Pylant v. Hartford Life and Acc. Ins. Co.
| Decision Date | 20 April 2006 |
| Docket Number | No. Civ.A. 305CV0379-G.,Civ.A. 305CV0379-G. |
| Citation | 429 F.Supp.2d 816 |
| Parties | Andrea D. PYLANT, Plaintiff, v. HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY, et al., Defendants. |
| Court | U.S. District Court — Northern District of Texas |
Bernard A. Guerrini, Law Office of Bernard A. Guerrini, Dallas, TX, for Plaintiff.
Jessica Spangler Taylor, Akin Gump Strauss Hauer & Feld, San Antonio, TX, Megan M. O'Laughlin, Akin Gump Strauss Hauer & Feld, Dallas, TX, for Defendants.
Maxel B. (Bud) Silverberg, Law Office of Maxel (Bud) Silverberg, Dallas, TX, Pro se.
Before the court are the cross motions for summary judgment of the plaintiff Andrea Pylant ("Pylant") and the defendants Hartford Life and Accident Insurance Company ("Hartford") and The First American Corporation Group Life, Medical, Dental, Disability Benefits Trust No. 502 ("Plan"). For the reasons stated below, the defendants' motion is granted and Pylant's motion is denied.
This is an action for review of the termination of long-term disability benefits by the administrator of an employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001, et seq. In September of 2000, Pylant began work as a technical writer for First American Financial Corporation ("First American"). Brief in Support of Plaintiff's Motion for Summary Judgment ("Pylant's Brief") at 2. She remained there until November of the following year. Id. In February 2002, Pylant filed a claim for disability after she was diagnosed with chronic fatigue, Epstein Barr, cytomegalovirus, and psoriatic arthritis. Id. at 6. Pylant's claim was approved on May 30, 2002, and she began receiving long-term disability ("LTD") benefits (effective as of March 21, 2002). Id. at 2; Defendants' Brief in Support of Their Motion for Summary Judgment ("Hartford's Brief') at 7. On January 28, 2004, however, Hartford wrote Pylant to inform her that her LTD payments would be terminated, effective February 1, 2004. Pylant's Brief at 16. Pylant appealed this decision, but Hartford upheld its previous termination of benefits based on its conclusion that she was no longer disabled. Id. at 2, 9. On February 24, 2005, Pylant filed this case, challenging Hartford's denial of LTD benefits. Docket Sheet. On October 28, 2005, Pylant and the defendants filed these cross motions for summary judgment. Id.
In early November of 2001, Pylant stopped working as a technical writer for First American because of fatigue and pain. Pylant's Brief at 6. She received a diagnosis of psoriatic arthritis in early January of the following year from her treating rheumatologist, Dr. Don Cheatum ("Dr.Cheatum"). Id. at 12. Pylant had previously qualified for short-term disability benefits effective November 15, 2001, but Hartford referred Pylant's claim to long term disability in February 2002 to determine her continued eligibility for benefits. Hartford's Brief at 3. Pylant informed Hartford, in response to a questionnaire, that her primary physicians were her family physician Dr. Kathleen Humphries ("Dr.Humphries") and Dr. Cheatum. Id. at 4. In her first Attending Physician Statement ("APS"), Dr. Humphries opined that Pylant could stand for a "short time," walk for "short trips" of less than 100 feet, sit for one to two hours a day, but "not in 1 block," and that Pylant could never lift, reach, work overhead, push or pull. Id. Dr. Humphries also opined that Pylant could use a keyboard for less than fifteen to twenty minutes at a time. Id. In Dr. Cheatum's first APS, he stated that Pylant could stand, walk, and sit, but she needed the opportunity to move around frequently due to stiffness. Id. at 5. Dr. Cheatum also concluded that Pylant could lift or carry less than ten pounds, drive a vehicle, and use a keyboard as long as she could "take breaks as needed." Id. Hartford also conducted a phone interview with Pylant in late March of 2002. Id. In that interview, Pylant stated she was unable to do her job because of her inability to sit for very long. Id. Because she was "on the couch 24/7," she could not do much and her mother did everything for her family. Id.
