Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_04-cv-00525/USCOURTS-azd-2_04-cv-00525-0/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1001 E.R.I.S.A.: Employee Retirement

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1 On December 22, 2005, the parties in this matter filed a

Stipulated Motion for Leave to Amend Complaint to Add Additional

Party. Motion for Leave to Amend (doc. 105). This motion requests

that Hartford Life Group Insurance Company ("Hartford") be added as

a defendant in this case. Id. The Court shall grant this motion and

deem this order to apply to all defendants in this matter, including

Hartford.

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Constance Ann Maynard, )

)

Plaintiff, ) No. CIV 04-0525 PHX RCB

)

vs. ) O R D E R

)

CNA Group Life Assurance )

Company, et al., )

)

Defendants. ) )

On June 8, 2005, Defendants CNA Group Life Assurance Company

("CNA"), et al., filed a Motion for Summary Judgment in this

matter.1 Motion for Summ. Judg. (doc. 72). Plaintiff Constance Ann

Maynard filed her response to this motion on August 22, 2005. Resp

(doc. 77). Thereafter, on October 11, 2005, Defendants filed a

motion to strike certain exhibits filed by Plaintiff. Mot. to

Case 2:04-cv-00525-RCB Document 109 Filed 01/11/06 Page 1 of 19
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Strike (doc. 92). Then, on October 17, 2005, Plaintiff filed a

motion for leave to file the Supplemental Declaration of Constance

Ann Maynard and the Declaration of Stuart H. Sandhaus. Mot. for

Leave to File (doc. 95). In addition, Plaintiff filed a request for

judicial notice. Request Jud. Not. (doc. 98). These motions were

fully briefed on November 3, 2005, and Defendants' motion for

summary judgement was argued orally on December 19, 2005. Reply to

Mot. to Strike (doc. 103).

I. Background Facts

Plaintiff's claims arise under the Employee Retirement Income

Security Act of 1974, 29 U.S.C. § 1001 et seq. ("ERISA"). Plaintiff

has sued for long-term disability ("LTD") insurance benefits under

an employee welfare benefit plan ("Hewitt Plan") provided by her

employer, Hewitt Associates, L.L.C. The Hewitt Plan purchased LTD

insurance coverage through Continental Casualty Company and CNA

Group Life Assurance Company (collectively "CNA") under policy

#SR83100971 ("Policy"). The Policy became effective February 1,

1997, but was amended on January 1, 2001, granting CNA

discretionary authority to determine claims as of January 1, 2001

("Policy-2"). DSOF (doc. 73) at Exbt. B.

Plaintiff worked for Hewitt Associates, L.L.C. as a

Measurement Consultant. The primary function and components of her

job were "[m]arketing of various surveys, including telemarketing

and assisting in the coordination of marketing materials to

clients." Exbt. C (doc. 73). Plaintiff's position required no heavy

or manual labor, and she was expected to work with a computer,

telephone, and a calculator. Id. She typically lifted or carried

business materials weighing less than ten (10) pounds. Id.

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On July 5, 2000, Plaintiff stopped working at Hewitt due to an

alleged disability, and, thereafter, submitted a claim to CNA for

LTD benefits. To demonstrate that an insured was disabled under

Policy-2, evidence must indicate that the claimant was

"continuously unable to perform the Material and Substantial

Duties" of his or her regular occupation. Exbt. B (doc. 73) at 7.

"Material and Substantial Duties" means "the necessary functions of

[the insured's] Regular Occupation which cannot be reasonably

omitted or altered." Id. at 16. "Regular Occupation" means "the

occupation that [the insured is] performing for income or wages" on

the date of the insured's disability. Id.

CNA reviewed Plaintiff's physical job requirements and the

medical records provided by Plaintiff's healthcare providers dating

back to June of 1999. CNA sent these documents to Dr. Eugene

Truchelut, an independent physician, board certified in internal

medicine. On or about April 24, 2001, Dr. Truchelut opined that

Plaintiff's medical records did not indicate an inability to

perform sedentary work activities. Exbt. E (doc. 30) at 5.

On June 7, 2001, CNA denied Plaintiff's claim for LTD

insurance coverage. After CNA denied Plaintiff's claim for LTD

benefits, she exercised her right to appeal CNA's decision and

submitted additional documents to CNA. On or about January 18,

2002, the appeals committee made a determination that Plaintiff was

not disabled under the plan and affirmed CNA's earlier decision.

