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QUINN v. NON-CONTRIBUTORY NAT. LONG TERM DISABIL.

September 13, 2000

CONSUETA QUINN, PLAINTIFF,
V.
THE NON-CONTRIBUTORY NATIONAL LONG TERM DISABILITY PROGRAM AND BLUE CROSS AND BLUE SHIELD DEFENDANTS.



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

MEMORANDUM AND OPINION ORDER

Consuela Quinn ("Quinn") has brought this Employee Retirement Income Security Act ("ERISA") action under 29 U.S.C. § 1132(a)(1)(B) ("Section 1132(a)(1)(B)") in her continuing attempt to get long term disability income benefits from Blue Cross and Blue Shield Association ("Blue Cross"). Quinn has also named as an added defendant the employee welfare benefits plan from which she seeks those benefits, the non-Contributory National Long Term Disability Program ("Program"). As the later discussion reflects, this case is a retread before this Court, having earlier climbed up the hill to our Court of Appeals and then having climbed down again.

As a result of this second go-round, both sides have again moved for summary judgment under Fed. R. Civ. P. ("Rule") 56 and have relatedly complied with this District Court's LR 56.1.*fn1 At this point those motions are fully briefed and ready for decision. For the reasons stated in this memorandum opinion and order Blue Cross' motion is granted, Quinn's motion is denied and this action is dismissed with prejudice.

Summary Judgment Standards

No case citations are really needed to support the universally established principle that Rule 56 requires the facts to be viewed from the nonmovant's perspective. So where as here cross-motions for summary judgment are filed, it becomes necessary to adopt a dual perspective — one that this Court has often described as Janus-like. In this case, though, no material facts are in dispute. Instead the question is one of law: whether Blue Cross properly exercised its duties as administrator of Quinn's benefit plan.

Background

Most of the relevant facts are recited in this Court's earlier opinion ("Opinion I," 990 F. Supp. 557 (N.D. Ill. 1997)) and in that of the Court of Appeals ("Opinion II," 161 F.3d 472 (7th Cir. 1998)) and will therefore not be repeated at length. In a nutshell, however, Quinn worked for Health Care Service Corporation ("Health Care") a Blue Cross licensee that participates in the Program. While on short-term disability in 1994 after a hysterectomy, Quinn was diagnosed with interstitial cystitis, a non-bacterial inflammation of the urinary bladder that can cause pain and frequent urination. Citing that condition, in February 1995 Quinn applied for long-term disability benefits under the Program. Conflicting medical testimony was presented, with Drs. E. Richard Blonsky and Anthony Schaef for opining that Quinn was not disabled and Drs. Dennis Pessis and Donald Hoard offering the opposite view. Based on the former opinions, to which Blue Cross gave greater weight, it denied Quinn's benefits claim. That determination was then upheld on administrative appeal.*fn2

Quinn next filed an ERISA action pursuant to Section 1132(a)(1)(B). On the ensuing cross-motions for summary judgment, this Court determined that while it "cannot be labeled an abuse of discretion for Blue Cross to have decided to accept the Schaeffer-Blonsky view rather than the opposing Pessis-Hoard opinion" (Opinion I at 561), Blue Cross did abuse its discretion by its "failure to investigate properly whether Quinn was capable of finding a comparable job at a similar salary . . ." (Id. at 563) That decision was initially coupled with an order remanding the matter to Blue Cross for further consideration, but when Quinn requested reconsideration under Rule 59(e) this Court determined that Halpin v. W.W. Grainger. Inc., 962 F.2d 685, 697 (7th Cir. 1992) called instead for granting the retroactive reinstatement of Quinn's benefits.*fn3

On appeal, the Court of Appeals agreed with this Court that Blue Cross' vocational skills determination had been made arbitrarily (Opinion II at 476)

We agree that [Blue Cross] was under no obligation to undergo a full-blown vocational evaluation of Quinn's job, but [it] was under a duty to make a reasonable inquiry into the types of skills Quinn possesses and whether those skills may be used at another job that can pay her the same salary range as her job with [Health Care].

But the Court of Appeals held that Gallo v. Amoco Corp., 102 F.3d 918 (7th Cir. 1996) rather than Halpin controlled the particular facts of the case.*fn4 So the Court of Appeals sided with this Court's original ruling*fn5 so that "the case should be remanded to the Program Secretary to make a more adequate assessment of whether Quinn is disabled as defined by the Program, specifically whether her vocational skills enable her to obtain another job with a comparable salary" (Opinion II at ¶ 479).*fn6

On remand Blue Cross placed Quinn's claim at the point when claims are first presented to the Claims Appeals Committee ("Appeals Committee") (BC St. ¶ 42). In response Quinn "notified Blue Cross that it [sic] would not consider the remand proceedings to be in compliance with the [Court of Appeals'] ruling unless the review was performed independently" (Q. Mem. 2; see also Jt.App. Tab E, BC1001). Nevertheless Quinn submitted a substantial number of items in support of her appeal (BC St. ¶ 45)

(1) a report of diagnostic vocational assessment performed on Quinn on March 29, 1999 by Cheryl R. Hoiseth ["Hoiseth"]; (2) Hoiseth'S curriculum vitae; (3) an "Updated Report of Donald E. Hoard, M.D." dated March 16, 1999; (4) notes of bladder instillations performed on 9/29/97, 11/24/97, 3/23/98, 5/18/98, 7/20/98, 9/28/98, 1/11/99, and 3/22/99; (5) a sworn statement from Dr. Donald E. Hoard dated March 21, 1997; and (6) a portion of the Social Security Administration's determination granting Quinn disability benefits.

Much of that material was discounted by Blue Cross because it considered that evidence relating to Quinn's health after August 31, 1995 (the date her original benefits had ended) was irrelevant to the issue whether Blue Cross' 1995 ...


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