Bigham v. Liberty Life Assurance Co. of Bos.

• Decision Date: 11 December 2015
• Docket Number: Case No. C15-349RSM
• Citation: 148 F.Supp.3d 1159
• Parties: Rose Bigham, Plaintiff, v. Liberty Life Assurance Company of Boston, Defendant.
• Court: U.S. District Court — Western District of Washington

148 F.Supp.3d 1159

Rose Bigham, Plaintiff,

v.Liberty Life Assurance Company of Boston, Defendant.

Case No. C15-349RSM

United States District Court, W.D. Washington, At Seattle.

Signed December 11, 2015

Melton L. Crawford, Law Office of Mel Crawford, Seattle, WA, for Plaintiff.

Katherine S. Somervell, Bullivant Houser Bailey PC, Portland, OR, Kristi Favard, Anderson Hunter Law Firm, Everett, WA, for Defendant.

ORDER GRANTING PLAINTIFF'S MOTION FOR JUDGMENT UNDER FRCP 52

AND DENYING DEFENDANT'S CROSS MOTION FOR JUDGMENT UNDER FRCP 52

RICARDO S. MARTINEZ

, UNITED STATES DISTRICT JUDGE

I. INTRODUCTION

This matter comes before the Court on Cross Motions filed by Plaintiff Rose Bigham and Defendant Liberty Life Assurance Company Of Boston (“Liberty Life”), seeking a final judgment from this Court under Federal Rule of Civil Procedure 52

based on an administrative record created in an underlying Employee Retirement Income Security Act (“ERISA”) dispute. Dkt. ##10 and 24. Plaintiff brings this action under ERISA, 29 U.S.C. § 1001 et seq. to recover long-term disability (“LTD”) benefits under the Liberty Life Long-Term Disability Plan (“LTD Plan”). Ms. Bigham, who worked as a Security Technical Program Manager for Amazon, LLC (“Amazon”), argues that she is disabled under the terms of the LTD Plan due to “chronic intractable pain, fibromyalgia, seronegative spondyloarthropathy, cervical and lumbar degenerative disc disease,” and related conditions. Dkt. #10 at 1-2. Liberty Life argues that medical evidence and post-diagnosis surveillance do not establish that Ms. Bigham is disabled or otherwise unable to perform her own occupation. For the reasons set forth below, the Court concludes that Ms. Bigham is entitled to long-term disability benefits under the terms of the LTD Plan. The Court remands to Liberty Life the issue of extending benefits beyond the 24-month period prescribed for “own occupation” benefits.

II. PROCEDURAL ISSUES

Before turning to the merits of the parties' arguments, the Court must determine whether it is appropriate to resolve this case on the parties' cross motions for judgment under Rule 52

(Dkt. ## 10 and 24) as opposed to summary judgment under Rule 56. The answer depends on what standard of review the court applies. See

Firestone Tire & Rubber Co. v. Bruch , 489 U.S. 101, 109, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989) (“ERISA does not set out the appropriate standard of review for actions under § 1132(a)(1)(B) challenging benefit eligibility determinations.”). The parties here have simplified the matter by stipulating to de novo review. See Dkt. #23 at 12. The court accepts the parties' stipulation and reviews the record de novo. See

Rorabaugh v. Cont'l Cas. Co. , 321 Fed.Appx. 708, 709 (9th Cir.2009) (court may accept parties' stipulation to de novo review).

Where review is under the de novo standard, the Ninth Circuit has not definitively stated the appropriate vehicle for resolution of an ERISA benefits claim. The de novo standard requires the court to make findings of fact and weigh the evidence. See Walker v. Am. Home Shield Long Term Disability Plan , 180 F.3d 1065, 1069 (9th Cir.1999)

(de novo review applies to plan administrator's factual findings as well as plan interpretation). Typically, a request to reach judgment prior to trial would be made under a Rule 56 motion for summary judgment, however under such a motion the court is forbidden to make factual findings or weigh evidence. T.W. Elec. Serv., Inc. v. Pac. Elec. Contractors Ass'n , 809 F.2d 626, 630 (9th Cir.1987). Instead, the parties here propose the Court conduct a trial on the administrative record under Rule 52.

This procedure is outlined in Kearney v. Standard Ins. Co. , 175 F.3d 1084, 1095 (9th Cir.1999)

(noting that “the district court may try the case on the record that the administrator had before it”). In a trial on the administrative record:

The district judge will be asking a different question as he reads the evidence, not whether there is a genuine issue of material fact, but instead whether [the plaintiff] is disabled within the terms of the policy. In a trial on the record, but not on summary judgment, the judge can evaluate the persuasiveness of conflicting testimony and decide which is more likely true.

Id .

