United States District Court, N.D. Mississippi, Greenville Division
TIMOTHY L. TURNER PLAINTIFF
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY DEFENDANT
MEMORANDUM OPINION AND ORDER
M. BROWN, UNITED STATES DISTRICT JUDGE
Life & Accident Insurance Company terminated Timothy L.
Turner's long term disability benefits based on its
determination that Turner was able to perform a job with
comparable pay commiserate with his functional capabilities.
Following an unsuccessful appeal to Hartford, Turner
initiated this suit against Hartford, alleging a wrongful
denial of benefits under the Employee Retirement Income
Security Act. Turner and Hartford have filed cross-motions
for summary judgment, both of which, at the parties'
request, this Court interprets as motions for judgment on the
record. Because the Court finds Hartford's termination of
Turner's benefits supported by substantial evidence and
not arbitrary and capricious, the Court may not overturn
Hartford's decision to terminate Turner's disability
26, 2015, Timothy L. Turner filed a complaint in this Court
against Hartford Life & Accident Insurance Company
(“Hartford”), asserting three claims under the
Employee Retirement Income Security Act
(“ERISA”): (1) wrongful denial of benefits; (2)
breach of fiduciary duty; and (3) intentional interference
with ERISA rights. Doc. #1. On July 28, 2015, Turner amended
his complaint as of right. Doc. #6. The amended complaint
asserts only a single ERISA claim - wrongful denial of
April 12, 2016, Hartford moved for summary judgment on
Turner's remaining claim. Doc. #24. The same day, Turner
filed a cross-motion for summary judgment. Doc. #27. On April
22, 2016, Turner filed an unopposed motion seeking an
extension of the deadline to respond to Hartford's
summary judgment motion. Doc. #29.
April 26, 2016, Hartford responded in opposition to
Turner's summary judgment motion and filed a motion to
strike certain exhibits attached to it. Doc. #30; Doc. #32.
Two days later, this Court denied Turner's motion for an
extension. Doc. #33. Turner responded in opposition
to Hartford's summary judgment motion on May 2, 2016,
Doc. #35, but did not respond to the motion to strike.
Hartford replied in support of its summary judgment motion on
May 9, 2016. Doc. #39.
August 11, 2016, the parties, after consultation with United
States Magistrate Judge Jane M. Virden, submitted to the
Court a proposed pretrial order which waives the right to
trial and asks the Court to convert the cross-motions for
summary judgment to motions for judgment on the record.
See Doc. #43. The Court approved and entered the
pretrial order on March 10, 2017. Doc. #44.
for Judgment on the Record
parties have asked the Court to treat the cross-motions for
summary judgment as motions for judgment on the
administrative record. A “motion for judgment on the
administrative record” is “a motion that does not
appear to be authorized in the Federal Rules of Civil
Procedure.” Muller v. First Unum Life Ins.
Co., 341 F.3d 119, 124 (2d Cir. 2003) (internal
quotation marks omitted). However, “it may be
appropriate for the district court to treat such a motion as
requesting essentially a bench trial on the papers with the
District Court acting as the finder of fact. In that
scenario, the district court may make factual findings, but
it must be clear that the parties consent to a bench trial on
the parties' submissions.” O'Hara v.
Nat'l Union Fire Ins. Co. of Pitt., 642
F.3d 110, 116 (2d Cir. 2011) (internal quotation marks and
clear the parties here have consented to a bench trial on
their submissions based on the pretrial order submitted.
Accordingly, the Court will treat the parties' motions
for summary judgment as motions for judgment on the record
and will decide them as the finder of fact.
The Group Long-Term Disability Policy
is an approximately 48-year old male who was employed in the
security and alarms business from 1994 until 2011. AR-308,
During the time period relevant to this suit, Tyco
International Management Company maintained a Group Long-Term
Disability Policy (“Policy”) through Hartford
applicable to Turner. Id. at 001.
the terms of the Policy, Hartford had “full discretion
and authority to make an initial determination and
interpretation of the terms and provisions of The
Policy.” Id. at 030.
relevance here, the Policy includes the following provisions:
Disability Benefit: What are my
Disability Benefits under the Policy?