Plaintiff, thereafter, filed this lawsuit. Complaint (doc. 1).

III. Defendants' Motion to Strike

Defendants ask the Court to strike numerous documents filed by

Plaintiff in support of her opposition to Defendants' motion for

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summary judgment. Mot. to Strike (doc. 92). Specifically,

Defendants move to strike (1) the Declaration of Constance Ann

Maynard ("Maynard Declaration"); (2) Exhibit A to the Maynard

Declaration; (3) Exhibits A, M, O, P, Q, R, S, T, U to the

Declaration of Stuart H. Sandhaus ("Sandhaus Declaration"); (4) the

Declaration of Daniel L. Peterson, M.D. ("Peterson Declaration");

(5) Exhibits A, B and G to the Peterson Declaration; (6) the

Declaration of Sheila P. Bastien, Ph.D. ("Bastien Declaration");

(7) Exhibits D, E, G and H to the Bastien Declaration; and (8)

Plaintiff's Controverting Statement of Facts in Opposition to

Defendants' Motion for Summary Judgment, ¶¶ 7, 40-50. Id. at 1-2. 

Defendants assert that all of these documents were produced after,

or are based upon documents produced after, CNA denied Plaintiff's

ERISA appeal, thus, they are not part of the administrative record.

Id. at 2. For this reason, Defendants request that the documents be

stricken. Id. at 2-3.

In contrast, Plaintiff argues that the contested documents

should not be stricken, because they are either part of the

administrative record or based upon documents that are part of the

administrative record. Resp. to Mot. to Strike (doc. 97) at 3-5.

First, Plaintiff's argument centers around evidence that was

submitted to Defendants after January 18, 2002, when the appeals

committee made its determination and affirmed CNA's earlier

decision to deny Plaintiff's claim for LTD benefits. Id. at 3.

"After Defendant CNA, who acted as the claims

administrator, denied Plaintiff's benefits on

January 18, 2002, Plaintiff filed an appeal with

the Plan Administrator/Fiduciary, Defendant

Hewitt. Both Defendant CNA and Hewitt thereafter

accepted, reviewed, and considered additional

evidence in support of Plaintiff's claim for LTD

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benefits." 

Id. Apparently, Plaintiff believes that she filed and Defendants

reviewed a "second" appeal of her claim that occurred after January

18, 2002. However, Plaintiff herself notes that CNA, in its letter

of January 14, 2003, in response to Plaintiff's submission of

additional evidence after January 18, 2002, stated "[t]here are no

further appeal reviews available." Id. at 4. In addition, Plaintiff

points out that Defendant Hewitt, in its response letter, stated,

"Ms. Maynard has exhausted all of her administrative

remedies...[and] [s]he may now pursue any available remedies in

court should she decide to do so." Id. The Court notes that

Defendant Hewitt in this letter also stated "CNA provided you with

a five-page final determination of benefits in which CNA advised

that Ms. Maynard's administrative record was closed and the

decision was final and binding." Sandhaus Declaration (doc. 81) at

Exbt. U.

Second, Plaintiff asserts that the documents should not be

stricken, because they are "based upon documents that are part of

the administrative record[.]" Resp. to Mot. to Strike (doc. 97) at

4. In support of this assertion, Plaintiff again argues that

Defendants reviewed the contested documents during the alleged

"second" appeal. Id. at 5. Plaintiff admits that the contested

information was "reviewed" by Defendants after the January 18, 2002

appeal decision. Id. ("The 'information' reviewed by Defendant CNA

included updated medical reports from treating and consulting

medical providers and rebuttal reports in response to documentation

that was provided to Plaintiff as enclosures with Defendant CNA's

letter of February 28, 2002."). However, Plaintiff argues that by

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merely stating that they "reviewed" Plaintiff's correspondence or

by referencing the additional materials in their response letters,

Defendants automatically made the additional evidence part of the

administrative record. Id. at 4-5. Plaintiff cites no authority to

support this assertion. Moreover, Plaintiff fails to show that any

of the contested evidence was considered by the plan administrator

in its initial denial of Plaintiff's LTD benefits or in its review

of her appeal. 

In abuse of discretion cases, evidence outside the

administrative record is completely inadmissible. Newman v.

Standard Insurance Company, 997 F.Supp. 1276, 1280 (C.D. Cal.

