Schaffer v. Benefit Plan of Exxon Corp.
| Decision Date | 11 July 2001 |
| Docket Number | No. CIV. A. G-00-241.,CIV. A. G-00-241. |
| Citation | 151 F.Supp.2d 799 |
| Parties | Phillip SCHAFFER and David W. Stiefel, v. BENEFIT PLAN OF EXXON CORPORATION and Participating Affiliates. |
| Court | U.S. District Court — Southern District of Texas |
Blair Bernard Brininger, III, Attorney at Law, Houston, TX, for plaintiffs.
William Scott Helfand, Magenheim Bateman et al, Houston, TX, for defendants.
ORDER GRANTING DEFENDANT'S MOTION FOR SUMMARY JUDGMENT AND DENYING PLAINTIFFS' MOTIONS FOR SUMMARY JUDGMENT
Plaintiffs bring this action pursuant to the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq., challenging their denial of benefits. Now before the Court are Plaintiffs' and Defendant's competing Motions for Summary Judgment. For the reasons stated below, Defendant's Motion for Summary Judgment is GRANTED and Plaintiffs' Motions are DENIED. Consequently, Plaintiffs' claims are DISMISSED WITH PREJUDICE in their entirety.
Plaintiffs are Phillip W. Schaffer ("Schaffer") and David W. Stiefel ("Stiefel"). Both are former employees of Exxon Company U.S.A. ("Exxon"), who injured their elbows on-the-job, and who were subsequently denied disability benefits under the Benefit Plan of Exxon Corporation ("Plan"). Defendant moved to sever and transfer the claims of Plaintiff Stiefel, but the Court denied the request in an Order dated December 19, 2000.
Plaintiff Schaffer began working for Exxon as a field mechanic craftsman in 1974 and became a participant in the Plan shortly thereafter. He suffered an on-thejob injury to his elbow on October 19, 1993.
Defendant's version of the subsequent events are as follows. Plaintiff received workers' compensation and temporary industrial disability benefits from November of 1993 until October of 1996. He then received long-term disability benefits from October of 1996 until April of 1997. In May of 1997, Dr. Richard O. Dockins, Exxon's Medicine and Environmental Health Department Director, determined that Plaintiff had a treatable medical condition and could return to a structured work transition program, or work-hardening program. Plaintiff refused to participate until he was seen by his doctor. His doctor had been Dr. James Pyle in Baytown, Texas, but at this time Plaintiff changed to Dr. Gerard Gable in Houston. Dr. Gable prescribed a work-hardening program for Plaintiff, and Plaintiff began the program on June 2, 1997. On June 11, 1997, Plaintiff reported that he had injured his back on June 6, 1997 while participating in the program. Dr. Dockins examined Plaintiff the next day and found "no evidence of any significant musculoskeletal injury." Dr. Dockins concluded that Plaintiff's refusal to participate was due to lack of motivation and "not strictly medical issues." Plaintiff nevertheless continued to refuse to participate in the program.
Exxon then placed Plaintiff on Family Medical Leave on June 23, 1997. On September 12, 1997, Plaintiff was informed that his claim for medical retirement benefits had been denied. Plaintiff was nevertheless granted a fourteen week extension of his Family Leave so he could identify and participate in a work transition program. Plaintiff did not respond.
In March of 1998, Exxon offered to perform a voluntary medical exam on Plaintiff, let Plaintiff update his medical records, and let him return to work. Again, Plaintiff did not respond to the offer. Thus, on September 23, 1998, Exxon terminated Plaintiff's employment. Again, there was no response from Plaintiff until approximately ten months later, on July 25, 1999, when Plaintiff submitted additional medical evidence and demanded that Defendant "pay his benefits."
Plaintiff offers the following version of the events. He alleges that his injury has made him incapable of engaging in any type of gainful employment from November 1, 1993 to the present. In May of 1994, Plaintiff's personal physician, Dr. Pyle, diagnosed Plaintiff with "Chronic Lateral Humeral Epicondylitis" or as it is commonly referred to "tennis elbow." Dr. Pyle placed him on restrictions of "no lifting, pulling, pushing over 10 lbs, no climbing ladders, no excessive use of wrists, no excessive extension position of elbows." In October of that year, Dr. Pyle determined that Plaintiff would possibly need surgery. In November of 1995, Exxon placed similar restrictions on Plaintiff.
In August of 1996, a review committee recommended that the Plan grant Plaintiff disability benefits. Defendant thereafter prepared a termination checklist for Plaintiff. In December of 1996, Defendant's doctor, Dr. Myron Harrison determined that Plaintiff was partly disabled.
