Waskiewicz v. Ford Motor Co.

• Decision Date: 22 March 2019
• Docket Number: Case No. 12-cv-11250
• Parties: LAURA WASKIEWICZ, Plaintiff, v. FORD MOTOR COMPANY SALARIED DISABILITY PLAN, Defendant.
• Court: U.S. District Court — Eastern District of Michigan

LAURA WASKIEWICZ, Plaintiff, v. FORD MOTOR COMPANY SALARIED DISABILITY PLAN, Defendant.

Case No. 12-cv-11250

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION

March 22, 2019

HON. MARK A. GOLDSMITH

OPINION & ORDER GRANTING PLAINTIFF'S MOTION FOR JUDGMENT (Dkt. 148)

This matter is before the Court following remand from the Sixth Circuit. Plaintiff Laura Waskiewicz was employed by Ford Motor Company from 1990 until she was terminated in 2010. UniCare, the claims processor for Defendant Ford Motor Company Salaried Disability Plan ("the Plan"), denied Waskiewicz disability benefits because she was not employed at the time she applied for such benefits, a decision which this Court affirmed on March 20, 2014. Waskiewicz v. UniCare Life & Health Ins. Co., No. 12-11250, 2014 WL 1118501 (E.D. Mich. Mar. 20, 2014). The Sixth Circuit reversed this decision in an October 15, 2015 opinion, noting that "plaintiff's application was denied because she failed to follow time-sensitive provisions that were neglected because of that very illness" for which she sought benefits. Waskiewicz v. UniCare Life & Health Ins. Co., 802 F.3d 851, 853 (6th Cir. 2015). The Sixth Circuit ordered that "[o]n remand, plaintiff shall be given the opportunity to show that her alleged failure to comply with certain of the requirements found in Section 3 of the Plan was due to the very disability for which she seeks benefits." Id. at 856.

Following remand, the parties engaged in additional discovery, and have submitted a record to the Court consisting of nearly 3,000 pages.¹ The parties now seek judgment on the record. For the reasons that follow, the Court grants Waskiewicz's motion for judgment on the record.

I. BACKGROUND

A. Termination of Employment and Denial of Benefits

Waskiewicz was employed by Ford Motor Company as a product design engineer from 1990 until October 26, 2010.² Waskiewicz, 802 F.3d at 852. On October 25, 2010, she suffered a debilitating emotional breakdown following a conversation with her supervisor, Tom Erickson, regarding her repeated failures to timely report to work. RC 2660. She left and did not return to work. Waskiewicz, 802 F.3d at 853. The following day, Erickson reported her absence to Tamika Pettway in Ford's Personnel Relations department. RC 2661. Pettway mailed a letter to Waskiewicz on October 28, 2010, advising her that her absence from work was not authorized. RC 2894. The letter stated that if Waskiewicz was unable to report to work for medical reasons, satisfactory medical documentation had to be provided to Gate 4 Medical. Id. If her absence was for non-medical reasons, documentation should be submitted directly to Pettway. Id. The letter further stated that a failure to provide this information within five business days of the letter would result in termination of Waskiewicz's employment effective October 25, 2010. Id.

This letter was sent to the wrong address and was returned to Ford on November 8, 2010.RC 2756. Nonetheless, Pettway sent a termination letter to Waskiewicz on November 18, 2010. RC 2855. The letter stated that, as a consequence of failing to provide satisfactory documentation to justify her absence, Waskiewicz was "being released from employment as a 'voluntary quit' effective October 26, 2010." Id. A copy of the October 28 letter was attached to the termination letter.

Waskiewicz received the termination letter on November 23, 2010. RC 2756. That same day, Waskiewicz's father, Jack Waskiewicz, contacted his daughter's physician, Dr. Pamela Rockwell. RC 2066. Dr. Rockwell, a family physician, had been treating Waskiewicz for her depression since October 19, 2009, and had found on two previous occasions (in October 2009 and June 2010) that Waskiewicz's depression prevented her from being able to work for a period of time. RC 90-91, 111-112, 785, 2472. Waskiewicz also emailed Dr. Rockwell on November 23, saying that she "ha[d] ben unable to maintain a regular schedule at work for some time now and things just got to a point where I had to leave. This happened about a month ago and since then I have sort of been detached from everything and everyone until now." RC 2536.

Dr. Rockwell saw Waskiewicz on November 24, 2010. RC 737. Waskiewicz told Dr. Rockwell that she had been feeling very depressed, and had not reported to work since October 25. Id. Waskiewicz described herself as "being in a fog with her brain not being in sync with her body movements." Id. She had stopped taking Effexor, a medication for depression, but continued to take her daily doses of insulin. Id.