1998). "Permitting a district court to examine evidence outside the

administrative record would open the door to the anomalous

conclusion that a plan administrator abused its discretion by

failing to consider evidence not before it." Taft v. The Equitable

Life Assurance Society, et. al, 9 F.3d 1469, 1472 (9th Cir. 1993).

The documents filed by Plaintiff and challenged by Defendants in

their motion to strike are not part of the administrative record.

Thus, the Court shall grant Defendants' motion and order the

documents stricken from the record. 

IV. Plaintiff's Motion for Leave to File and Request for Judicial

Notice

Plaintiff moves the Court for leave to file the Supplemental

Declaration of Constance Ann Maynard and the Declaration of Stuart

H. Sandhaus. Mot. for Leave to File (doc. 95). In explaining her

reasoning for this request, Plaintiff notes that she has recently

suffered from ill-health and, "[u]ntil recently, [she] was simply

unable to assist counsel in preparing her more complete Declaration

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in Support of the Opposition to Defendants' Motion for Summary

Judgment." Id. at 3. Plaintiff argues that this equals "excusable

neglect," and, under Federal Rule of Civil Procedure 6(b)(2), the

Court may allow the late submission of her complete declaration.

Id. In addition, Plaintiff requests that the Court take judicial

notice of certain settlement agreements involving Departments of

Insurance of forty-eight (48) states and UnumProvident. Request

Jud. Not. (doc. 98) at 1. Defendants ask the Court to deny

Plaintiff's motion due to the fact that the affidavits Plaintiff

seeks to introduce are not part of the administrative record. Resp.

to Mot. for Leave to File (doc. 100).

As noted above, in abuse of discretion cases, evidence outside

the administrative record is completely inadmissible. See Newman,

997 F.Supp. at 1280; Taft, 9 F.3d at 1472. Plaintiff, in her

motion, clearly states that the affidavits she seeks to file with

the Court are new. Mot. for Leave to File (doc. 95) at 3 ("Over the

course of the past several weeks, Plaintiff has been able to confer

with counsel and prepare a more comprehensive declaration, which

she hereby seeks leave to file."). Thus, such documents are not

part of the administrative record and are inadmissible in this

matter. The Court shall deny Plaintiff's motion. For the same

reason, the Court shall also deny Plaintiff's request for judicial

notice. 

V. Defendants' Motion for Summary Judgment

a. Summary Judgment Standard

To grant summary judgment, the Court must determine that the

record before it contains "no genuine issue as to any material

fact" and, thus, "that the moving party is entitled to judgment as

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a matter of law." Fed.R.Civ.P. 56(c). In determining whether to

grant summary judgment, the Court will view the facts and

inferences from these facts in the light most favorable to the

nonmoving party. See Matsushita Elec. Co. v. Zenith Radio Corp.,

475 U.S. 574, 587 (1986).

The mere existence of some alleged factual dispute between the

parties will not defeat an otherwise properly supported motion for

summary judgment; the requirement is that there be no genuine issue

of material fact. See Anderson v. Liberty Lobby, Inc., 477 U.S.

242, 247-48 (1986). A material fact is any factual dispute that

might affect the outcome of the case under the governing

substantive law. Id. at 248. A factual dispute is genuine if the

evidence is such that a reasonable jury could resolve the dispute

in favor of the nonmoving party. Id. 

A party opposing a motion for summary judgment cannot rest

upon mere allegations or denials in the pleadings or papers, but

instead must set forth specific facts demonstrating a genuine issue

for trial. See id. at 250. Finally, if the nonmoving party's

evidence is merely colorable or is not significantly probative, a

court may grant summary judgment. See, e.g., California

Architectural Build. Prods., Inc. v. Franciscan Ceramics, 818 F.2d

1466, 1468 (9th Cir. 1987).

b. Standard of Review

Typically, the standard of review to be applied by district

courts in reviewing challenged denials of ERISA benefits is "a de

novo standard[.]" Firestone Tire & Rubber Co. v. Bruch, 489 U.S.

101, 115 (1989). However, when an ERISA administrator or fiduciary

is given discretionary authority to determine eligibility for

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2 During oral argument, Plaintiff for the first time argued that

Policy-2 does not contain a provision granting Defendant Hewitt the

right to delegate its "fiduciary responsibilities" to Defendant CNA.

