Torrey v. Qwest Communications International, Inc.

838 F. Supp. 2d 1201, 2012 WL 826891, 2012 U.S. Dist. LEXIS 32208
CourtDistrict Court, D. Colorado
DecidedMarch 12, 2012
DocketCivil Action No. 09CV645
StatusPublished
Cited by1 cases

This text of 838 F. Supp. 2d 1201 (Torrey v. Qwest Communications International, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Torrey v. Qwest Communications International, Inc., 838 F. Supp. 2d 1201, 2012 WL 826891, 2012 U.S. Dist. LEXIS 32208 (D. Colo. 2012).

Opinion

ORDER

R. BROOKE JACKSON, District Judge.

Plaintiff Patrick Torrey seeks long term disability (“LTD”) benefits pursuant to the Employee Retirement Income Security [1203]*1203Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. Pending before the Court is Defendant’s Motion for Entry of Judgment Following Remand [docket # 61], which has been fully briefed.

FACTS

The facts were discussed at length in Judge Arguello’s remand order of February 28, 2011, 2011 WL 782615. Order Overruling and Remanding Benefits Determination [docket # 53] (hereafter “Feb. 28, 2011 Order”). I nevertheless will restate certain key facts in addition to discussing information developed after the remand.

Initial Benefits Determination

Mr. Torrey was employed by Qwest Corporation as a Network Technician, a job rated as “heavy” in terms of physical exertion, until June 5, 2006. Shortly before that date Mr. Torrey, then age 39 (date of birth September 5, 1966), fell down a flight of stairs, exacerbating a preexisting lower back condition. His primary care physician, James Gregory, M.D., referred him to a specialist in pain and physical medicine, Lawrence A. Lesnak, D.O. Dr. Lesnak ordered an MRI which revealed degenerative disc disease and a right sided bulging disc at L5-S1.

Meanwhile, after unsuccessfully attempting to return to work, he applied for and was granted short term disability (“STD”) benefits under the Qwest Disability Plan (“the Plan”). The Plan is sponsored, funded and administered by the defendant, Qwest Communications International, Inc. (“QCII”). The specific administrator of the plan was the Qwest Employee Benefits Committee, which in turn delegated the administration to a third party administrator, the Reed Group Ltd. The Reed Group administers the Plan under the name Qwest Disability Group.1

Dr. Lesnak referred Mr. Torrey to an orthopedic surgeon, Amit O. Agarwala, M.D, who saw him for the first time in August 2006. On September 12, 2006 Dr. Gregory sent the third party administrator copies of his office’s records, including records of Mr. Torrey’s visit to Dr. Agarwala and an MRI report, and indicated that he had no further input regarding Mr. Torrey’s disability status except that “he is still unable to work.” R. 478.

Dr. Agarwala initially tried conservative measures, including epidural injections and physical therapy. When those measures did not relieve Mr. Torrey’s back and leg pain, Dr. Agarwala recommended spinal fusion surgery. A second, concurring opinion was obtained from orthopedic surgeon Hugh McPherson, M.D. Dr. Agarwala performed the surgery on January 31, 2007. R. 462. The surgery appeared to be successful, but notwithstanding medication and physical therapy, Mr. Torrey continued to have pain in his lower back and right leg.

Plaintiffs 52 weeks of STD benefits were exhausted as of June 21, 2007, and he applied for LTD benefits. Under the terms of the Plan, disability for purposes of the first 12 months of LTD benefits means that the Participant is unable to perform his last Company-assigned job. R. 9. His application for LTD benefits under that definition was approved effective June 22, 2007. R. 146. The “Decision Rationale,” authored by Susan Mackin, Case Manager, states, “[h]e meet (sic) the definition of disability and is not considered gainful.” Ibid.

Mr. Torrey continued to be followed by Dr. Lesnak and two other physical medicine specialists, Angelo E. Romagosa, M.D. and Roberta Anderson-Oser, M.D. In April 2008 Mr. Torrey received facet joint [1204]*1204injections and nerve blocks. Also in April 2008 the Plan’s third party administrator requested updated medical information. Dr. Romagosa provided medical records, including a diagnosis of intermittent right L5 radiculopathy (a compression or irritation of a nerve). R. 185. This was confirmed by an EMG test in May 2008. Dr. Romagosa did not, however, provide an opinion on Mr. Torrey’s ability to work.

The first 12 months of LTD benefits expired on June 21, 2008. At that point the Plan’s definition of “disability” changes:

After a Participant has received LTD Benefits for 12 months, Disability means (1) the Participant is unable to engage in any occupation or employment, which inability is supported by Objective Medical Documentation, or (2) the Participant is unable to engage in any occupation or employment, for which he may reasonably become qualified for by training, education or experience, other than a job that pays less than 60% of his Based Pay at the time the Participant terminates employment due to the Disability.

R. 9-10.2

Notwithstanding the change in definition, QW II continued to provide LTD benefits. However, the third party administrator retained Anil Agarwal, M.D., an orthopedic surgeon (unrelated to Dr. Amit Agarwala who performed the spinal fusion surgery), to conduct an Independent Medical Examination (“IME”). Based upon his review of Mr. Torrey’s medical history since June 5, 2006 and his physical examination of Mr. Torrey on October 10, 2008, Dr. Agarwal diagnosed acute mild lumbar strain, temporary duration; postoperative L5-S1 degenerative disk disease with lumbar radiculitis; narcotic prescription drug dependence; and symptom magnification/malingering. R. 433. By way of further explanation, Dr. Agarwal opined that Mr. Torrey had a mild lumbar strain due to a fall; that there was no objective evidence of radiological disk herniation or physical signs of radiculopathy; that the surgery was not medically necessary or appropriate; and that he has received excessive amounts of narcotic pain medications. R. 433-34.

The bottom line of Dr. Agarwal’s opinion was that Mr. Torrey could return to full time work, subject to the restrictions that he not sit more than four hours, stand for more than four hours, or walk more than two to three hours per eight hour work day, and that he not lift or carry more than 15 pounds. R. 435. The doctor stated, “obviously he is not disabled and [it is] bad for him to be labeled as disabled.” R. 436. Reasons given for the latter opinion included that Mr. Torrey had no neurological deficit and that if he did not return to work he would become drug dependent and start suffering from depression. Ibid.

The third party administrator hired a vocational consultant, Kathryn Duder, MA, CRC, CEAS, to perform a “transitional skills analysis.” According to her report of November 18, 2008, her assignment was to assess Mr. Torrey’s education, training, experience and work restrictions “to determine if the claimant can perform occupations that can earn greater than $2,777.05 per month.” R. 249. Based upon Dr. Agarwal’s IME, Ms. Duder assumed a lifting limit of 15 pounds, a carrying limit of 10 pounds, a sitting limit of four out of eight hours, a standing limit of four out of 8 hours, and a walking limit of three out of eight hours. She concluded that Mr. Torrey could perform a number of available jobs in the Denver area in the light and [1205]*1205sedentary categories, including sales representative, dispatcher, communications consultant, and maintenance service dispatcher. According to the Dictionary of Occupational Titles, all of these jobs exceed Mr. Torrey’s abilities as determined by the IME.

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838 F. Supp. 2d 1201, 2012 WL 826891, 2012 U.S. Dist. LEXIS 32208, Counsel Stack Legal Research, https://law.counselstack.com/opinion/torrey-v-qwest-communications-international-inc-cod-2012.