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MULLALLY v. BOISE CASCADE CORP. LONG TERM DISABILITY PLAN

January 10, 2005.

LISA MULLALLY f/k/a LISA BARCH, Plaintiff,
v.
THE BOISE CASCADE CORPORATION LONG TERM DISABILITY PLAN and CONTINENTAL CASUALTY COMPANY, a CNA company, Defendants.



The opinion of the court was delivered by: JOHN W. DARRAH, District Judge

MEMORANDUM OPINION AND ORDER

Plaintiff, Lisa Mullally, filed suit against Defendants, the Boise Cascade Corporation Long Term Disability Plan and Continental Casualty Company, alleging that she was wrongfully denied disability benefits under the Employee Retirement Income Security Act of 1974 ("ERISA), 29 U.S.C. §§ 1001-3508. Specifically, Plaintiff contends that she was continuously unable to perform her job. In response, Defendants contend that they conducted an investigation of Plaintiff's claim and determined that Plaintiff had failed to establish she was continuously incapable of performing her job. Presently before the Court are cross motions for summary judgment.

LEGAL STANDARD

  Summary judgment is appropriate when no genuine issue of material fact exists and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c); Cincinnati Ins. Co. v. Flanders Elec. Motor Serv., Inc., 40 F.3d 146, 150 (7th Cir. 1994). "One of the principal purposes of the summary judgment rule is to isolate and dispose of factually unsupported claims or defenses. . . ." Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Thus, although the moving party on a motion for summary judgment is responsible for demonstrating to the court why there is no genuine issue of material fact, the non-moving party must go beyond the face of the pleadings, affidavits, depositions, answers to interrogatories, and admissions on file to demonstrate, through specific evidence, that a genuine issue of material fact exists and to show that a rational jury could return a verdict in the non-moving party's favor. Celotex, 477 U.S. at 322-27; Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 254-56 (1986); Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87 (1986); Waldridge v. American Hoechst Corp., 24 F.3d 918, 923 (7th Cir. 1994).

  Disputed facts are material when they might affect the outcome of the suit. First Ind. Bank v. Baker, 957 F.2d 506, 507-08 (7th Cir. 1992). When reviewing a motion for summary judgment, a court must view all inferences to be drawn from the facts in the light most favorable to the opposing party. Anderson, 477 U.S. at 247-48; Popovits v. Circuit City Stores, Inc., 185 F.3d 726, 731 (7th Cir. 1999).

  BACKGROUND

  The undisputed facts, for the purposes of these motions, are taken from the parties' Local Rule 56.1(a) & (b) statements of material facts and exhibits ("Pl.'s 56.1" and "Defs.' 56.1") and the Administrative Record ("R.").

  Plaintiff was employed by Boise Cascade Corporation as a senior marketing claim analyst. Defs.' 56.1 ¶ 3; Pl.'s 56.1 ¶ 7. Plaintiff's job required her to work for forty hours a week. Defs.' 56.1 ¶ 13. Plaintiff typically sat for five hours per day, stood for one hour per day, and walked for up to two hours per day. Defs.' 56.1 ¶ 13. By virtue of her employment, Plaintiff was a participant, as defined by ERISA, in Boise Cascade's long-term disability insurance plan purchased from Continental Casualty and issued to Boise Cascade. Defs.' 56.1 ¶¶ 4-5.

  The plan itself consists of two sets of documents — the Policy and the Certificate. R. at 6-26. The Policy states that Continental Casualty "will deliver certificates of insurance to the Employer for issuance to each Insured Employee. The certificates will describe the benefits, to whom they are payable, the policy limitations, and where the policy may be inspected." R. at 11. The Certificate then states that "[w]hen making a benefit determination under the policy, We have discretionary authority to determine Your eligibility for benefits and to interpret the terms and provisions of the policy." R. at 12. The Certificate, though, states it is not the policy and "is merely evidence of insurance provided under the policy." R. at 12. Nothing in the Policy makes any reference in any way to Continental Casualty's decision-making process regarding benefit eligibility. R. at 6-26.

  Plaintiff sought long-term disability benefits and claimed that she was disabled because of "chronic pain that is debilitating — to the nerves around [her] left kidney with pain that flows around left flank and down left leg." Defs.' 56.1 ¶ 10. To meet the definition of disability, Plaintiff was required to show that she was continuously unable to perform the material and substantial duties of her regular occupation. Defs.' 56.1 ¶ 7. To make this showing, Plaintiff was required to provide proof in the form of: (1) objective medical findings which support her disability, which include but are not limited to tests, procedures, or clinical examinations standardly accepted in the practice of medicine for her disabling condition; and (2) the extent of her disability, including restrictions and limitations which prevent Plaintiff from performing her regular occupation. Defs.' 56.1 ¶ 8.

  Plaintiff was examined by Dr. Richard Fessler, who diagnosed Plaintiff with chronic pain syndrome secondary to left renal congenital abnormality. Pl.'s 56.1 ¶ 10. Plaintiff was also examined by Dr. Luz Feldmann, who diagnosed Plaintiff with complex regional pain syndrome, myofascial low back pain, site low back pain, CV angle pain, and spasms. Pl.'s 56.1 ¶ 47. Dr. Feldmann felt Plaintiff was disabled because she could not keep regular and consistent work hours. Defs.' 56.1 ¶ 12.

  Dr. Richard Penn examined Plaintiff, as well. He first opined that Plaintiff should work part-time and gradually increase her hours, but that it would be doubtful Plaintiff would make a full recovery. Pl.'s 56.1 ¶ 34. Later on, Dr. Penn reported Plaintiff had bad days with symptoms of nausea and dizziness. Pl.'s 56.1 ¶ 41. Thereafter, he concluded that if Plaintiff would return to work, it would be extremely difficult and would probably result in many absences and an inability to carry out her job as needed. Pl.'s 56.1 ¶ 77. Therefore, Dr. Penn later stated that Plaintiff was disabled and may not be able to resume meaningful employment. Pl.'s 56.1 ¶ 79.

  To support her claims, Plaintiff filled out daily-activity logs. Pl.'s 56.1 ¶¶ 53-66. The logs show that Plaintiff did activities such as driving her daughter to school, laundry, dusting, dishwashing, cooking, shopping for groceries, and walking. Pl.'s 56.1 ¶¶ 53-66. The logs also show that Plaintiff frequently rested. Pl.'s 56.1 ¶¶ 53-66. Furthermore, Plaintiff frequently took prescription medication to cope with her pain, both orally and through a Morphine pump that was surgically implanted. Pl.'s 56.1 ¶¶ 21-24, 26-28, 30, 37-38, 40, 43-44, 53-66. The dosage of the pump started at less than 5 mg per day of Morphine, and was raised six times to reach a dosage of 14 mg per day. Pl.'s 56.1 ¶¶ 20-24, 27, 30.

  Plaintiff's supervisor, Diane Oddo, also confirmed that Plaintiff was not able to work on a regular basis. Pl.'s 56.1 ¶¶ 82-83. According to the supervisor, Plaintiff frequently missed time from work because of her condition, which caused Plaintiff to fall behind and caused an extra burden on her co-workers. Pl.'s 56.1 ¶ 83. Plaintiff's supervisor also noted Plaintiff was given many accommodations as a result of her condition. Pl.'s 56.1 ¶ 83. Finally, the supervisor noted that Plaintiff had difficulty accomplishing her work because of the pain Plaintiff was ...


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