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Taylor v. Prudential Insurance Company of America

United States District Court, S.D. Mississippi.

July 1, 2013

THERESA A. TAYLOR, PLAINTIFF
v.
THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, DEFENDANT

Page 477

For Theresa A. Taylor, Plaintiff: Virginia R. Kennedy, LEAD ATTORNEY, HEIDELBERG HARMON, PLLC, Ridgeland, MS.

For The Prudential Insurance Company of America, Defendant: Christopher Daniel Meyer, John M. Lassiter, BURR & FORMAN, LLP - Jackson, Jackson, MS; Ian H. Morrison - PHV, Violet H. Borowski - PHV, PRO HAC VICE, SEYFARTH SHAW, LLP - Chicago, Chicago, IL.

OPINION

Tom S. Lee, UNITED STATES DISTRICT JUDGE.

Page 478

MEMORANDUM OPINION AND ORDER

This cause is before the court on the motion of defendant The Prudential Insurance Company of America for judgment on the pleadings, which the court has converted to a motion for summary judgment. Plaintiff Theresa A. Taylor has responded to the motion and the court, having considered the memoranda of authorities, together with attachments submitted by the parties, concludes that the motion should be granted and plaintiff's claim for long-term disability benefits dismissed without prejudice.

Plaintiff Theresa Taylor filed this action against Prudential alleging that she was wrongfully denied short-term and long-term disability benefits under a disability plan governed by the Employee Retirement Income Security Act (ERISA), 29 U.S.C. § 1001 et seq. According to her complaint, Taylor worked as a territorial sales manager with the Wm. Wrigley Jr. Co. until February 2, 2011, when she stopped working due to symptoms associated with fibromyalgia, sleep apnea and worsening of spinal disease, which she claims rendered her disabled from her job. Through her employment, Taylor participated in Wrigley's ERISA-governed disability plan (Plan), which was administered by Prudential. Under the Plan's Short Term Disability Coverage, following a seven-day elimination period, benefits are payable for a period of up to fifty-two weeks on account of a disability, which the Plan defines as follows:

You are disabled when Prudential determines that:

o you are unable to perform the material and substantial duties of your regular occupation due to your sickness or injury; and
o you have a 20% or more loss of weekly earnings due to that same sickness or injury.

The Plan's Long Term Disability Coverage provides for payment of benefits to a participant who remains disabled following a fifty-two week elimination period during which she was continuously disabled. Just as with the Plan's Short Term Disability Coverage, during the first twelve months of Long Term Disability coverage, a claimant will be considered disabled if she is unable to perform the material and substantial

Page 479

duties of her regular occupation; after twelve months, she will be considered disabled if she is unable to perform the duties of any gainful occupation for which she is reasonably fitted by education, training or experience.

On February 2, 2011, Taylor submitted to Prudential an application for disability benefits. Her claim was initially denied on March 11, 2011, for lack of objective medical evidence to support a finding that she met the Plan definition of disabled. Taylor appealed the denial decision and submitted additional medical documentation. By letter of April 28, 2011, she was advised that she was entitled to receive short-term disability benefits for a closed four-week period, from her last date of work through March 3, 2011, for diagnostic testing, evaluation and physical therapy. Taylor appealed this decision, ...


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