Oral Argument, December 19, 2005 at 11:23:56AM-11:25:01AM. Citing

Winterstein v. Stryker Corporation Group Life Insurance Plan, 2005 WL

3149742 (9th Cir. 2005), Plaintiff asserted that this lack of

contract language requires that Defendants' denial of Plaintiff's

benefits be subject to a de novo review. Oral Argument, December 19,

2005 at 11:24:29AM-11:25:01AM. The Court, however, finds Plaintiff's

argument and reliance on Winterstein to be misplaced. 

First, the Court notes that Winterstein is an unpublished case

and, consequently, not binding precedent in this Circuit. Ninth

Circuit Rule 36-3. Second, the court in Winterstein stated that

"CNA's benefits decision must be reviewed de novo unless the

Corporation's discretionary authority was properly delegated to CNA."

2005 WL 3149742 at *1. This rule is no different from that defined

previously in this order or in the case law cited in support of such

definition. Although the court in Winterstein went on to find that

discretionary authority had not been properly delegated to CNA, such

a holding is not clearly relevant to this case. Id. To the extent

that Plaintiff seems to be arguing that this Court should reach the

same conclusion because CNA was involved in both Winterstein and this

case, the Court notes that there is no evidence in the record that

establishes any similarity between the contracts involved in

Winterstein and the case at bar. Accordingly, the Court finds that

the holding in Winterstein raises no new issues in this matter.

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benefits or to construe plan terms, the proper review of a denial

of benefits is under an abuse of discretion standard. See id.;

Ingram v. Martin Marietta Long Term Disability Income Plan for

Salaried Employees of Transferred GE Operations, 244 F.3d 1109,

1112 (9th Cir. 2001). 

In its Order of March 29, 2005, the Court concluded that, as a

matter of law, Policy-2 is the controlling document in this case.

Order (doc. 60). The parties did not dispute that the language

included in Policy-2 conferred discretionary authority upon CNA.2

Accordingly, the Court determined that the appropriate standard of

review in this matter is the abuse of discretion standard. Id. at

12. 

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The Ninth Circuit has held that ERISA plan administrators

"abuse their discretion if they render decisions without any

explanation, or construe provisions of the plan in a way that

conflicts with the plain language of the plan." Taft, 9 F.3d at

1472 (citing Eley v. Boeing Co., 945 F.2d 276, 279 (9th Cir. 1991)

and Johnson v. Trustees of W. Conference of Teamsters Pension Trust

Fund, 879 F.2d 651, 654 (9th Cir. 1989). In addition, "an

administrator also abuses its discretion if it relies on clearly

erroneous findings of fact in making benefit determinations." Taft,

9 F.3d at 1473; see Jones v. Laborers Health & Welfare Trust Fund,

906 F.2d 480, 482 (9th Cir. 1990). 

c. Analysis

1. Explanation of Denial of Benefits

Courts have held that ERISA plan administrators "abuse their

discretion if they render decisions without any explanation[.]"

Taft, 9 F.3d at 1472. Here, it is not clear whether Plaintiff

alleges that Defendants abused their discretion by rendering a

decision denying her LTD benefits without any explanation. Although

Plaintiff, in her Response to Defendants' motion for summary

judgment, enumerates this allegation in a heading, she does not

contest the existence of an explanation, but ultimately argues that

Defendants' decision was erroneous. Resp. (doc. 77) at 7

("Defendants provide no explanation or medical evidence as to why

it is discrediting the overwhelming medical evidence and opinions

of Ms. Maynard's treating and consulting medical providers that she

is disabled and is continuously unable to perform each of the

material duties of her regular occupation."). Plaintiff fails to

raise any specific argument alleging the complete absence of an

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explanation. In fact, Plaintiff received a five-page explanation of

the plan administrator's decision. Thus, the Court concludes that

there exists no genuine issue as to any material fact in relation

to this issue.

2. Plain Language of the Plan

Courts have also held that ERISA plan administrators abuse

their discretion if they "construe provisions of the plan in a way

that conflicts with the plain language of the plan." Taft, 9 F.3d

at 1472. Again, it is not clear to the Court whether Plaintiff

intends to allege that Defendants abused their discretion in this

manner.

