Conners v. Maine Medical Center, Civ. 98-273-P-C.
| Decision Date | 03 March 1999 |
| Docket Number | No. Civ. 98-273-P-C.,Civ. 98-273-P-C. |
| Parties | Joseph L. CONNERS, Plaintiff, v. MAINE MEDICAL CENTER and UNUM Life Insurance Company of America, Defendants. |
| Court | U.S. District Court — District of Maine |
Jon Holder, Holder & Grover, Portland, Maine, for plaintiff.
William J. Kayatta Jr., Peter H. Jacobs, Pierce Atwood, Portland, Maine, for MMC.
Patricia A. Peard, Bernstein, Shur, Sawyer & Nelson, Portland, Maine, for UNUM Life Insurance.
Before the court are cross motions for summary judgment filed in an action brought by Plaintiff, Mr. Joseph Conners, against Defendants, Maine Medical Center ("MMC") and UNUM Life Insurance Company of America ("UNUM"). Mr. Conners filed a four-count Amended Complaint alleging that the Long Term Disability Plan ("LTD Plan") available to MMC employees violates the Americans With Disabilities Act, 42 U.S.C. § 12101 et seq. ("ADA"), and the Maine Human Rights Act, 5 M.R.S.A. § 4572 ("MHRA"), by providing a two-year cap on benefits for mental disabilities, but not for physical disabilities, and that Defendants' refusal to pay benefits beyond the two-year period was a wrongful denial of disability benefits in violation of the Employee Retirement Income Security Act, 29 U.S.C. § 1001 et seq. ("ERISA").
MMC gives employees the option to participate in its LTD Plan, which is funded solely through employee contributions. UNUM acts as the disability claims administrator, meaning that UNUM considers employees' claims for benefits under the LTD Plan, determines whether such claims are valid, and pays out benefits for valid claims. Maine Medical Center Long Term Disability Plan Affidavit of Stella M. Fohlin ("Fohlin Affidavit") (Docket No. 21), Attachment A at 27-28. If a claim is denied, employees may appeal to UNUM and UNUM shall make the final decisions regarding claims for benefits. Id.
Since 1988, MMC has maintained an LTD Plan funded by an insurance policy that MMC purchased from UNUM, a company which sells a variety of insurance products to employers and other entities. Id. ¶ 4. The LTD Plan is open to all employees, disabled and nondisabled alike. Under the LTD Plan, benefits for total physical disability may be paid out until the recipient reaches age sixty-five. Id. For disabilities caused by mental or nervous conditions, benefits are limited to twenty-four months, with an additional ninety-day coverage if the recipient is hospitalized on the date benefits would otherwise expire. Id. at 19. The language of the LTD Plan was approved by the Maine Bureau of Insurance in 1995. Id. ¶ 7. While an employee of MMC, Mr. Conners enrolled in the LTD Plan.
Mr. Conners worked for MMC as an electrician beginning in October of 1978. Fohlin Affidavit, Attachment B at 13. As a result of two tours in the Vietnam War, Mr. Conners suffers from post-traumatic stress disorder and severe depression and anxiety. Id. at 8, 11, 17, 45-52, and 68-72. He was diagnosed as having this condition by a physician in October 1993. Id. at 8. As a result of his illness, Mr. Conners has trouble concentrating, feels anxious and distracted, and cannot function at work. Id. at 8, 11, 17, 45-52. Mr. Conners' physician prescribed him mind-altering drugs for the depression and anxiety and advised him not to work while taking the medication. Id. at 8, 11, and 17. Mr. Conners has been unable to work since October 27, 1993, and in April 25, 1994, Mr. Conners filed an application for LTD benefits with UNUM. Id. at 5-13.
In May of 1994, UNUM approved Mr. Conners' application for disability benefits. Id. at 21-22. Mr. Conners was notified on June 27, 1994, in writing that he was subject to the twenty-four month limitation on benefits because he suffered from a disability caused by a psychiatric disorder. Id. at 32-33. After additional correspondence not relevant here, Mr. Conners was reminded on January 24, 1996, that in order to receive disability benefits beyond the two-year term, he would have to submit evidence that he was physically disabled. Id. at 89-80. Mr. Conners complained to UNUM that he had not been aware of the two-year limitation on mental disability benefits when he enrolled in the LTD Plan and that he wished to submit evidence to show that he was physically disabled. Id. at 81-83. In addition, Mr. Conners complained to the Maine Bureau of Insurance that the UNUM policy was discriminatory. Id. at 84-87.
