Ivy v. Raytheon Employees Disability Trust
| Citation | 307 F.Supp.2d 301 |
| Decision Date | 09 March 2004 |
| Docket Number | No. CIV.A. 03-10815-WGY.,CIV.A. 03-10815-WGY. |
| Parties | Wanda IVY, Plaintiff, v. RAYTHEON EMPLOYEES DISABILITY TRUST, Raytheon Company, and Metropolitan Life Insurance Company, Defendants. |
| Court | U.S. District Court — District of Massachusetts |
Richard S. Weiss, Richard S. Weiss & Assoc., Boston, MA, for Wanda Ivy, Plaintiff.
Stephen S. Churchill, James F. Kavanaugh, Jr., Conn, Kavanaugh, Rosenthal, Peisch & Ford, LLP, Boston, MA, for Metropolitan Life Insurance Company, Raytheon Company, Raytheon Employees' Disability Trust, Defendants.
The plaintiff, Wanda Ivy ("Ivy"), brought this action against Raytheon Disability Trust (the "Trust"), Raytheon Company ("Raytheon"), and Metropolitan Life Insurance Company ("MetLife") for reinstatement of her long term disability benefits pursuant to the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1132(a)(1)(B). After hearing oral argument on January 13, 2004, the Court entered an order allowing the Defendant's Motion for Summary Judgment [Doc. No. 11]. See Order of 1/14/04 [Doc. No. 22]. This memorandum sets for the analysis that led to that order.
The undisputed facts of Ivy's employment, medical condition, and treatment are taken from MetLife's claim file. Defs.' Ex. B [Doc. No. 15].
Ivy began working for Raytheon on February 14, 1977. Id. at 216. She was last employed as "Materials Handler C," with somewhat ambiguous duties. Id. Ivy stated that she "works in shipping and receiving and does a lot of lifting sometimes up to 80-90 pounds." Id. at 86. She described herself as a "shipper" on an insurance form and reported to her treating physician that she was involved in "box shipping, lifting packages, load[ing] and unload[ing] trucks, single lifting thirty to forty pounds." Id. at 40, 164. In their respective treatment notes, Ivy's therapist reported that she was a fork-lift operator, id. at 53, but her psychiatrist noted that she worked at a desk job immediately prior to leaving Raytheon. Id. at 31.
Ivy stopped working on July 28, 2000 due to bursitis and an injury in her left shoulder. Id. at 113, 216. Shortly thereafter, she began to complain of debilitating anxiety concerning alleged marital problems.1 Her psychological problems prevented her from returning to work after her physical impairments improved.
While employed by Raytheon, Ivy participated in the company's long term disability benefits plan (the "Plan"). The Plan provides benefits to covered employees who meet the defined requirements for being fully disabled2 for eighteen months or totally disabled3 thereafter. Defs.' Ex. A [Doc. No. 15] ¶¶ 1.2, 2.19, 2.22, 5.1. The Plan receives its funding exclusively from employees who choose to participate. Id. ¶ 1.2.
MetLife, the Claims Administrator, has a fiduciary duty to restrict Plan benefits to employees who meet the established eligibility criteria. Id. ¶¶ 2.5, 7.3. Furthermore, the Plan grants MetLife "full discretion [ ] to interpret the Plan with respect to claims for Benefits; to determine whether a claimant is eligible for Benefits; and to resolve any other matter related to claims under the Plan (including appeals of denied claims)." Id. ¶ 8.5 (emphasis added).
While Ivy's initial disability was based on a physical injury, her claim for long term disability is based exclusively on psychological and emotional impairments. She sought treatment from a physician, psychologist, psychiatrist, and therapist. The medical and psychiatric records provided by these treating doctors were reviewed by two independent physicians employed by MetLife.
Ivy's treating physician, Theresa Chang, M.D. ("Dr.Chang"), noted on October 20, 2000 that Ivy had developed an anxiety disorder and was disabled. Defs.' Ex. B at 184. Eight months later, Dr. Chang stated that Ivy "remains disabled at this time" but provided no further details as to the severity or extent of Ivy's impairments. Id. at 69.