In her Response, Plaintiff lists this allegation in a heading,

however she does not specifically argue how Defendants' decision

conflicted with the plain language of the plan. Resp. (doc. 77) at

9. Plaintiff instead asserts that Defendants breached their

fiduciary duties when they "secreted the alleged Policy-2 from the

beneficiary until after the administrative record was closed and

subsequent to the commencement of this litigation, knowing that

Plaintiff would not be able to perfect her claim under a policy

that contained material changes[.]" Id. at 10. The only specific

material changes that Plaintiff notes are "the terms for

establishing disability and the changing of the standard of

judicial review from de novo to abuse of discretion." Id. Plaintiff

does not, however, point to any evidence that indicates that

Defendants' denial of benefits conflicted with the plain language

of either plan. Regardless, the Court, in its Order of March 29,

2005, (doc. 60), concluded that Policy-2 is the controlling policy

in this matter, and Plaintiff has not shown the existence of any

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3 Plaintiff also raises an argument that Defendants breached

their fiduciary duties to Plaintiff, thus making their decision an

abuse of discretion. Resp. (doc. 77) at 9, 10. However, beyond a mere

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genuine issue as to any material fact in relation to whether

Defendants' decision was in conflict with the plain language of

Policy-2.

3. Clearly Erroneous Findings of Fact

Lastly, an administrator may be found to have abused its

discretion if it relies on clearly erroneous findings of fact in

making benefit determinations. See Taft, 9 F.3d at 1473; see also

Jones, 906 F.2d at 482. A fiduciary's decision will not be

overturned where "there is substantial evidence to support the

decision, that is, where there is 'relevant evidence [that]

reasonable minds might accept as adequate to support a conclusion

even if it is possible to draw two inconsistent conclusions from

the evidence.'" Snow v. Standard Ins. Co., 87 F.3d 327, 332 (9th

Cir. 1996) (quoting Maynard v. City of San Jose, 37 F.3d 1396, 1404

(9th Cir. 1994). "Abuse of discretion" means the entire record

leads to the firm conviction that a mistake has been made by the

plan administrator. See Boyd v. Bert Bell/Pete Rozell NFL Players

Retirement Plan, 410 F.3d 1173, 1179 (9th Cir. 2005). However,

"even decisions directly contrary to evidence in the record do not

necessarily amount to an abuse of discretion." Taft, 9 F.3d at

1473-74.

Here, Plaintiff argues that Defendants' decision to deny her

benefits was clearly erroneous because she provided substantial

evidence indicating that she is disabled from Chronic Fatigue

Syndrome ("CFS"). Resp. (doc. 77) at 4.3

 "The administrative record

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statement of this assertion, Plaintiff fails to argue or cite any

authority that supports this claim.

4

 Although it is not specified in her Response, Plaintiff seems

to designate Daniel L. Peterson, M.D. and Sheila P. Bastien, Ph.D. as

her "treating and consulting healthcare providers." 

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contains a plethora of evidence establishing that Plaintiff is

disabled from CFS. (SOF ¶¶ 12, 13, 15, 21)." Id. Plaintiff argues

that her "treating and consulting healthcare providers were

unanimous in their findings that Plaintiff was severely disabled by

debilitating Chronic Fatigue Syndrome." Id. at 11-12.4 Moreover,

Plaintiff notes that she "received the maximum amount of Short Term

Disability benefits from Defendant Hewitt, and was approved for

benefits by the Social Security Administration." Id. at 12.

Plaintiff asserts that once she submitted sufficient evidence to

support her claim, it became Defendants' burden to produce

"sufficient substantial evidence to establish that the CFS

diagnosis was erroneous...and that Plaintiff was not disabled from

CFS." Id. at 5. Although Plaintiff does not cite any authority that

supports her burden-shifting argument, she contends that Defendants

failed to fulfill this burden. Id. "Without affirmative evidence

that Plaintiff was not disabled by CFS, it can only be concluded

that Defendants [sic] denial of benefits was erroneous." Id.

In addition, Plaintiff argues that the review of her medical

record was biased and incomplete. Resp. (doc. 77) at 11.

Specifically, Plaintiff notes that Dr. Truchelut (1) never examined

Plaintiff; (2) never contacted Plaintiff's treating and consulting

healthcare providers to discuss her "complex and debilitating

illnesses"; (3) never requested that Plaintiff submit to an

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5 "Unpublished dispositions and orders of this Court are not

binding precedent, except when relevant under the doctrine of law of

the case, res judicata, and collateral estoppel." Ninth Circuit Rule

36-3.

