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Gittings v. Tredegar Corp.

May 20, 2010

DALE C. GITTINGS, PLAINTIFF,
v.
TREDEGAR CORPORATION, ET AL., DEFENDANTS.



The opinion of the court was delivered by: Milton I. Shadur Senior United States District Judge

MEMORANDUM OPINION AND ORDER

Dale Gittings ("Gittings") has brought this action under a provision of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §1132(a)(1)(B),*fn1 seeking long term disability payments pursuant to the Tredegar Corporation Employee Benefit Plan ("Plan"), which is underwritten by Sun Life Assurance Company of Canada ("Sun Life"). Although Gittings had named both the Plan and Sun Life as defendants, this Court has earlier explained that Sun Life is not a proper party under the well-established principles exemplified in such cases as Blickenstaff v. R.R. Donnelley & Sons Co. Short Term Disability Plan, 378 F.3d 669, 674 (7th Cir. 2004) and therefore dismissed it from the case.

Plan has now moved for judgment on the administrative record under Fed. R. Civ. P. ("Rule") 52.*fn2 Both parties have submitted an agreed administrative record, and each has tendered proposed findings of fact and conclusions of law and responses to the same.*fn3 Gittings has also tendered some additional exhibits with his initial Rule 52 briefing, and Plan has moved to strike those materials.

For the reasons stated in this memorandum opinion and order, Plan's motion for judgment on the administrative record is denied. This matter is remanded to Plan to make a more adequate assessment of whether Gittings was eligible to submit a claim for long term disability benefits under Plan.*fn4

Findings of Fact

Gittings worked for Tredegar for more than 34 years (R. 88). His last occupation there was as Maintenance Supervisor, a position he had held from May 1, 2005 to January 27, 2006 (id.).

On August 22, 2005 Gittings was injured in a motorcycle accident (R. 135). His doctors determined that he had suffered a torn meniscus and scheduled surgery to treat the injury (id. 126). After the surgery Gittings developed an infection and required two further procedures (G. Mem. 7). After a lengthy recovery period when Gittings was out from work on short-term disability leave (R. 105), Gittings' doctors informed him that he would likely require a total knee replacement in the future (id. 126).

Gittings returned to work in either November or December of 2005 (R. 105, 159). He contends that he was on "light duty" after his return and that he never again resumed the regular duties of his occupation (id. 159-60). On January 27, 2006 Tredegar terminated Gittings (id. 88). Tredegar appears to have told Sun Life (acting as the claims administrator) that Gittings was fired for "company violations," though that is documented only in a letter from Sun Life to Gittings (id. 156).

On June 19, 2006 Gittings, through counsel, submitted a claim to Plan for long term disability benefits (R. 82-83). Plan responded with a request that Gittings return some required forms, including a personal statement and a statement from Gittings' physician detailing his injury and disability as well as his prognosis (id. 126-29, 133-49). Gittings provided those forms as well as authorization forms allowing Plan to request his medical records (id.).*fn5

Plan also communicated with Tredegar, asking it to submit an employer's statement along with Gittings' payroll and attendance records (R. 80). Tredegar submitted Gittings' payroll records from April 2005 to January 2006. But it provided his timesheets only for April through August 2005 and for January 2006, omitting the timesheets for the period following his accident and through his absence on short term disability leave (id. 103-07, 113-24). Tredegar claims that it had "[n]o knowledge of [Gittings'] disability on Jan. 27, 2006" (id. 96).

On July 25, 2006 Plan called Gittings' counsel to inform him that Gittings would not be covered for benefits because Gittings was working full time and receiving his full paycheck as of the date of his termination (R. 78, 155-56). Gittings appealed Plan's decision on January 16, 2007 (id. 78). His counsel noted in the appeal letter that Gittings was not, in fact, working in his own occupation when he was terminated but was instead performing only "light duty and office work" (id. 160). Gittings also resubmitted his physician's statement, personal statement and authorization forms (id.)

On March 2, 2007 Plan again denied Gittings' claim (R. 210-13). Plan stated that because Gittings had worked full time up to his termination with no loss of income and because he had filed for unemployment compensation benefits after his termination--then indicating that he could work--he did not appear to be unable to perform all of the material and substantial duties of his occupation (id. 212).*fn6

In March 2007 Gittings was awarded Social Security disability income retroactive to the date of his motorcycle accident (R. 78, G. Mem. 8). His attorney wrote Sun Life to inquire whether that award would affect Plan's denial of Gittings' long term disability claim (R. 78). Sun Life informed Gittings' attorney that he could submit the Social Security documentation with a request for review but that it would not consider the award determinative (id.). One month later Gittings' attorney followed up with Sun Life, stating that he was gathering the documentation and would submit it as soon as possible (id.). Sun Life replied ...


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