Parker v. Metropolitan Life Ins. Co.

• Decision Date: 17 January 1995
• Docket Number: 94-2506 M1/BRO.,No. 94-2155 M1/A,94-2155 M1/A
• Parties: Ouida Sue PARKER, Plaintiff, v. METROPOLITAN LIFE, INSURANCE COMPANY, Defendant. Ouida Sue PARKER, Plaintiff, v. SCHERING-PLOUGH CORPORATION, and Schering-Plough Health Care Products, Inc., Defendant.
• Court: U.S. District Court — Western District of Tennessee

875 F. Supp. 1321

Ouida Sue PARKER, Plaintiff, v. METROPOLITAN LIFE, INSURANCE COMPANY, Defendant.

Ouida Sue PARKER, Plaintiff, v. SCHERING-PLOUGH CORPORATION, and Schering-Plough Health Care Products, Inc., Defendant.

Nos. 94-2155 M1/A, 94-2506 M1/BRO.

United States District Court, W.D. Tennessee, Western Division.

January 17, 1995.

COPYRIGHT MATERIAL OMITTED

Kaye G. Burson, Rutledge & Rutledge, Memphis, TN, for plaintiff.

John J. Heflin III, Rickey Bourland Heflin & Alvarez, Memphis, TN, for defendants.

ORDER GRANTING DEFENDANT METROPOLITAN LIFE'S MOTION TO DISMISS ALL CLAIMS ARISING UNDER THE ADA AND GRANTING DEFENDANT METROPOLITAN LIFE'S MOTION FOR SUMMARY JUDGMENT AND GRANTING SCHERING-PLOUGH DEFENDANTS' MOTION FOR SUMMARY JUDGMENT

McCALLA, District Judge.

This matter is before the Court on defendant Metropolitan Life's Motion to Dismiss All Claims Arising Under the Americans with Disabilities Act, filed September 2, 1994, Metropolitan Life's Motion for Summary Judgment filed November 21, 1994, and defendants Schering-Plough Corporation and Schering-Plough Health Care Products, Inc.'s Motion to Dismiss filed August 9, 1994.¹

For the reasons stated, this Court hereby GRANTS defendant MetLife's Motion to Dismiss All Claims Arising Under the ADA, GRANTS defendant MetLife's Motion for Summary Judgment, regarding plaintiff's ERISA claims, and GRANTS defendants Schering-Plough Corporation and Schering-Plough Health Care Products Inc.'s Motion for Summary Judgment.

This is an action for long-term disability benefits pursuant to an employee benefits plan. 29 U.S.C. § 1001 et seq., (Employee Retirement Income Security Act of 1974, as amended). Plaintiff also asserts claims under the Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et seq., and as to the defendants Schering-Plough Corporation and Schering-Plough Health Care Products ("Schering-Plough defendants"), plaintiff asserts state law claims of negligence and intentional infliction of emotional distress.²

In plaintiff's remaining claims against Metropolitan Life ("MetLife") and the Schering-Plough defendants, she alleges unlawful discrimination under the ADA, because they administered and offered an employee long-term disability plan that distinguishes between benefits for mental and physical disabilities. Plaintiff asserts that under the ADA MetLife is a "covered entity," that she is a "qualified individual with a disability," and therefore, that she is entitled to relief under the Act.

Plaintiff also asserts that MetLife and the Schering-Plough defendants violated ERISA by wrongfully denying her disability benefits under the Schering-Plough long-term disability plan. Plaintiff claims that defendants MetLife and Schering-Plough have misconstrued the plan language regarding mental illness and that, in fact, plaintiff's illness has a physical and/or chemical origin which removes her condition from the mental or nervous disorders provision of the plan.

Plaintiff further asserts that the defendants, as fiduciaries under ERISA, retained discretionary control of claims and breached their fiduciary duty by denying benefits to her under the plan.

The material facts in this case are not in dispute. Plaintiff is approximately fifty-four (54) years old, is a widow, and is no longer working. Plaintiff was an employee of Schering-Plough Corporation and began her employment on April 20, 1981. Defendants concede that the plaintiff became disabled on October 29, 1990, and it is not disputed that her disability continues to this date. During plaintiff's employment, she participated in a long-term disability plan provided by Schering-Plough Corporation. The Schering-Plough long-term disability plan was administered at least in part by MetLife.³ Plaintiff received long-term disability benefits continuously from April 29, 1991, through April 28, 1993, at which time her benefits were discontinued.