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Independent Medical Examination; (4) and there was no peer review

conducted on any of the submitted medical documentation and

reports. Id. Plaintiff also argues that Dr. Truchelut failed to

review and consider certain medical reports prepared by Dr.

Peterson and Dr. Bastien. Oral Argument, December 19, 2005 at

11:27:59AM-11:30:59AM.

In support of her arguments, Plaintiff mainly relies on the

decision in Camerer v. Continental Casualty Co., 76 Fed. Appx. 837

(9th Cir. 2003). The Court notes that Camerer is an unpublished

case and, therefore, is not binding precedent in this Circuit. Id.

at 839.5 In any event, Plaintiff's reliance on Camerer is

misplaced. 

In Camerer, a former employee sued his employer's group plan

administrator following the denial of disability benefits under an

ERISA-governed welfare benefits plan. Id. The court affirmed the

District Court's award of disability benefits to the plaintiff,

finding that the plan administrator had abused its discretion. Id.

The court in Camerer did not determine the standard of review that

should have been applied, but instead stated that the plan

administrator abused its discretion under any standard. Id.

Camerer's occupation involved the manipulation of heavy steel beams

surrounded by fast moving blades, and his medical records showed

that he suffered the effects of a traumatic brain injury, causing

him to have impaired visual-motor coordination, impaired memory,

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and difficulties with attention and retaining newly-acquired

information. Id. Pointing out that the plan administrator's denial

letters failed to acknowledge any of these neurological impairments

and misunderstood critical facts in relation to Camerer's claim,

the court determined that the plan administrator abused its

discretion. Id. at 840. Such an extreme case is not on par with the

matter that stands before this Court.

In the instant case, Plaintiff does not dispute that the

medical records submitted to Defendants include inconsistencies

regarding the status of her alleged disability and diagnosis. Resp.

(doc. 77) at 3-4. Plaintiff only challenges the weight Defendants

placed on such inconsistencies in making their final decision.

Defendants, however, were not required to give deference to

Plaintiff's treating physician's opinion or provide specific

reasons for rejecting his opinion. See Black & Decker Disability

Plan v. Nord, 538 U.S. 822, 834 (2003). Moreover, the decision is

not automatically deemed arbitrary and capricious because

Defendants did not consider or find dispositive the fact that

Plaintiff was approved for benefits by the Social Security

Administration. See Madden v. ITT Long Term Disability Plan for

Salaried Employees, 914 F.2d 1279, 1285 (9th Cir. 1990). Finally,

Plaintiff fails to cite, nor can the Court find, any authority

indicating that Defendants were required to examine Plaintiff in

person, contact Plaintiff's treating and consulting healthcare

providers to discuss her "complex and debilitating illnesses,"

request that Plaintiff submit to an Independent Medical

Examination, or have a peer review conducted on the submitted

medical documentation and reports. 

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In making its initial decision denying Plaintiff's claim for

LTD benefits, Defendant CNA considered the report and analysis of

Dr. Truchelut. Exbt. D (doc. 73). In his report, Dr. Truchelut

notes Dr. Peterson's diagnoses of CFS and other ailments. Id. at 5.

In addition, Dr. Truchelut lists Dr. Peterson's conclusions that

Plaintiff was incapable of sustained lifting, standing or walking

for more than two hours per day, and that, due to cognitive

dysfunction, Plaintiff had difficulty with concentration and

completion of tasks. Id. However, despite these opinions, Dr.

Truchelut found that Plaintiff's medical record did not support a

finding that Plaintiff was unable to perform sedentary work

activities. Id.

In support of this conclusion, Dr. Truchelut specifically

points out that at the time Plaintiff stopped working, her

"physical examination was fairly benign, and laboratory studies

prior to that were generally negative." Id. The report itself

includes numerous references to Plaintiff's medical record where

the evident status of her medical conditions conflict. Exbt. E

(doc. 73). Dr. Truchelut cites on at least twenty-eight occasions

in his report that Plaintiff's exams or test results were "within

normal limits", "negative", "described as normal", "unremarkable",

or "benign". Id. Finally, Dr. Truchelut notes that although

Plaintiff's record showed that she had a poor tolerance to vigorous

exercise, "it is generally accepted that sustained sedentary

activity typically requires less that 5 mets, and [Plaintiff] went

well beyond that." Id.