Ivy's psychologist, Paul Jansen, Ph.D. ("Dr.Jansen"), diagnosed her with generalized anxiety on August 23, 2000. Id. at 179. He amended his diagnosis to major depression in November, 2002. Id. at 62. He consistently opined that Ivy's attention and concentration were impaired and that she could not return to work operating a fork-lift. Id. at 59, 60. He noted, however, that she was capable of carrying out routine daily activities such as taking care of her children and running errands and that she might be able to return to less demanding work. Id. He stated:
Ms. Ivy's disability falls within some very specific parameters. For example, a problem with attention or concentration would be dangerously disabling to an air-traffic controller, but might have a minimal impact on a person who stocks supermarket shelves.... Ivy's ... inability to focus/concentrate clearly put her and her co-workers at risk for significant injury.... [S]he was and continues to be functionally disabled.
Id. at 60 (emphasis in original).
Ivy was also treated by psychiatrist Burns Woodward, M.D. ("Dr.Woodward"), who diagnosed her with major depression with psychotic features. Id. at 157. Dr. Woodward's treatment notes mention that Ivy exhibited features of depression including excessive crying, sleep problems, lack of energy, and poor concentration but that she could do chores, run errands, take care of her three children, and perform other activities of daily living. Id. at 93-99. He noted that he was unable to evaluate Ivy's work capacity, id. at 96, and that she was "disabled from her current job but not from any job." Id. at 97. In a discussion with Dr. Jansen, Dr. Woodward agreed that Ivy was "not making much progress." Id. at 25. Dr. Woodward consistently noted that while Ivy suffered from symptoms of depression, medication was unlikely to very beneficial because she was "stuck" in an unhappy marital situation. Id. at 97-99.
In 2002, Ivy saw a therapist, Marcia Drootin, R.N., M.S., C.S., who stated that Ivy was not improving and her prognosis was uncertain. Id. at 37.
To assist it in evaluating Ivy's claim, MetLife submitted her entire file to two independent medical consultants for review. Leonard Kessler, M.D. ("Dr.Kessler"), a physician board certified in psychiatry and neurology, reviewed Ivy's file four times. He reviewed treatment notes from Drs. Jansen and Woodward and conducted teleconferences with both doctors. In a report dated December 27, 2000, Dr. Kessler summarized the findings of Drs. Jansen and Woodward and noted that Ivy was Id. at 154. On March 15, 2001, Dr. Kessler reported that there were no objective formal mental status examinations to support Ivy's subjective complaints of impaired attention and concentration. Id. at 127. Dr. Kessler's final report dated May 2, 2002 noted that during the previous year, Ivy had not exhibited psychotic symptoms or taken neuroleptic medications, had seen her psychologist and psychiatrist each only once a month, and had exhibited merely "SOME depressive symptoms." Id. at 88-89 (emphasis in original). He concluded that Id. at 89.
Ivy's file was also reviewed on December 26, 2002 by Mark Schroeder, M.D. ("Dr.Schroeder"), a physician board certified in neurology and psychiatry. Dr. Schroeder concluded that Ivy's file did not contain evidence that demonstrated the existence of a "severe global objective psychiatric impairment sufficient to preclude [Ivy] from performing the essential duties of her own occupation as a Materials Handler." Id. at 17. He noted that Dr. Woodward's records did not address how Ivy's preoccupation with her marital problems would affect her ability to perform the essential obligations of her job. Id. Dr. Schroeder also determined that Dr. Jansen did not provide objective evidence of Ivy's attention or concentration deficits and that his notes document "primarily self-reported symptoms of emotional distress, and describe primarily family stresses and conflicts." Id.
MetLife initially approved Ivy's short term disability benefits for the period August 2, through October 31, 2000. Id. at 64. At the conclusion of this period, Ivy's condition satisfied the Plan's definition of "full disability" and on November 1, 2000, she began to receive long term disability benefits. Id. Shortly thereafter, MetLife concluded that Ivy's condition had improved and terminated her benefits on March 15, 2001. Id. at 64-67. In a letter to Ivy informing her of the termination, MetLife commented on the "lack [of] information regarding treatment at the level of intensity indicative of a severe psychiatric disorder preclusive of work ability." Id. Ivy appealed MetLife's decision to terminate her benefits but her appeal was unsuccessful. Id. at 10-12.
Under ERISA, the standard of review applied to determinations of benefits eligibility depends on whether the claim administrator or fiduciary is vested with discretionary authority. Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). Absent discretionary authority, the determination is reviewed de novo. Id. Where the claim administrator has been granted discretion, however, the determination is reviewed under a more deferential "arbitrary, capricious, or an abuse of discretion" standard. Doyle v. Paul Revere Life Ins., 144 F.3d 181, 183 (1st Cir.1998) (quoting Diaz v....
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