Wuollet v. Short-Term Disability Plan of RSKCo

360 F. Supp. 2d 994, 2005 U.S. Dist. LEXIS 3272, 2005 WL 503370
CourtDistrict Court, D. Minnesota
DecidedMarch 3, 2005
DocketCiv.04-652 RHK/JGL
StatusPublished
Cited by2 cases

This text of 360 F. Supp. 2d 994 (Wuollet v. Short-Term Disability Plan of RSKCo) is published on Counsel Stack Legal Research, covering District Court, D. Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wuollet v. Short-Term Disability Plan of RSKCo, 360 F. Supp. 2d 994, 2005 U.S. Dist. LEXIS 3272, 2005 WL 503370 (mnd 2005).

Opinion

MEMORANDUM OPINION AND ORDER

KYLE, District Judge.

Introduction

After Continental Casualty Company (“Continental”) denied Judy Wuollet’s claim for post polio syndrome-related short-term and long-term disability benefits, Wuollet filed suit alleging that Continental, the Short>-Term Disability Plan of RSKCo, and the Long-Term Disability Plan of RSKCo (collectively, “Defendants”) breached their fiduciary duties under the Employee Retirement Income Security Act of 1974 (“ERISA”). Each side has moved for summary judgment. For the reasons set forth below, the Court will grant Wuollet’s Motion and deny Defendants’ Motion.

Background

I. Wuollet’s Disability Plans

Wuollet was a Nurse Care Manager at RSKCo, a workers’ compensation claim management company. During her tenure, she participated in RSKCo’s short-term and long-term disability plans. 1 Under both plans, “disability”

*996 means that Injury or Illness causes physical or mental impairment to such a degree of severity that the employee is:
1. Continuously unable to perform the Material and Substantial Duties of the employee’s Regular Occupation; and,
2. Not working for wages in any occupation for which the employee is or becomes qualified by education, training or experience.

“Material and Substantial Duties” are “the necessary functions of the employee’s Regular Occupation that cannot be reasonably omitted or altered.” “Regular Occupation” is “the occupation that the employee is performing for income or wages on the employee’s Date of Disability. It is not limited to the specific position the employee held with RSKCo.” Benefit claims under the plans were reviewed and administered by Continental. (Mohs Aff. Ex. A at AR 84, 429, 483, 491, 1169, 1177, 1192, 1196,1278,1282.)

II. Wuollet’s Medical History Prior To Her Short-Term Disability Claim

In 1952, at the age of three, Wuollet was diagnosed with polio and since then she has had several surgeries on her lower extremities, including heel lengthening, hammertoe corrections, and the fusion of her ankle joints. (See Mohs Aff. Ex. A at AR 80-81, 502.) Beginning in the late 1980s and early 1990s, Wuollet experienced weakness and fatigue. In 1993, Dr. Kurtis Hoppe diagnosed her with Post Polio Syndrome (“PPS”). {Id. at AR 581.) PPS is a slowly progressing syndrome that affects twenty-five percent or more of polio survivors and may strike up to forty years after the initial polio infection. Common symptoms include fatigue, weakness, and pain. PPS patients may also suffer a host of other symptoms, including muscle cramps and twitches. (See id. at AR 1056, 1094-1105, 1113-21); see also Abram v. Cargill, Inc., 395 F.3d 882, 884 n. 2 (8th Cir.2005) (describing PPS).

On November 5, 1996, Wuollet saw Dr. Barbra Seizert, a physician who practices in physical medicine and rehabilitation. (Mohs Aff. Ex. A at AR 79-83; see id. at AR 1147-49 (curriculum vitae).) Dr. Sei-zert noted that Wuollet complained of spasms in her back and legs and had pain in her right knee. {Id. at AR 79.)

In 2001 and 2002, Wuollet saw Dr. Anne Brutlag, a specialist in rehabilitative medicine. {See id. at AR 1150-52 (curriculum vitae)); Abram, 395 F.3d at 883-84. On September 5, 2001, Dr. Brutlag confirmed Wuollet’s PPS and stated:

She does note discomfort in her low back and right hip region mainly in association with static standing or moving to standing from a seated position.... She does continue to make considerable lifestyle changes. She is gradually experiencing more and more fatigue which she relates to her [PPS]. She does continue to work full-time, and notes that she is at this point able to tolerate it, but has to make a lot of adjustments in other parts of her life.

*997 (Mohs Aff. Ex. A at AR 797-98.) Dr. Brutlag also noted that Wuollet was “actually doing quite well” and “[h]er back pain is definitely better.” (IcL at AR 798.) She recommended exercise and using Cele-brex, an anti-inflammatory medicine. (Id.)

On February 12, 2002, Dr. Brutlag reported:

Judy Wuollet is seen in recheck examination today reporting that her pain has increased and she is having more and more difficulty walking. She notes that she has been having pain and spasm in her back more consistently, and is having more pain laterally and posteriorly at the right greater than left hip and buttock. She notes that it is gradually becoming more and more difficult for her to walk distances, and she has to lean more and more heavily on her cane.... She currently notes fair ability to perform light housework, sleep, her regular and light duty job; inability to perform heavy housework, yardwork, sports and recreational activities. She notes increased pain in the back in association with bending, lifting, jarring, static sitting, static standing, and distance walking. Stress and tension also increase her symptoms.... She continues to work full-time as a nurse case manager for a worker’s compensation group. She notes that she is very fatigued by the end of the day, and notes considerable increase in her pain level and fatigue by the end of a work week....
She is very much struggling with the pain and fatigue, and is concerned about her ability to continue to work on a full-time basis certainly, and perhaps even part-time.

(Id. at AR 809-11.)

On March 5, 2002, Wuollet again saw Dr. Brutlag, who observed:

She notes that her sleep has gradually become more disturbed and she is having more difficulty performing light housework. She reports fair ability to perform light duty work, poor ability to sleep, perform light housework and her regular job, inability to perform heavy housework, yardwork, and sports and recreational activities.... She is having more difficulty coping with her pain. She notes increased symptoms in association with sitting, particularly driving in a car, walking more than a block and a half, and static standing.

(Id. at AR 818-19.) Dr. Brutlag recommended facet injections for Wuollet’s back pain and continued medication. (Id. at AR 819.)

On June 5-11, 2002, Wuollet took paid leave from work due to back and neck pain. (See id. at AR 13, 546-47.) From this point on, she never returned to work.

On June 11, 2002, Dr. Brutlag determined that Wuollet was unable to continue with her employment. Dr. Brutlag observed:

She reports that her symptoms have escalated since I last saw her in March. She is having pain in her neck and shoulder on the right side and in her right buttocks and posterolateral thigh.

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360 F. Supp. 2d 994, 2005 U.S. Dist. LEXIS 3272, 2005 WL 503370, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wuollet-v-short-term-disability-plan-of-rskco-mnd-2005.