A similar analysis was conducted on Plaintiff's appeal. After

Plaintiff appealed CNA's initial denial of benefits, she submitted

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additional information regarding her claim. Exbt. F (doc. 73) at 1.

In its letter affirming the original decision in this matter, CNA

notes that it reviewed and considered all the information, "as well

as the psychological information presented by Dr. Bastien, but the

evidence does not support a functional loss or significant

deterioration that would preclude Ms. Maynard from continuously

performing the substantial and material duties of her regular

occupation[.]" Id. at 2. Again, CNA cites numerous inconsistencies

in Plaintiff's medical record, noting that most of her clinical

tests showed "benign", "negative", or "normal" results. Id. 2-3.

CNA acknowledges the abnormalities noted by Dr. Bastien in the

neuropsychological testing, but states that "this alone does not

substantiate Ms. Maynard's inability to continue working." Id. at

4. "The psychological testing and information presented does not

support a mental or emotional impairment that would preclude Ms.

Maynard from working." Id. at 4-5. 

Although Plaintiff asserts that Defendants failed to consider

certain medical "reports" produced by Dr. Peterson and Dr. Bastien,

she has not specifically indicated which "reports" she claims were

not reviewed and whether or not they are even part of the

administrative record. It is evident in Dr. Truchelut's report that

he reviewed and considered medical records produced by Dr.

Peterson. Exbt. D (doc. 73) (citing Dr. Peterson's notes and

findings in Plaintiff's medical records). Although, in his report,

Dr. Truchelut refers to medical "records" produced by Dr. Peterson

instead of "reports", it is not clear to this Court that Dr.

Truchelut was not referring to the same materials that Plaintiff

claims Defendants failed to review. Moreover, Plaintiff has not

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shown that any reports produced by Dr. Bastien were submitted by

Plaintiff prior to Dr. Truchelut's review. Regardless, it is clear

from Defendants' letter denying Plaintiff's appeal that Dr.

Bastien's report was reviewed in reference to Plaintiff's appeal.

Exbt. F (doc. 73) (citing Dr. Bastien's notes and findings in

Plaintiff's medical records). 

It is evident in the letters and reports described above that

CNA considered the evidence before it in making its decision to

deny Plaintiff's claim for LTD benefits. Plaintiff argues that

Defendants' disregard of her treating and consulting physicians'

opinions qualifies as an abuse of discretion. However, beyond the

conclusive statements of her doctors, Plaintiff does not specify

any clinical evidence in the record that clearly supports such

findings. More importantly, Plaintiff fails to raise any argument

that indicates that CNA based its decision on clearly erroneous

findings of fact. Thus, the Court finds no genuine issue as to any

material fact in existence in relation to this matter and concludes

that Defendants did not abuse their discretion. Defendants are

entitled to judgment as a matter of law.

Therefore, 

IT IS ORDERED that the parties' Stipulated Motion for Leave to

Amend Complaint to Add Additional Party (doc. 105) is GRANTED. 

IT IS FURTHER ORDERED that Defendants' Motion to Strike (doc.

92) is GRANTED. The following shall be stricken from the record:

(1) the Declaration of Constance Ann Maynard (doc. 80); (2) Exhibit

A to the Maynard Declaration (doc. 80); (3) Exhibits A, M, O, P, Q,

R, S, T, U to the Declaration of Stuart H. Sandhaus (doc. 81); (4)

the Declaration of Daniel L. Peterson, M.D. (doc. 82); (5) Exhibits

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A, B and G to the Peterson Declaration (doc. 82); (6) the

Declaration of Sheila P. Bastien, Ph.D. (doc. 83); (7) Exhibits D,

E, G and H to the Bastien Declaration (doc. 83); and (8)

Plaintiff's Controverting Statement of Facts in Opposition to

Defendants' Motion for Summary Judgment, ¶¶ 7, 40-50 (doc. 78).

IT IS FURTHER ORDERED that Plaintiff's Motion for Leave to

File Supplemental Declaration of Plaintiff and Declaration of

Stuart H. Sandhaus in Support of Opposition to Defendant's [sic]

Motion for Summary Judgement (doc. 95) and Request for Judicial

Notice (doc. 98) are DENIED.

IT IS FINALLY ORDERED that Defendants' Motion for Summary

Judgment (doc. 72) is GRANTED. The clerk shall enter judgment and

terminate this case.

DATED this 10th day of January, 2006.

Copies to counsel of record

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