We will pay You a Monthly Benefit if You:
1) become Disabled while insured under The Policy;
2) are Disabled throughout the Elimination Period;
3) remain Disabled beyond the Elimination Period; and
4) submit Proof of Loss to Us.
Termination of Payment:
When will my benefit payments end?
Benefit payments will stop on the earliest of:
1) the date You are no longer Disabled;
2) the date You fail to furnish Proof of Loss;
3) the date You are no longer under the Regular Care of a
Any Occupation means any occupation for
which You are qualified by education, training or experience,
and that has an earnings potential greater than the lesser
1) the product of Your Indexed Pre-disability Earnings and
the Benefit Percentage; or
2) the Maximum Monthly Benefit.
Disability or Disabled
means You are prevented from performing one or more of the
Essential Duties of:
1) Your Occupation during the Elimination Period;
2) Your Occupation, for the 24 month(s) following the
Elimination Period, and as a result Your Current Monthly
Earnings are less than 80% of Your Indexed Pre-disability
3) after that, Any Occupation.
Essential Duty means a duty that:
1) is substantial, not incidental;
2) is fundamental or inherent to the occupation; and 3)
cannot be reasonably omitted or changed.
Your ability to work the number of hours in Your regularly
scheduled work week is an Essential Duty.
Your Occupation means Your Occupation as it
is recognized in the general workplace. Your Occupation does
not mean the specific job You are performing for a specific
employer or at a specific location.
Id. at 022, 024, 030-031, 034.
Turner's Initial Health Problems
2005, Turner underwent cervical spine surgery. Id.
at 360. Following surgery, Turner developed moderate paresis
of the right true vocal cord. Id. On June 9, 2006,
Turner was seen by John Schweinfurth, M.D., for a follow-up
of the right true vocal cord paresis. Id.
Schweinfurth observed that the vocal cord paresis had
resolved but noted that Turner had “problems with
inflammation of both vocal cords.” Id. at 361.
At a follow-up appointment three weeks later, Schweinfurth
diagnosed Turner with dysphonia, “likely secondary to
right vocal strain and synkinesis.” Id. at
362. Approximately one month later, on July 25, 2006, Turner
returned to Schweinfurth. Id. at 365. Schweinfurth
found that Turner “seems to be doing well at this point
and progressing well. We will have him follow up in our
clinic on as needed basis.” Id.
February 22, 2008, Turner was evaluated by Rahul Vohra, MD,
based on “complaints of back pain and intermittent
bilateral leg tingling.” Id. at 645-46. Turner
saw Vohra throughout 2008 and, sometime between October 31,
2008, and January 15, 2009, underwent surgery and
decompression on his back. Id. at 638-646. On
January 15, 2009, Vohra observed that Turner “is doing
significantly better from a radicular perspective status post
lumbar decompression.” Id. at 638. Throughout
2009 and into 2010, Turner returned to Vohra with a variety
of complaints, including neck pain, back pain, leg pain, and
depression. Id. at 631-38.
Long Term Disability Approval
2010, Turner held the position of a Rep-Core Account
Executive with Tyco. AR- 861. On April 6, 2010, Turner
presented to Vohra with “increasing neck and back
pain.” Id. at 631. Turner reported to Vohra
that “[h]e drives a great deal at work and … has
had significant difficulty with this.” Id.
Turner told Vohra that “[h]e stopped working about two
weeks ago.” Id.
18, 2010, Turner returned to Vohra complaining “of neck
pain as well as low back pain.” Id. at 865. A
month later, on July 16, 2010, he presented to Vohra with
“axial cervical pain, lumbar pain, and rare tingling in
both feet.” Id. at 863. Vohra observed
diminished lumbar range and reflexes, and completed a
“Release to Return to Work Status: Short Term
Disability” form stating that Turner was not released
to return to full duty or light duty. Id. at 864.
Sometime later, Turner began receiving short term disability
benefits. Id. at 242.
August 2010, Turner contacted Hartford about obtaining long
term disability (“LTD”) benefits. Id. at
150. However, on October 4, 2010, Turner informed Hartford
that he had been cleared to return to work with no formal
restrictions or limitations. Id. at 148. The same
day, Hartford denied Turner's application for long term
disability. Id. at 236-38.
