Tracy v. Pharmacia & Upjohn Absence Payment Plan

195 F. App'x 511
CourtCourt of Appeals for the Sixth Circuit
DecidedOctober 12, 2006
Docket05-2212
StatusUnpublished
Cited by17 cases

This text of 195 F. App'x 511 (Tracy v. Pharmacia & Upjohn Absence Payment Plan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Tracy v. Pharmacia & Upjohn Absence Payment Plan, 195 F. App'x 511 (6th Cir. 2006).

Opinion

KENNEDY, Circuit Judge.

Plaintiff Joel Tracy appeals the district court’s decision upholding the finding by the Employee Retirement Income Security Act (ERISA) Plan Administrator 1 that Mr. Tracy is not entitled to permanent long-term disability payments. On appeal, Tracy argues that he has demonstrated that he is unable to be gainfully employed because of his disability. For the reasons that follow, we AFFIRM the district court’s finding that Tracy is not entitled to continued long-term disability payments under the terms of the Pharmacia & Upjohn Absence Payment Plan.

BACKGROUND

On April 23, 1989, Plaintiff Joel Tracy (“Plaintiff’ or “Tracy”) was hired by Pharmacia & Upjohn (now Pfizer) (“Upjohn”) as a planning manager. Tracy eventually *513 became a Market Intelligence Planning Manager.

A. Leave of Absence

In April of 1996, Tracy requested leave under the Family and Medical Leave Act (“FMLA”) for depression and idiopathic hypersomnolence. He submitted a letter from Dr. Michael Fusillo, a psychiatrist, who found that Tracy was suffering from depression and hypersomnia (excessive daytime sleepiness and/or prolonged nighttime sleep). Dr. Fusillo reported that Tracy had been treated for depression and hypersomnia for a number of years and he noted that Tracy had sought help from the University of Michigan Sleep Disorder Center. Dr. Fusillo treated Tracy with Ritalin, which eventually lost its effect. He then treated Tracy with Dexedrine, which also began to lose its effect. Dr. Fusillo recommended that Tracy take a month’s leave of absence, during which time Dr. Fusillo would try altering the medication regime and Tracy could try to develop a regular sleep schedule. Dr. Fusillo recommended that this period be followed by a return to work at a part-time status: 20 hours a week with some accommodations for his sleep disability. Dr. Fusillo explained, “That is, if he could have access to a bed so that he could nap, he then would be able to plan a schedule with sleep and work.” J.A. at 146. He wrote further, “Of significance is the fact that work that bores him tends to contribute to the hypersomnia and work that he finds stimulating, tends to help it.” Id. at 147.

Dale Peerbolte, a physician at Upjohn, reviewed Dr. Fusillo’s letter and approved Tracy’s FMLA certification. Tracy took medical leave from April 17, 1996 to May 17, 1996, followed by intermittent leave through June 1,1996.

B. Initial Disability Determination

Tracy returned to work in June, but he was unable to work for more than 20 to 30 hours a week. On November 19, 1996, Tracy left his job at Upjohn and requested disability status. Under the Pharmacia & Upjohn Absence Payment Plan (“Plan”) a participant is entitled to initial long-term disability (“LTD”) benefits if he is “permanently unable to be gainfully employed at Upjohn.” J.A. at 428 (emphasis added).

While Upjohn reviewed his disability status, Tracy proposed that he could continue working as a planning manager if the company provided him with certain accommodations including: a home office or facilities at work to allow rest when he gets tired, flexible hours, and secretarial or technical support. Tracy’s supervisor found that Tracy was limited to 20 hours of work a week and, because the position was a full-time position, Tracy was incapable of performing his job because of his impairment. J.A. at 691. On December 13, 1996, the Disability Review Committee determined Tracy met the standard for an initial term of disability benefits through December 31,1999.

While receiving initial LTD benefits, on January 22, 1999, Tracy consulted with Dr. Richard Munson of the Sleep Disorders Center at Evanston Hospital. Dr. Munson completed an attending physician’s report and attached a letter, which stated that “[i]n order to improve his daytime functioning, and to prevent possible injury due to falling asleep while driving, he should maintain a regular work-sleep schedule. This should include a consistent starting and ending time to his workday, as well as a normal eight-hour shift without overtime.” J.A. at 190.

Tracy did in fact work during the first three years he was on disability leave with Upjohn. It appears from the report of a Dr. Richard Hurlburt, Ph.D., (dated *514 4/1/00) and other documents in the record (J.A. at 233, 386), that Tracy worked at Searle as Marketing Research Manager for one year during 1998-1999 and that he notified Searle that he was on disability. Tracy stated in a resume he submitted to Searle that, prior to Searle, he worked from 1997-1998 at Westwood Squib as a manager. He also told the claim investigator that he was eventually let go by Searle because he had been working an average of eleven hours a day and it did not have an eight-hour position. J.A. at 386. No other information is available in the record concerning either of these jobs. There is no other information about job attempts.

C. Permanent Disability Determination

By November 19, 1999, Prudential Insurance Company (“Prudential”) had contacted Tracy, identified itself as a claims service provider, and informed him that his continued eligibility to receive disability payments would be evaluated. After the initial three-year term of LTD benefits, Tracy’s eligibility to receive continued LTD benefits was governed by a different standard: a participant must now be “unable to be gainfully employed anywhere.” J.A. at 428 (emphasis added). This determination is “based on the existence or nonexistence of a qualifying disability and will not depend on the availability of actual employment.” J.A. at 428.

Prudential considered the information that Tracy submitted and other information in his file and notified him on January 11, 2000, that he was not eligible to receive continued disability benefits under the Plan. The letter noted the difference in the standard for initial LTD benefits limited to three years, which he had been receiving, and continuing LTD benefits he was now claiming and that Tracy could not show he was “unable to perform any work anywhere.” J.A. at 201. Prudential did extend his benefits through February 29, 2000, and offered him job placement assistance.

Tracy met with Barbara Lemke, a vocational consultant with Prudential, in February 2000 for a vocational evaluation. She advised Tracy that by using his “current skills, abilities, and education” he could be employable in the field of market research consulting. J.A. at 209. Tracy informed Lemke that he had been “working the stock market at home” since his termination from his last job in May 1999. J.A. at 219. He asked that he be granted $3,000 to $5,000 to pay for a class in investment training and he expressed confidence that he could support himself by day trading from his home. He explained that at home he could work eight hours a day and take naps when required. Prudential denied his request for retraining benefits, finding that he was employable without further retraining. J.A. at 209.

On February 24, Lemke mailed Tracy a letter indicating that she had left him several phone messages that had not been returned.

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