Thus, when applying the de novo standard in an ERISA benefits case, a trial on the administrative record, which permits the court to make factual findings, evaluate credibility, and weigh evidence, appears to be the appropriate proceeding to resolve the dispute. See

Casey v. Uddeholm Corp. , 32 F.3d 1094, 1099 (7th Cir.1994) (on de novo review of an ERISA benefits claim, the “appropriate proceeding[ ]...is a bench trial and not the disposition of a summary judgment motion”); Lee v. Kaiser Found. Health Plan Long Term Disability Plan , 812 F.Supp.2d 1027, 1032 (N.D.Cal.2011) (“De novo review on ERISA benefits claims is typically conducted as a bench trial under Rule 52 ”); but see

Orndorf v. Paul Revere Life Ins. Co. , 404 F.3d 510, 517 (1st Cir.2005) (“When there is no dispute over plan interpretation, the use of summary judgment...is proper regardless of whether our review of the ERISA decision maker's decision is de novo or deferential.”).

Given the above law, and the clear intent of the parties, the Court will resolve the parties' dispute in a bench trial on the administrative record rather than on summary judgment. Therefore, the court issues the following findings and conclusions, pursuant to Rule 52

.

III. FINDINGS OF FACT

1. Plaintiff Rose Bigham was employed by Amazon as an “AWS Security Technical Program Manager II”. AR2389.¹ Ms. Bigham's position required “strong problem-solving skills, excellent communication skills, the ability to influence people from customers to managers,” as well as “exemplary project management, critical thinking...and a passion for creating reliable and maintainable systems.” Id. It required her to be “extremely good at multi-tasking, innovative, creative, self-directed and a great team player” and to be able to “drive continuous process improvement, and collaborate effectively with aggressive cross-functional business and software development teams to solve problems and implement new solutions[.]” Id. This position also required Ms. Bigham to “complete complicated mathematical equations and assist in the protection of information.”

2. Ms. Bigham was offered Short Term Disability (“STD”) and Long Term Disability (“LTD”) benefits by her employer Amazon through plans administered by Liberty Life. See AR001827-AR001911 (STD Plan); AR000001-45 (LTD Plan); AR000046 (Amazon's application for Liberty Life STD and LTD coverage); AR000047 (claim sheet for Rosemary Bigham indicating LTD and STD benefits eligible as of August 1, 2011). As a regular full time employee working a minimum of 30 hours per week, Ms. Bigham was eligible for STD and LTD benefits. AR001829; AR00003.

3. Under the STD Plan, benefits are awarded based on an employee meeting the following definition of disability: an employee “as a result of Injury or Sickness [is] unable to perform the Material and Substantial Duties of [his/her] Own Job.” AR01832. These benefits are only available for a short term: 25 weeks. AR001830. “Sickness” is defined as “illness, disease, pregnancy or complications of pregnancy.” AR001839. “Material and Substantial Duties” is defined as “responsibilities that are normally required to perform your Own Job and cannot be reasonably eliminated or modified.” AR001835.

4. Under the LTD Plan, benefits are awarded beyond the 25-week window. Under this plan, “Disabled” is defined as when the employee “as a result of Injury or Sickness, is unable to perform the Material and Substantial Duties of his Own Occupation.” AR00008. “Sickness” is defined as “illness, disease, pregnancy or complications of pregnancy.” AR00015. The Plan defines “Material and Substantial Duties” as “responsibilities that are normally required to perform the Covered Person's Own Occupation, or any other occupation, and cannot be reasonably eliminated or modified.” AR00011.

5. LTD Plan benefits are limited to 24 months unless the employee can show that she “is unable to perform, with reasonable continuity, the Material and Substantial Duties of Any Occupation.” AR00004; AR00008. “Any Occupation” is defined as “any occupation that the [employee] is or becomes reasonably fitted by training, education, experience, age, physical and mental capacity.” AR00007.

6. Records indicate that Ms. Bigham has suffered from the chronic conditions of seronegative spondyloarthropathy

, fibromyalgia, and cervical and lumbar degenerative disc disease prior to 2013. See AR001994-97; AR001033; AR001205; AR001363; AR1379. In January of 2013, Ms. Bigham suffered from an increase in her symptoms from these chronic conditions, and felt that she could no longer continue working. AR002332. Ms. Bigham applied for STD benefits, which Liberty Life granted. See AR002336. After several weeks of leave, Ms. Bigham attempted to return to work on March 10, 2013, at which point Liberty Life terminated her STD benefits. Id .

7. Ms. Bigham again stopped work on April 11, 2013, and reapplied for STD benefits, which Liberty Life granted on April 15, 2013. AR002454. In granting these benefits, Liberty Life specifically found that Ms. Bigham had an “inability to perform [her] job” and that there was “medically supported disability” as of April 12, 2013. AR002454.

8. On July 13, 2013, Liberty Life terminated Ms. Bigham's STD benefits. AR002412.

9. On September 18, 2013, Ms. Bigham's rheumatologist, Richard Neiman, M.D., stated in a declaration that he had diagnosed Ms. Bigham with fibromyalgia since 2009. AR001994. He stated that “Ms. Bigham's fibromyalgia causes her to experience many of the common symptoms of that disease including persistent widespread musculoskeletal pain, muscle stiffness, severe fatigue, disturbed sleep and disruption of cognitive function.… [including] problems with...