{"id":7568,"date":"2020-05-04T15:34:45","date_gmt":"2020-05-04T20:34:45","guid":{"rendered":"https:\/\/www.nickortizlaw.com\/?p=7568"},"modified":"2024-01-04T17:26:35","modified_gmt":"2024-01-04T22:26:35","slug":"bigham-v-liberty-life-with-de-novo-review-court-should-conduct-bench-trial-on-the-record","status":"publish","type":"post","link":"https:\/\/www.nickortizlaw.com\/bigham-v-liberty-life-with-de-novo-review-court-should-conduct-bench-trial-on-the-record\/","title":{"rendered":"Bigham v. Liberty Life – With De Novo Review Court Should Conduct Bench Trial On The Record"},"content":{"rendered":"

Case Name:\u00a0<\/strong>Rose Bigham v. Liberty Life Assurance Company of Boston<\/p>\n

Court:\u00a0<\/strong>United States District Court for the Western District of Washington at Seattle<\/p>\n

Type of Claim:\u00a0<\/strong>Long Term Disability<\/a><\/p>\n

Insurance Company:\u00a0<\/strong>Liberty Life Assurance Company of Boston<\/a> a\/k\/a Liberty Mutual Insurance Company (hereinafter \u201cLiberty Life\u201d)<\/p>\n

Claimant\u2019s Employer:<\/strong> Amazon, LLC<\/p>\n

Claimant\u2019s Occupation \/ Job Position:\u00a0<\/strong>Security Technical Program Manager<\/a><\/p>\n

Disabilities:<\/strong>\u00a0chronic\u00a0intractable pain<\/a>,\u00a0fibromyalgia<\/a>, seronegative spondyloarthropathy,\u00a0cervical\u00a0and\u00a0lumbar degenerative disc disease<\/a>, and related conditions.<\/p>\n

Definition of Disability:\u00a0<\/strong>Under the LTD Plan, benefits are awarded beyond the 25-week window. Under this\u00a0plan, \u201cDisabled\u201d is defined as when the employee \u201cas a result of Injury or Sickness, is\u00a0unable to perform the Material and Substantial Duties of his Own Occupation.\u201d\u00a0\u201cSickness\u201d is defined as \u201cillness, disease, pregnancy or complications of\u00a0pregnancy.\u201d The Plan defines \u201cMaterial and Substantial Duties\u201d as\u00a0\u201cresponsibilities that are normally required to perform the Covered Person\u2019s Own\u00a0Occupation, or any other occupation, and cannot be reasonably eliminated or modified.\u201d<\/p>\n

LTD Plan benefits are limited to 24 months<\/a> unless the employee can show that she \u201cis unable to perform, with reasonable continuity, the Material and Substantial Duties of Any Occupation.\u201d \u201cAny Occupation\u201d<\/a> is defined as \u201cany occupation that the [employee] is or becomes reasonably fitted by training, education,\u00a0experience, age, physical and mental capacity.\u201d<\/p>\n

Benefits Paid?<\/strong>\u00a0Liberty Life granted\u00a0LTD\u00a0benefits with a reservation of rights. Several months later\u00a0Liberty Life terminated the Plaintiff\u2019s benefits.<\/p>\n

Procedural history:<\/strong>\u00a0The Plaintiff\u00a0appealed the termination of benefits.\u00a0Liberty Life denied that appeal, and the Plaintiff filed a lawsuit.<\/p>\n

Issues:\u00a0<\/strong>(1) Whether Ms. Bigham\u2019s condition qualifies as a disability under the LTD\u00a0Plan. (2)\u00a0Liberty Life contends that Ms. Bigham\u2019s symptoms are purely subjective, and cites to\u00a0Jordan v. Northrup Grumman, 370 F.3d 869 (9th Cir 2004) for the proposition that it is\u00a0\u201cappropriate for an administrator to require objective evidence of functional\u00a0restrictions.\u201d (3)\u00a0Whether\u00a0the surveillance footage is \u201cinconsistent\u201d with Ms. Bigham\u2019s\u00a0self-reporting of her pain physical capabilities, and whether \u201cplaintiff\u00a0in fact does suffer from debilitating pain and fatigue sufficient to preclude her from\u00a0performing her own occupation\u2026\u201d. (4)\u00a0Whether the claim should be\u00a0remanded to Liberty Life for the issue\u00a0of extending benefits to Ms. Bigham beyond the 24-month period prescribed for \u201cown\u00a0occupation\u201d benefits under the Plan. (5) Whether\u00a0it is appropriate to resolve this case on the parties\u2019 cross motions for judgment under Rule 52\u00a0as opposed to summary judgment under Rule 56.<\/p>\n

