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GOMULUCH v. AMERITECH

May 3, 1999

KATHRYN GOMULUCH, PLAINTIFF,
v.
AMERITECH, A CORPORATION AND AMERITECH'S LONG TERM DISABILITY PLAN, DEFENDANTS.



The opinion of the court was delivered by: Castillo, District Judge.

MEMORANDUM OPINION AND ORDER

Kathryn Gomoluch sued Defendants alleging that Ameritech and Ameritech's Long Term Disability Plan ("LTDP") violated the Employment Retirement Income and Security Act ("ERISA") when it terminated her long term disability benefits. Gomoluch's claim is brought pursuant to ERISA's civil enforcement provision, 29 U.S.C. § 1132 (a)(1)(B). Currently before the Court is Defendants' motion for summary judgment. Ameritech also asks us to dismiss the case against it, arguing that it is not a proper defendant to this suit. We grant Defendants' motion for summary judgment for the reasons stated below.

RELEVANT FACTS

Gomoluch worked as a Service Representative at Ameritech. She suffered from interstitial cystis, and as a result, experienced pain in her abdomen and an increased need to urinate. On June 19, 1995, she stopped reporting to work and began receiving short-term disability benefits under Ameritech's Sickness and Accident Disability Plan. When those benefits expired, Gomoluch applied for long-term disability benefits under Ameritech's LTDP. Although she received benefits for June and July of 1996, Defendants terminated her benefits as of August 1, 1996. In a letter dated December 12, 1996, Ameritech notified Gomoluch that her benefits had been terminated, explaining that although she met the definition of disability under Ameritech's LTDP for the months of June and July, "[t]here was no medical documentation submitted which would substantiate continued disability after July 1996."

Gomoluch contacted Ameritech's Long Term Disability Manager, Bradley Johnson, to obtain information for appealing the termination decision. Johnson informed Gomoluch that the Benefit Committee decided appeals. Johnson directed Gomoluch to send the committee a letter stating the reasons she was entitled to benefits, along with medical documentation supporting her claim that she was unable to work after July of 1996.

Gomoluch complied, supplying the Benefit Committee with an explanatory letter and her medical records from August to October of 1996. In addition, Gomoluch submitted letters from three different treating physicians, dated August, October, and December 1996. In the December 1996 letter, Gomoluch's physician, Dr. Sproul stated that Gomoluch had been prescribed Elmiron to manage her pain and that "[a]lthough she seems significantly improved on these medicines, she continues to have problems with urinary frequency and urgency and inability to hold her urine for any length of time." Dr. Sproul opined that "[t]his combined with her ileostomy and her chronic asthma has made it difficult for her to maintain a schedule that will allow her to work regularly."

Linda Nikitas, the Benefit Committee Coordinator, directed a letter to Gomoluch acknowledging receipt of the correspondence and documentation, and requesting any additional documentation Gomoluch believed was pertinent to her appeal. No further documentation was forthcoming.

Johnson forwarded Gomoluch's disability file to Dr. Avrom Simon, a consulting physician. Johnson asked Dr. Simon to review Gomoluch's file, call her physician, and render his opinion as to her ability to work with or without accommodation. Dr. Simon contacted Dr. Sproul by telephone and requested information about Gomoluch's condition. Dr. Sproul revealed that although the Elmiron reduced Gomoluch's pain and need to urinate, she had discontinued the medication because her insurance did not cover it. Drs. Simon and Sproul agreed that Gomoluch could work at a sedentary job if she was allowed bathroom breaks when needed and could take Elmiron regularly.

The Assistant Secretary to the Benefit Committee, Kathy Ort, subsequently received Gomoluch's file. Ort prepared a report for the Benefit Committee that summarized Gomoluch's case and recommended upholding the termination. Dr. Anfield, the medical advisor to the Benefit Committee, agreed with Ort's recommendation.

Nikitas distributed Gomoluch's entire file to the Benefit Committee several days before it met to vote on Gomoluch's appeal. Gomoluch's file contained her appeal letter; her medical records; notes from plan administrators regarding her claim; letters from treating physicians dated August 28 and November 1, 1996; Dr. Sproul's December 18, 1996 letter; Dr. Simon's handwritten notes; and Ort's recommendation and report.

Dr. Anfield and Ort attended the Benefit Committee meeting held on May 27, 1997. Dr. Anfield summarized the information contained in Gomoluch's file, discussing the medical findings and their significance, and answered the members' questions regarding Gomoluch's condition. The Committee voted to uphold the termination of Gomoluch's long-term benefits. On June 5, 1997, Ort sent a letter to Gomoluch informing her that the Committee voted to deny Gomoluch's benefits "due to a lack of objective medical documentation to substantiate" her claim that she was "unable to engage in any occupation or employment (with reasonable accommodation), for which [she was] qualified, or may reasonably become qualified, based on training, education or experience." This suit followed.

SUMMARY JUDGMENT STANDARD

Summary judgment is proper when there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c). To avoid summary judgment, the nonmovant must advance "specific facts showing that there is a genuine issue for trial." Fed.R.Civ.P. 56(e). A genuine issue for trial exists when "the evidence is such that a reasonable jury could return a verdict for the ...


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