It is undisputed that plaintiff received two years of medical benefits for her mental disability in accordance with the terms of her long-term disability plan. The plan provides in pertinent part:

MENTAL OR NERVOUS DISORDERS. If you are totally disabled due to a mental or nervous disorder, your LTD long-term disability benefit is payable for up to twenty-four (24) months. At the end of twenty-four (24) months of LTD benefit payments, benefits will continue only if you are confined in a hospital or other institution qualified to provide care and treatment for your mental or nervous disorder. Further, if you are confined for at least fourteen (14) consecutive days, your LTD benefit is extended to provide benefits for an additional ninety (90) days after the confinement. If during the additional ninety (90) day period you are again confined in a hospital or institution for fourteen (14) days or more, your LTD benefit will be paid during the confinement and the ninety (90) day period following your release.

Summary Plan Description Claims record at 34.

The plan provides for continual disability payments up to age sixty-five (65) for individuals with disabilities other than mental/nervous disabilities, i.e., physical disabilities. Id. at 33. There is no dispute that plaintiff's primary diagnosis is major depression. In correspondence dated May 17, 1993, plaintiff's physician, Dr. M.W. Lathram, Jr., specifically stated the following:

The above-named party, Sue Parker, has just had an office visit. I will reiterate that the records indicate that she has been a patient since 1975 with many hospitalizations for the same diagnosis, major depression. She has had thorough examinations on many occasions, including a most thorough examination by Dr. Paul Neal, clinical psychologist.

Sue continues to show signs of major depression with a great deal of anger, pity, and some suicidal ideation, decreased psychomotor activity, obsessional concern to the point of rumination, which has hindered life efficiency. I have used different approaches, including electroshock therapy in 1991. She had a trial with Lithium for over a year. I have prescribed amitriptyline (Elavil), lorazepam 0.5 QID (Ativan). I am adding the chemical, Tegretol (carbamazine), 400 mg daily to help arrest the process.

In my opinion the lady has a chronic major depression and all evidence indicates that this is a chemical disorder of a deepseated nature. I hope this letter will aid you in making a decision in considering her for extended disability benefits.

Claims record at 118.

For purposes of this Order addressing consolidated cases 94-2155 and 94-5026, we will first consider plaintiff's ADA claims.

I. Plaintiff's Claims Under Title I of the ADA

Under Title I of the ADA, plaintiff alleges unlawful discrimination by the Schering-Plough defendants because they maintain on behalf of their employees a long-term disability plan that distinguishes between benefits for mental and physical disabilities. Plaintiff's ADA Title I action against MetLife arises out of MetLife's discontinuation of long-term disability benefit payments to plaintiff under the terms of the Schering-Plough plan in which plaintiff participated. Again, Plaintiff asserts that since the plan provides less benefits for persons with mental disabilities than for persons with physical disabilities, the ADA is violated. The Schering-Plough defendants assert that plaintiff's claims under the ADA should be dismissed because plaintiff is not a "qualified individual with a disability" as defined by the Act and therefore, that plaintiff is not entitled to the Act's protection.⁴

Title I of the ADA addresses disability discrimination by employers. Section 102(a) of Title I of the ADA states that "no covered entity shall discriminate against a qualified individual with a disability...." 42 U.S.C. § 12112(a). (Emphasis added).

A qualified individual with a disability is defined, in pertinent part, as:

an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires. (emphasis added).

42 U.S.C. § 12111(8).

In Beauford v. Father Flanagan's Boys' Home, 831 F.2d 768 (8th Cir.1987), cert. denied, 485 U.S. 938, 108 S.Ct. 1116, 99 L.Ed.2d 277 (1988), the Eighth Circuit considered whether an employee on disability leave who was no longer able to perform the essential functions of her job and who claimed disability discrimination in the provision of health and disability benefits was entitled to the protection of the Rehabilitation Act of 1973. Because provisions under the ADA are to be interpreted consistent with similar requirements under the Rehabilitation Act, the Beauford court's analysis is instructive in the present case. See 42 U.S.C. § 12117(b); Tyndall v. Nat. Educ. Centers, 31 F.3d 209 (4th Cir.1994).

In considering the employee's claim, the court first noted that the clear language of the Rehabilitation Act extended the Act's protection only to "otherwise qualified handicapped individuals." The court next considered the Supreme Court's interpretation of an "otherwise qualified individual" under the Rehabilitation Act as "one who is able to meet all of a program's requirements in spite of his handicap." Id. at 771 (citing Southeastern Community College v. Davis, 442 U.S. 397, 406, 99 S.Ct. 2361, 2367, 60 L.Ed.2d 980 (1979)). Finally, the Eighth Circuit found that both the statute's language and its interpretation by the Supreme Court indicated that section 504 of the Rehabilitation Act was designed to prohibit discrimination within an employment relationship in which the employee is able to do the job in question. Therefore, the court denied the employee's claim because by her own admission she was no longer able to perform her job. Id.

While the Eighth Circuit determined whether the plaintiff in Beauford was "qualified" at the time she claimed benefits under the plan rather than at the time she was offered admission into the...