Viani v. The Lincoln National Life Insurance Company

CourtDistrict Court, S.D. California
DecidedSeptember 23, 2021
Docket3:21-cv-00004
StatusUnknown

This text of Viani v. The Lincoln National Life Insurance Company (Viani v. The Lincoln National Life Insurance Company) is published on Counsel Stack Legal Research, covering District Court, S.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Viani v. The Lincoln National Life Insurance Company, (S.D. Cal. 2021).

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 SOUTHERN DISTRICT OF CALIFORNIA 10 11 PAUL LAWRENCE VIANI, Case No.: 21-cv-00004-BEN (DEB)

12 Plaintiff, ORDER ON JOINT DISCOVERY 13 v. MOTION

14 THE LINCOLN NATIONAL LIFE [DKT. NO. 23] INSURANCE CO., A LINCOLN 15 FNANCIAL GROUP COMPANY fka 16 LIBERTY LIFE ASSURANCE COMPANY OF BOSTON, 17

18 Defendant.

20 I. INTRODUCTION 21 Before the Court is the parties’ Joint Discovery Motion. Dkt. No. 23. Plaintiff 22 Lawrence Viani (“Plaintiff”) seeks discovery outside the administrative record, which 23 Defendant The Lincoln National Life Insurance Company (“Defendant”) opposes. Id. 24 For the reasons set forth below, the Court GRANTS in part and DENIES in part 25 Plaintiff’s request to compel responses to the discovery at issue. 26 /// 27 /// 28 /// 1 II. PROCEDURAL HISTORY 2 Plaintiff’s Complaint alleges violations of the Employee Retirement Income 3 Security Act of 1974, 29 U.S.C. §§ 1001 et seq. (“ERISA”). Dkt. No. 1. Plaintiff seeks 4 benefits under a long-term disability (“LTD”) policy issued by Defendant. Id. at 5, 7. 5 a. Allegations in Plaintiff’s Complaint 6 From July 2011 through December 15, 2017, Qualcomm employed Plaintiff as a 7 Senior Staff Engineer. Id. at 2, 4. Plaintiff participated in Qualcomm’s Welfare Benefit 8 Plan (the “Plan”), which provided LTD benefits through Defendant. Id. at 2–3. 9 Plaintiff experienced Petit Mal seizures as a teenager. Id. at 4. In 2003, Plaintiff 10 suffered a Grand Mal seizure and was prescribed Oxcarbazepine. Id. The medication 11 diminished Plaintiff’s seizure activity. Id. In September 2016, however, Plaintiff 12 experienced two Grand Mal seizures while asleep and “experience[ed] an increase in 13 seizure activity of approximately one per month in the late evening.” Id. In January 2017, 14 Plaintiff suffered a twenty-minute seizure and convulsed for three to five of those minutes. 15 Id. Plaintiff was diagnosed with epilepsy and prescribed Vimpat. Id. 16 In March 2017, Plaintiff “experienced a seizure that lasted about two [] minutes” 17 following a visit to urgent care earlier that day. Id. Beginning on April 21, 2017, “Plaintiff 18 was unable to return to work” because his seizures had become increasingly intense, more 19 frequent, and longer in duration. Id. On October 17, 2017, Plaintiff attempted to return to 20 work, but the stress of the job “adversely affected his medical condition precluding Plaintiff 21 from continuing his work after December 15, 2017.” Id. Plaintiff alleges he “continues to 22 be disabled to this date.” Id. 23 In April 2017, Plaintiff applied for LTD benefits. Dkt. No. 23 at 10. Defendant 24 “determined Plaintiff was entitled to LTD benefits under the Plan . . . .” and paid Plaintiff 25 $8038.10 per month. Dkt. No. 1 at 4–5. On March 13, 2020, Defendant terminated 26 Plaintiff’s benefits, asserting “Plaintiff should be able to physically perform sedentary 27 work.” Id. at 5. 28 1 On July 22, 2020, Plaintiff administratively appealed Defendant’s termination of 2 benefits. Id. On September 16, 2020, Defendant “denied Plaintiff’s administrative appeal 3 stating that because Plaintiff’s subjective complaints of cognitive limitations (fatigue, loss 4 of concentration/memory) were not supported by appropriate testing to determine its 5 validity it was not considered as a limitation in determining if Plaintiff was able to return 6 to work as an engineer.” Id. at 6. 7 On January 4, 2021, Plaintiff filed this case pursuant to 29 U.S.C. §1132(a)(1)(B). 8 Id. at 2. Plaintiff alleges Defendant “ignored the opinions of Plaintiff’s treating physicians, 9 Plaintiff’s vocational rehabilitation counselor, the cognitive testing (showing impaired 10 scores on tests of language, diminished right-hand speed dexterity consistent with left 11 frontal dysfunction and mildly impaired score on visual memory), and Plaintiff’s own 12 subjective complaints.” Id. at 5–6. Plaintiff asserts “[t]his denial was wrongful and 13 constitutes a breach of [Defendant’s] obligations to provide benefits under the terms of the 14 PLAN and a breach of the fiduciary duties to provide a full and fair review of the claim.” 15 Id. at 6. 16 b. Plaintiff’s Discovery Requests 17 Plaintiff requests the Court compel responses to Interrogatory Nos. 5, 6, 8, 9, and 18 11–18. Dkt. No. 23 at 22. These Interrogatories seek information regarding reviewing 19 physicians Drs. Pearce (hired through Exam Coordinators Network) and Marehbian (hired 20 through Network Medical Review) whom Defendant retained to review Plaintiff’s medical 21 records and opine on Plaintiff’s alleged LTD. See id. at 12, 22–23. Specifically, Plaintiff’s 22 Interrogatories seek: 23 24 1) The number of claims [Defendant] referred to each for the years 2017 - 2020 and the monies paid to each on an annual basis[.] (Interrogatories 5, 6, 25 13, 14) 26 2) On an annual basis the number of reviews by each that resulted in a denial 27 of benefits by [Defendant.] (Interrogatories 11, 12, 15, 17) 28 1 3) The number of reviews that resulted in a granting of benefits by [Defendant.] (Interrogatories 8, 9, 16, 18). 2