Despite Mr. Conners' attempt to show that the disability from which he suffered was physical and his complaint that the LTD Plan was discriminatory, Mr. Conners was notified on April 17, 1996, that his disability benefits would be terminated on April 26, 1996. Id. at 111-12. A year later on April 24, 1997, Mr. Conners filed an appeal, id. at 117, which was denied by UNUM on May 30, 1997. Id. at 126-27. Again, UNUM explained that Mr. Conners was not eligible for benefits beyond twenty-four months because his disability was caused by a mental disorder. Id.; Plaintiff's Statement of Facts Not in Dispute (Docket No. 25), Exhibit 6. Mr. Conners appealed for a second time, contending that the distinction between mental and physical disabilities was against the law. Id. at 130; Plaintiff's Statement of Material Facts Not in Dispute, Exhibit 13. UNUM denied Mr. Conners' request that it designate his disability as physical, for the final time, by letter on June 5, 1997. Id. at 131-32; Plaintiff's Reply Memorandum to Defendants' Joint Objection to Cross Motion for Summary Judgment, (Docket No. 30), Exhibit A.
On April 25, 1997, MMC informed Mr. Conners that his employment had been terminated in April of 1996, according to the LTD Plan policy that once LTD benefits are terminated and the employee does not return to work, employment is suspended. Plaintiff's Reply Memorandum to Defendants' Joint Objection to Cross Motion for Summary Judgment, Exhibit C. In this letter MMC explained that the termination of disability benefits and, thus, Mr. Conners' employment, meant that MMC no longer contributed to his pension. Id. Upon receiving this letter, Mr. Conners filed an appeal that was denied by a letter from the Maine Medical Center in December of 1997. Plaintiff's Statement of Facts Not in Dispute, Exhibit 2. In October of 1997, Mr. Conners filed a complaint with the Maine Human Rights Commission. Id., Exhibit 5 at 2. On April 15, 1998, the Maine Human Rights Commission issued a report favorable to Mr. Conners and recommended that the Commission conclude that unlawful discrimination against Mr. Conners had occurred. Id., Exhibit 5. On July 20, 1998, Mr. Conners filed this action in state court. Defendants's Statement of Facts As to Which There is No Dispute (Docket No. 22), ¶ 1. UNUM and MMC removed the action to this Court in July of 1998, and Mr. Conners filed an Amended Complaint in this Court in October of 1998 (Docket No. 12).
Summary judgment is appropriate when the record shows that there is no genuine issue as to any material fact and that the moving party is entitled to summary judgment as a matter of law. Fed.R.Civ.P. 56(c). Once the moving party has come forward identifying those portions of "the pleadings, depositions, answers to interrogatories, and admissions on file, together with affidavits, if any" which "it believes demonstrate the absence of a genuine issue of material fact," the adverse party may avoid summary judgment only by providing properly supported evidence of disputed material facts that would require trial. Celotex Corp. v. Catrett, 477 U.S. 317, 317, 322, 106 S.Ct. 2548, 2551-52, 91 L.Ed.2d 265 (1986).
The trial court must "view the entire record in the light most hospitable to the party opposing summary judgment, indulging all reasonable inferences in that party's favor." Griggs-Ryan v. Smith, 904 F.2d 112, 115 (1st Cir.1990). The court will not, however, pay heed to "conclusory allegations, improbable inferences [or] unsupported speculation." Medina-Munoz v. R.J. Reynolds Tobacco Co., 896 F.2d 5, 8 (1st Cir.1990). If no genuine issue of material fact emerges, then the motion for summary judgment may be granted. Because the facts in this case are not in dispute, the Court's analysis focuses on the legal questions raised by the parties in their cross motions for summary judgment.
In Count I of his Amended Complaint, Mr. Conners alleges that the LTD Plan violates Title I of the ADA because of the disparity in benefits between mental and physical disabilities. Title I proscribes discrimination in the terms and conditions of employment and mandates in relevant part:
(a) General rule
No covered entity shall discriminate against a qualified individual with a disability because of the disability of such individual in regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment.
42 U.S.C. § 12112(a). In Count II of his Amended Complaint, Mr. Conners alleges that the LTD Plan violates Title III of the ADA. Title III of the ADA provides:
(a) General rule
No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations by any person who owns, leases (or leases to), or operates a place of public accommodation.
42 U.S.C. § 12182(a). Mr. Conners claims that the Defendants violated Title I and Title III of the ADA because the disparity in the duration of the benefit program for a mental versus a physical disability constitutes discrimination against him on the basis of his mental disability. Defendants raise several objections to Mr. Conners' claims including that Mr. Conners does not have standing to assert his claim, that his claims are not timely, and that disability plans that provide fewer...
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