator the fiduciary

responsibility for the administration of all claims under the

Program. See Summary Plan Description: AT&T Mobility Disability

Benefits Program (“SPD”) at 29 (Doc. N o . 1 - 1 ) . Under the

Program, the Claims Administrator has the power to “determine

whether [an employee is] Disabled under the terms of the Program

for STD, LTD or Supplemental LTD benefits.” Id. at 2 2 .

The Program offers both Short Term Disability (“STD”) and

Long Term Disability (“LTD”) benefits to eligible AT&T Mobility

employees. Under the Program, an eligible employee is entitled

to up to twenty-six weeks of STD benefits i f , as a result of a

disability, the employee is unable to perform the duties of his

or her “Customary Job.” See id. at 8 . “Customary Job” is

defined as “the work activity that [the employee was] hired to

regularly perform for the Employer and that serves as [the

employee’s] source of income from the Employer.” Id. at 2 9 .

Upon the expiration of STD benefits, an employee is

eligible for LTD benefits as long as the employee remains

2 “Disabled” under the terms of the Program. See id. at 8 . An

employee is considered “Disabled” for the purposes of LTD

benefits if “[d]uring the first twenty-four (24) months after

[the] exhaustion of STD Benefits, [the employee is] continuously

unable to perform [the employee’s] Customary Job.” Id. at 1 1 .

B. Medical Evidence

On April 9, 2008, Richards, an employee of AT&T Mobility

Services LLC, suffered a back injury while attempting to lift a

rolling cabinet door. Richards was initially treated for her

injury on April 1 4 , 2008 by her primary care provider, Certified

Physician’s Assistant (“PA-C”) Judith Santangelo. During the

appointment Richards indicated that “[s]he was unable to work

longer than 2 hours today because of her pain.” Admin. R.

D00473. A week later, in a follow-up appointment with PA-C

Santangelo, Richards explained that “[o]ver the past week the

pain has persisted making it hard . . . to walk[,] sit or stand

for any length of time” and that she was “not able to return to

work” since her position required her “to stand all day with

frequent bending.” Id. at D00476.

On April 3 0 , 2008, Richards returned for another follow-up

with PA-C Santangelo. During this visit, Richards noted a

“[s]light improvement with the pain in [her] lower back and [ ]

3 left leg,” although Richards complained that she was still

“having back spasms and can only stand for a few minutes.” Id.

at D00483.

On May 2 7 , 2008, an MRI of Richards’ lumbar spine was

performed at Portsmouth Regional Hospital. A report of the MRI

noted as follows:

A very mild diffuse disc bulge is present at the L2-3 level without evidence for neural foraminal2 narrowing. Moderate disc space height loss is present at the L3-4 level with a small central disc herniation. Mild bilateral neural foraminal narrowing is present at this level. Moderate to severe disc space height loss is present at the L4-5 level with a very mild diffuse disc bulge and mild bilateral neural foraminal narrowing. The fat about the exiting nerve roots is intact. Moderate disc space height loss is present at the L5-S1 level with a left posterolateral3 disc herniation measuring 13 x 6 mm in size, which impinges upon the exiting nerve root at this level and also upon the lower exiting nerve root. This results in a mild spinal stenosis 4 .

Id. at D00244.

On June 2 5 , 2008, Richards was examined by neurosurgeon D r .

Clinton Miller. In his report, D r . Miller noted that Richards

2 “Foramen” or “foramina” is “an aperture or perforation through a bone or membranous structure.” Stedman’s Medical Dictionary 698 (27th ed. 2000). 3 “Posterolateral” means “behind and to one side.” Id. at 1431. 4 “Stenosis” refers to a “stricture of any canal or orifice.” Id. at 1695. 4 was a “pleasant, friendly, cooperative woman” who “appears in no

acute distress and who gets about the office and examining room

with ease.” Id. at D00280. D r . Miller went on to state that

the

[G]eneral physical examination is notable only for weight issues. Examination of the back shows a normal spinal curvature with somewhat hyperlordotic5 lumbar curve. Her gait is slightly cautious but not antalgic6 and she was able to walk on her tiptoes and on her heels without difficulty. Tandem gait is normal. Detailed manual motor testing shows universal normal tone, strength and coordination throughout both lower extremities.

Id. at D00280.

In D r . Miller’s opinion, Richards suffered from “[l]ow[er]

back pain with intermittent right or left lumbar radiculopathy7

due to multilevel lumbar degenerative disk disease and

spondylotic8 lateral recess stenosis.” Id. D r . Miller also

noted that he did “not see any reason to actively consider[] a

5 “Lordosis” refers to “an anteriorly convex curvature of the vertical column . . .” Id. at 1032. 6 “Antalgic” or “analgesic” is characterized as “reduced response to painful stimuli.” Id. at 6 7 , 9 4 . 7 “Radiculopathy” is a “[d]isorder of the spinal nerve roots.” Id. at 1503. 8 “Spondylosis” is the “ankylosis” or “stiffening or fixation” of “the vertebrae; often applied nonspecifically to any lesion of the spine of a degenerative nature.” Id. at 9 0 , 1678. 5 neurosurgical treatment option at this time given her functional

status” but instead emphasized that Richards should do “core

strengthening exercises faithfully . . . get plenty of aerobic

exercise through reinstitution of her walking program; use short

bursts of high-dose nonsteroidal anti-inflammatory agents to

manage flare up of back or radicular leg symptoms and adopt good

body mechanics proactively in all of her lifting activities.”

Id. at D00280-81.

Over the next few weeks, Richards continued to see PA-C

Santangelo. During these visits Richards relayed that she had

been “[m]aking progress with physical therapy and water therapy”

and that she could “now stand and walk for 15 min before having

worsening pain.” Id. at D00505. Richards did not feel that she

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