Then, "inexplicably" the Defendant decided that Plaintiff was not following his doctor's orders and ordered his return to work. Only after deciding that Plaintiff had a treatable medical condition did Defendant ask Dr. Dockins to support the decision. Defendant allegedly stated that it was "not planning to disability retire Plaintiff ... [but] to bring him back to work or deny his benefits."
Plaintiff injured his back during the work-transitioning program. Subsequently, Dr. Donald T. Lazaraz diagnosed Plaintiff with "Rheumatoid Spondylitis of the Lumbar Spine" which affected his spine and joints, both shoulders, and elbows. Dr. Lazaraz opined that Plaintiff was not capable of returning to work and was a candidate for retirement. Furthermore, Dr. Lazaraz believed that surgery would only worsen symptoms. Plaintiff had a positive result from an arthritis blood test. Approximately one year later, Dr. Lazaraz found that Plaintiff had a ten percent impairment for each elbow weakness, equal to a nineteen percent impairment using the combined value system.
Plaintiff submitted additional documents to Defendants on July 25, 1999. Defendant Plan agreed to review the documents, but nonetheless refused to reverse the denial of benefits.
Plaintiff Stiefel began working for Exxon as a mechanical draftsman in 1977 and became a participant in the Plan shortly thereafter. He suffered an on-the-job injury to his elbow in 1995.
Defendant offers the following version of subsequent events. After his injury, Plaintiff was diagnosed with carpal tunnel syndrome and underwent surgery in August of 1996. In March of 1997, Plaintiff applied for Special Disability benefits, which were denied because it was not clear that Plaintiff was likely to recover within twenty-four months.
In December of 1997, Dr. Kenneth R. Kemp, Jr. determined that Plaintiff was at maximum medical improvement as of July 31, 1997. Dr. Kemp found that Plaintiff had a five percent impairment in his right wrist, a two percent impairment in the left upper extremity, and a seven percent impairment in the right upper extremity for a total of nine percent whole person impairment.
In October of 1998, Exxon certified Plaintiff as being able to return to work and ordered him to do so by December 10, 1998. When Plaintiff did not return by that date, or provide additional medical information, Exxon considered him as having resigned.
Plaintiff offers the following version of the events. Plaintiff was diagnosed with carpal tunnel syndrome, for which he was treated with a wrist brace for two months, but his elbow pain continued to intensify. In December of 1995, Plaintiff was further diagnosed with "cubital tunnel syndrome" in the right elbow and "hyper-extension valgus overload syndrome" in the right elbow. Then in February of the following year, Plaintiff was diagnosed with "bilateral neuropathy" and "bilateral median neuropathy," and delayed relaxation of reflexes. Plaintiff was recommended to undergo surgeries to correct the polyneuropathy. In July of 1997, Dr. Lazaraz diagnosed Plaintiff with Rheumatoid arthritis of the spine, aggravated by shoulder and elbow musculoskeletal strain and "post-operative ulnar transfer-carpal tunnel decompression."
Plaintiff claims that Defendant denied his Medical Retirement benefits stating no warranted grounds. Plaintiff appealed this decision. The appeal was denied because Plaintiff was still an employee. Thereafter, Plaintiff was evaluated by a Dr. Eric Scheffey who determined that he was not a candidate for gainful employment and outlined his work restrictions. Dr. Scheffey stated that Plaintiff would not be able to maintain attention for a period of two hour segments and that Plaintiff's medication interfered with Plaintiff's coordination, concentration, and ability to remain alert. Plaintiff appealed his denial of medical retirement and sent additional documents to Defendant. In the mean-time, on March 23, 1999, Plaintiff received a fully favorable decision for benefits retroactive to December 6, 1995 from the Social Security Administration. Defendant was informed of this decision. On May 24, 1999, Defendant denied Plaintiff's appeal for medical retirement benefits claiming that he was not terminated for disability. Plaintiff thereafter sent more documents to Defendant. He was informed that the Plan would review his claim, but the appeal was ultimately denied again on November 19, 1999.
Summary judgment is appropriate if no genuine issue of material fact exists and the moving party is entitled to judgment as a matter of law. See FED. R. CIV. P. 56(c); Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 2552-53, 91 L.Ed.2d 265 (1986). When ruling on a motion for summary judgment the evidence is viewed through "the prism of the substantive evidentiary burden." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 254, 106 S.Ct. 2505, 2513, 91 L.Ed.2d 202 (1986). Generally, "a denial of benefits challenged under [ERISA]1 is to be reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan."...
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