Holdings:\u00a0<\/strong>(1) \u201cIt is clear from the record that Ms. Bigham\u2019s job required her to be able to focus her thoughts and interact with others for long periods of time on a daily basis. Doctors who personally examined Ms. Bigham, including Dr. Neiman, Dr. Girolami, and Dr. Goodman, concluded that Ms. Bigham\u2019s condition made it impossible for her to reliably perform this essential job function. This evidence alone is persuasive that Ms. Bigham is disabled under the Plan.\u201d (2) \u201cHowever, this citation does not convince the Court that purely subjective symptoms doom Ms. Bigham\u2019s claim for two reasons. First, unlike the Court here, the court in Jordan was reviewing the plan administrator\u2019s decision for abuse of discretion, not de novo review. The Court here is not required to grant any deference to Liberty Life\u2019s previous decisions. Second, the court in Jordan did not rule that subjective symptoms are insufficient evidence of disability<\/a>, it found that the plaintiff in that case failed to provide sufficient medical documentation of functional restrictions.\u201d (3) \u201cAfter reviewing the surveillance footage<\/a> and the rest of the record, the Court disagrees with Liberty Life\u2019s analysis and conclusions. The surveillance footage neither proves nor disproves that Ms. Bigham\u2019s documented chronic intractable pain, fibromyalgia, seronegative spondyloarthropathy, cervical and lumbar degenerative disc disease, and related conditions prevent her from doing her job.\u201d (4) \u201cThe Court does not have sufficient evidence or argument before it determine whether Ms. Bigham is \u2018unable to perform, with reasonable continuity, the Material and Substantial Duties of\u2026. any occupation that the [employee] is or becomes reasonably fitted by training, education, experience, age, physical and mental capacity.\u2019\u201d For these reasons, the Court remanded to Liberty Life the issue of extending benefits into the \u201cown occupation\u201d period. (5) \u201cThe answer depends on what standard of review the court applies. \u2026 Thus, when applying the de novo standard in an ERISA benefits case, a trial on the administrative record, which permits the court to make factual findings, evaluate credibility,\u00a0and weigh evidence, appears to be the appropriate proceeding to resolve the dispute. \u2026\u00a0Given the above law, and the clear intent of the parties, the Court will resolve the\u00a0parties\u2019 dispute in a bench trial on the administrative record rather than on summary judgment.\u00a0Therefore, the court issues the following findings and conclusions, pursuant to Rule 52.\u201d<\/p>\n

Other Interesting Comment:\u00a0<\/strong>\u201cThe LTD Plan does not require Ms. Bigham to be completely incapacitated. The\u00a0Plan does not discuss intermittent disability or provide a threshold frequency of\u00a0disabling symptoms. Instead, Ms. Bigham will qualify as disabled under the Plan if she\u00a0can establish that she is unable to perform, as a result of illness or disease, the\u00a0responsibilities that she is normally required to perform in her occupation, which cannot\u00a0otherwise be reasonably eliminated or modified.\u201d<\/p>\n

Summary:\u00a0<\/strong>\u201cPlaintiff\u2019s Motion for Judgment under Federal Rule of Civil Procedure 52 (Dkt.\u00a0#10) is GRANTED. Plaintiff is entitled to receive long-term disability benefits\u00a0from the beginning of her eligibility through the 24-month period prescribed in the\u00a0LTD Plan, to recover pre-judgment interest on those unpaid benefits, and to recover\u00a0attorney\u2019s fees and costs. However, the Court REMANDS to Liberty Life the issue\u00a0of extending benefits to Ms. Bigham beyond the 24-month period prescribed for\u00a0own occupation benefits under the LTD Plan.\u201d<\/p>\n

\n

Disclaimer: This was not a case handled by disability attorney Nick A. Ortiz. The court case is summarized here to give readers a better understanding of how Federal Courts decide long term disability ERISA claims.<\/p>\n

Here is a PDF copy of the decision:\u00a0Bigham v. Liberty Life<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Case Name:\u00a0Rose Bigham v. Liberty Life Assurance Company of Boston Court:\u00a0United States District Court for the Western District of Washington at Seattle Type of Claim:\u00a0Long Term Disability Insurance Company:\u00a0Liberty Life Assurance Company of Boston a\/k\/a Liberty Mutual Insurance Company (hereinafter \u201cLiberty Life\u201d) Claimant\u2019s Employer: Amazon, LLC Claimant\u2019s Occupation \/ Job Position:\u00a0Security Technical Program Manager Disabilities:\u00a0chronic\u00a0intractable …<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[246],"_links":{"self":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/7568"}],"collection":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/comments?post=7568"}],"version-history":[{"count":0,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/7568\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/media?parent=7568"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/categories?post=7568"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/tags?post=7568"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}