First American gave Hartford a description of Pylant's occupation as a technical writer, indicating that she was required to sit for up to eight hours, occasionally lift or carry up to ten pounds, occasionally push or pull up to twenty pounds, reach for books or into file drawers while sitting, and use a "computer keyboard and mouse at a fairly constant level of activity." Hartford's Brief at 6. Hartford then had a rehabilitative specialist compare this job description with that of a technical writer in the national economy. Id.; see also Appendix to Defendants' Brief in Support of Their Motion for Summary Judgment ("Hartford's Appendix") at 484-88 (). This specialist determined that, while Pylant's particular position was a light duty position, a technical writer in the general workplace was a sedentary duty position. Id. Based on this information, Pylant's own statements, and the opinions of her primary physicians, Hartford determined on May 30, 2002, that Pylant was eligible for LTD benefits. Id. at 6-7.
In October 2002, Hartford decided to evaluate Pylant's continued eligibility for LTD benefits. Hartford's Brief at 7. Pylant submitted an APS and Physical Capabilities Evaluation Form ("PCE") from Dr. Humphries as well as a Claimant Questionnaire completed by herself. Id. On the basis of this information, Hartford determined that Pylant continued to qualify for LTD benefits. Id.
In June of 2003, Hartford again reviewed Pylant's eligibility for LTD benefits. Hartford's Brief at 8. Pylant submitted a Claimant Questionnaire in which she stated that she had "trouble using [her] hands" and on "some days" she could not use her right arm at all. Id. Typical days involved her helping her children get ready for school, napping, and assisting in home chores. Id. Despite these problems, Pylant occasionally attended church and her children's sporting activities and could perform almost all activities of daily living without assistance. Id. Around the same time, Hartford received an APS and PCE from Dr. Humphries. Pylant's physician provided a divergent account of her abilities, stating that Pylant could never drive a vehicle and could only sit, stand, or walk for less than fifteen minutes at a time. Id. Based on this discrepancy, Hartford's claims examiner referred Pylant's claim to Hartford's Special Investigations Unit ("SIU") for further fact-gathering. Id. at 8-9.
In late August of 2003, Hartford's SIU hired Dempsey Investigations to perform video surveillance of Pylant's daily activities. Hartford's Brief at 9. For two days, Dempsey Investigations videotaped Pylant near her home and her child's school. Id.; see also DVD copy of video surveillance attached to Hartford's Appendix as Exhibit 1B.1. Pylant was observed driving her children to school, removing a child weighing in excess of twenty pounds from the rear of her car, and then carrying that child with both hands into her home. Hartford's Brief at 9. Another day, Pylant drove to her children's school, sat in her vehicle for more than ten minutes while moving around, leaned into the passenger seat to adjust the seat, used her right arm over the seat to attend to her infant, and picked up the same infant with both hands while lifting her over the seat. Id. Later in the video (and on the same day), Pylant exited the vehicle while carrying the child and spent approximately eighteen minutes standing, rocking, and carrying the child. Id. She was also observed bending over at the waist to pick up an item that had fallen to the ground. Id.
Based on this surveillance, which contradicted the opinions of both Pylant and her physician regarding her functionality, SIU conducted an in-person interview with Pylant. Hartford's Brief at 9. During this two-hour interview, the investigator did not note any cognitive or concentration problems, nor did the investigator notice any sort of pain indicators. Id. Pylant informed the investigator that she was not taking any prescription medications and, declining to view the video, admitted that she was readily capable of performing the activities seen during the surveillance. Id. at 9-10. Pylant also stated that she had limitations (viz., walk a maximum of fifteen minutes, stand a maximum of five to ten minutes, lift/carry items weighing a maximum of ten pounds, no overhead lifting with her right arm, little grip strength in hands/fingers, and type only five minutes at a time), but had absolutely "no limitations or restrictions" on how long she could sit. Id. at 10.
In September of 2003,1 Hartford requested that Pylant submit another Claimant Questionnaire and have her treating physician complete another APS and PCE. Hartford's Brief at 10. Hartford was reevaluating whether Pylant continued to be eligible for LTD benefits; after March 21, 2004, Pylant would have to be totally disabled from any occupation in order to qualify. Id. Pylant's Claimant Questionnaire stated she could not drive longer than fifteen minutes, was unable to sit, stand or walk for more than fifteen minutes (contradicting her statement in her interview that she had no limitations on sitting), and had experienced increased pain in her joints. Id. at 11. Pylant also informed Hartford that she required more rest, could not use her right arm and hand at all, and needed assistance with bathing and using the toilet. Id. The APS and PCE were submitted in this instance by Dr. Cheatum. Id. In these documents, Dr. Cheatum opined that Pylant could sit, stand, walk, and drive for approximately an hour at a time, could occasionally lift, carry, push and pull...
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