On November 26, 2010, Waskiewicz emailed Dr. Rockwell, asking her to provide documentation that Waskiewicz had been unable to report to work for medical reasons since October 25. RC 2542. Waskiewicz offered to come to the clinic to pick up the letter and fax it to the appropriate location at work. Id. Dr. Rockwell agreed, id., and on November 29, wrote a letterstating that Waskiewicz "has been unable to work since October 25, 2010. She is under my care and her return to work date is indeterminate at this time," RC 2953. This letter was faxed to Gate 4 Medical on November 30, 2010. RC 2954.

Jack Waskiewicz called UniCare on December 1, 2010, to initiate his daughter's claim for disability benefits. RC 61. UniCare told him to contact Ford to initiate the disability-leave process. RC 62. UniCare also stated that Waskiewicz would need to have the Disability Certification Form completed by her physician and submitted to UniCare immediately. Id. On December 13, 2010, UniCare received certification from Dr. Rockwell that Waskiewicz had been disabled due to depression, poorly-controlled Type I diabetes, and "transgender" issues (not further explained in the Disability Certification Form) since October 25, 2010, and would be unable to return to work for an indeterminate period of time. RC 67, 125. On December 22, 2010, UniCare sent a letter informing Waskiewicz that her application for benefits was denied because she had been terminated as of October 25, 2010, and persons who are not employed are not covered under the Plan. RC 70-71.

In March 2011, UniCare received a Disability Certification Form from Dr. Sandra Samons, who started seeing Waskiewicz regularly on December 2, 2010. RC 75. On March 23, 2011, UniCare sent Waskiewicz a second denial of benefits letter, explaining:

As stated in our previous letter dated December 22, 2010, UniCare has received information from Ford Motor Company indicating that effective October 25, 2010, you are no longer employed as a regular salaried employee. According to the Salary Plan dated January 1, 2010, persons who are not employed as a regular salaried employee are not covered under the plan, and are not eligible for disability benefits.

[ . . . ]

Your disability claim has been denied based on the requirements provided in the Ford Motor Company Salary Plan Language effective January 1, 2010, Section 2, entitled "Definitions",subsections 2.08 and 2.13, and Section 3 Eligibility for Benefits (I, ii iv) which state:

[ . . . ]

Section 3. Eligibility for Benefits. As used in the Plan, a Covered Employee must meet the following conditions:

(i) Must be an Active Employee with a Disability.

(ii) Must be an Employee receiving appropriate care and treatment from a physician practicing within the scope of his/her license and be complying with the prescribed treatment plan.

(iv) Must provide proof of Disability including, but not limited to objective and clinical evidence of the Disability at the time of commencement of the Disability and throughout the duration of the Disability.

RC 114-115.

B. Litigation

Waskiewicz filed the instant complaint on March 20, 2012. This Court granted summary judgment in favor of UniCare after determining that, under an arbitrary-and-capricious standard, the rationale for denying Waskiewicz's benefits - "that Plaintiff was not eligible to apply for benefits because she was not an employee of Ford at the time of filing the disability claim" - was a reasonable decision. Waskiewicz, 2014 WL 1118501, at *7.³ In so doing, the Court rejected Waskiewicz's argument that, because she qualifies as an "Active Employee" under Section 3 of the Plan, her subsequent termination did not bar her from applying for benefits. Id. at *10. The Court noted that Waskiewicz needed to comply with all of the eligibility requirements in Section 3, one of which required her to be an "Employee" - which she was not at the time she applied for benefits. Id.

The Sixth Circuit approached the case in a different light on appeal. The court noted that, according to UniCare's files,

[Plaintiff's] father called re [plaintiff's] benefit status. Advised that [plaintiff] was first treated November 24th, disability would have commenced that date[,] however, [plaintiff] was [terminated] and therefore not eligible for benefits. Father stated [plaintiff] was catatonic since 10/25/10 and could not see a Dr.... Advised father of the policies in the Salary Plan that [contact] must be made w/in first 7 days, father asked for an exception. Advised that we administer Plan and explained Appeal process.

Waskiewicz, 802 F.3d at 854 (quoting RC 74). The court reasoned that Waskiewicz's failure to comply with the notification deadlines outline in Section 4.02 of the Plan was "not surprising given that she was suffering from severe mental illness and was unable to comply due to the very disability for which she sought coverage." Id. at 855. UniCare's denial of benefits based on Waskiewicz's retroactive termination was arbitrary and capricious, said the court, and appeared inconsistent with "the spirit of employer-provided health care benefits generally and with this Plan specifically." Id. at 855-856.

The Sixth Circuit stated that it was "hard pressed to believe that plaintiff's failure to comply with reporting deadlines prescribed by the Plan should result in the denial of benefits as long as the failure to comply was...