October 7, 2010, Turner reopened his long term disability
claim. Id. at 141. Hartford approved the claim on
December 9, 2010. Id. at 232-34. The approval lists
a disability date of April 7, 2010, and an effective date of
October 30, 2010. Id. at 235.
First Functional Evaluation and Award of Social Security
August 5, 2011, Vohra, at Hartford's request, completed
an “Attending Physician's Statement of
Functionality” (“APS”) for Turner. AR-718.
In the APS, Vohra noted that Turner: (1) could
“rarely” lift/carry up to ten pounds; (2) could
never lift or carry anything heavier than ten pounds; (3)
could never bend at the waist, kneel, or crouch; (4) could
occasionally drive; (5) could never reach above the shoulder
or below the waist; and (6) could occasionally (defined as
1-33%) finger/handle. Id. at 717. The APS reported
that Turner did not suffer from a psychiatric/cognitive
impairment. Id. at 716.
November 10, 2011, Turner attended a follow-up appointment
with Vohra, during which Vohra observed that Turner
“continues to have moderate cervical paraspinal spasm
with diminished cervical range of motion.” Id.
at 586. Vohra noted that Turner reported increasing pain with
the change in weather but an improvement in his depression
symptoms, which he believed to be due to counseling.
Id. Turner informed Vohra that he was attending his
children's ballgames and was “going for a walk
January 31, 2012, the Social Security Administration found
Turner to be entitled to monthly disability benefits based on
a disability which began April 3, 2010. Id. at 677.
March 1, 2012, Turner returned to Vohra. Id. at 585.
Turner reported attending counseling and taking hydrocodone
and Zoloft. Id. Vohra noted that Turner's
“functional level is very good” but that
“occasionally, … [Turner] will have to
significantly limit his activities secondary to neck
pain.” Id. Turner informed Vohra that
“[d]riving still consistently causes significant
pain.” Id. Vohra concluded that Turner was
“stable” and was “doing well from the
standpoint of his depression with the Zoloft and his pain is
well controlled with the hydrocodone.” Id.
March 12, 2012, Vohra submitted to Hartford an
“Attending Physician's Statement of Continued
Disability.” Id. at 662-63. The statement
contains the same restrictions set forth in Vohra's
August 5, 2011, assessment, including the conclusion that
Turner does not suffer from a cognitive or psychiatric
impairment. Id. On March 27, 2012, Hartford wrote to
Vohra to ask him to “explain the medical reasoning that
[Turner] is only able to reach occasionally at waist/desk
level and do occasional fingering and handling.”
Id. at 659. Vohra responded, “[Turner] has had
a 2 level fusion & anterior ... plate lumbar
March 21, 2012, Turner, who was complaining of left knee
pain, was examined by Michael G. Holman, MD. Id. at
566-68. Holman found that Turner had “[f]ull range of
motion bilaterally but ... limited flexion, ” and noted
that the symptoms were “highly suggestive of meniscus
tear or a loose body in the knee.” Id. at 567.
Holman prescribed an NSAID and use of a brace. Id.
May 3, 2012, Letter and Subsequent Review
3, 2012, Hartford sent Turner a letter stating, in relevant
Your LTD benefits became effective on 10/30/2010. Effective
10/30/2012 you must be considered Disabled as outlined in the
second portion of the above definition in order to continue
to be eligible for LTD benefits.
Please be advised that this office has initiated a review to
determine if you will qualify for benefits on and after
10/30/2012. When we have completed our review, we will notify
you regarding our determination.
that month, on May 30, 2012, Turner underwent an MRI on his
right knee. Id. at 570. The MRI revealed a
“[t]ear of the posterior horn of the medial
minisicus” and “[s]ignificant degenerative
changes of the patellofemoral joint with joint space
narrowing, cartilage loss, and osteophyte formation.”
20, 2012, Turner presented to Holman with “[p]ainful
triggering in the right thumb, ” which Holman
attributed to tendonitis. Id. at 557. Holman
performed an injection on Turner's thumb and made an
appointment for Turner to undergo surgery. Id. at
September 28, 2012, Hartford sent Turner a letter stating, in
relevant part, that he was determined to have met “the
policy definition of Disability and that you will continue to