3 Id. at 22; see also Declaration of Barbara A. Casino, Dkt. No. 23-2 (“Casino Decl.”), Ex. 3. 4 Plaintiff also requests the Court compel responses to Requests For Production 5 (“RFP”) 5, and 9–14, which seek: 6 7 [RFP] NO. 5: All claims’ manuals, claims’ handling manuals, procedure manuals, guides, appeals books, instructional and training documents 8 available to your claims analysts during the pendency of Plaintiff’s claim for 9 disability benefits that discuss: . . . . 10 c. evaluation and use of medical reviewers, 11 d. use of independent medical examiners, g. evaluation of subjective complaints/symptoms, 12 h. evaluation of cognitive issues, 13 i. evaluation of medication side effects, j. how to evaluate whether an occupation is gainful 14 k. questions to be presented to medical reviewers, 15 l. evaluation of seizure disorders/epilepsy, m. evaluation of fatigue.1 16

17 [RFP] NO. 9: All documents relating to financial bonuses, incentives, stock options or any other type of compensation program (beyond regular salary or 18 wages) in effect for any individuals handling, managing, overseeing or 19 investigating Plaintiff’s claim and appeal for long-term disability benefits, including for all persons identified in response to interrogatory No. 1. 20

21 [RFP] NO. 10: All documents that describe any relationship between you and Network Medical Review Co. (MNR) including, but not limited to, 22 contracts, memoranda of understanding, service agreements, vendor 23 agreements, policy letters and invoices in effect during 2019.

24 [RFP] NO. 11: All documents that describe any relationship between you 25 and Genex Services LLC (Genex) and/or Exam Coordinators Network 26 27 1 Because Plaintiff narrowed his request regarding RFP No. 5, the Court omits certain 28 1 including, but not limited to, contracts, memoranda of understanding, service agreements, vendor agreements, policy letters and invoices in effect during 2 2019. 3 [RFP] NO. 12: All documents that constitute or describe policies and 4 procedures for selecting medical reviewers for disability claims and/or 5 appeals during 2019.

6 [RFP] NO.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Firestone Tire & Rubber Co. v. Bruch
489 U.S. 101 (Supreme Court, 1989)
Abatie v. Alta Health & Life Ins. Co.
458 F.3d 955 (Ninth Circuit, 2006)
Dilley v. Metropolitan Life Insurance
256 F.R.D. 643 (N.D. California, 2009)
Laethem Equipment Co. v. Deere & Co.
261 F.R.D. 127 (E.D. Michigan, 2009)
Gonda v. Permanente Medical Group, Inc.
300 F.R.D. 609 (N.D. California, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
Viani v. The Lincoln National Life Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/viani-v-the-lincoln-national-life-insurance-company-casd-2021.