Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-02423/USCOURTS-cand-3_04-cv-02423-0/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1132 E.R.I.S.A.: Employee Benefits

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United States District Court

For the Northern District of California

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IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

ROBIN ALLENBY,

Plaintiff,

 v.

WESTAFF, INC., et al.,

Defendants. /

No. C 04-2423 TEH

ORDER RE PLAINTIFF’S AND

DEFENDANTS’ MOTIONS FOR

JUDGMENT

This matter came before the Court on Monday, December 4, 2006, on the parties’

cross motions under Federal Rule of Civil Procedure 52 for judgment on the

administrative record. Having carefully considered the parties’ written and oral

arguments, the record herein, and the relevant case law, the Court grants in part and

denies in part Plaintiff’s motion, and denies Defendants’ motion, for the reasons set forth

below. The foregoing shall constitute the Court’s Findings of Fact and Conclusions of

Law pursuant to Rule 52(a).

I. BACKGROUND

Robin Allenby (“Plaintiff”) brings this action under the Employee Retirement

Income Security Act of 1974 (“ERISA”), 29 U.S.C. 29 U.S.C. § 1001, et seq., seeking to

overturn the final determination of Canada Life Assurance Company (“Canada Life”)

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denying Plaintiff’s claim for long term disability benefits. She seeks to recover benefits

commencing Monday, June 24, 2002 through the date of judgment.

Plaintiff worked at Westaff, Inc., (“Westaff”) as an attorney for approximately 16

years from February 24, 1986 through her retirement on July 1, 2002. She started as a

litigation attorney, and was promoted over the years, serving the last six as the General

Counsel for the company. In October 2002, Plaintiff submitted her claim for LongTerm Disability Benefits to Canada Life which provides Long Term Disability Insurance

for Westaff employees. In her application, Plaintiff seeks disability benefits

commencing June 24, 2002 due to repetitive stress injury. Administrative Record

(“AR”) 187, 813. After Canada Life rejected her claim and appeal, Plaintiff filed the

instant suit against Westaff., Westaff, Inc. Long-Term Disability Plan, and Canada Life

Assurance Co. (collectively “Defendants”). Plaintiff and Defendants now both move

for a judgment in their favor based on the administrative record.

II. STANDARD OF REVIEW

The denial of long term disability benefits is reviewed de novo unless the plan or

policy expressly confers upon the plan administrator the discretionary authority to

determine benefits, in which case the denial will be reviewed for abuse of discretion.

Johnson v. Buckley, 356 F.3d 1067, 1075 (9th Cir. 2004); Ingram v. Martin Marietta

Long Term Disability Income Plan for Salaried Employees of Transferred GE

Operations, 244 F.3d 1109, 1112-13 (9th Cir. 2001). The parties both agree that in this

case no such discretion is expressly conferred upon the plan administrator and thus the

denial of benefits is reviewed de novo.

When a Court conducts a de novo review of an administrator’s denial of longterm disability benefits in an ERISA case, the Court effectively conducts a bench trial

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Given that the court is conducting a de novo review, rather than reviewing the

Defendants’ decision for abuse of discretion, the Court does not separately discuss the

specific rationales advanced by Defendants in their letters denying Plaintiff’s claim.

See also Defs.’ Opp. at 8-9 (noting that because the Court reviews the matter de novo, Plaintiff’s “criticism of Canada Life’s handling of her claim and its reasons for

denying it is both baseless and irrelevant”).

2

 Plaintiff has been receiving disability benefits from her individual disability

insurance policy with Unum Provident. She has also been receiving workers

compensation benefits during the period in question. AR 277, 579.

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upon the record. Kearney v. Standard Ins. Co., 175 F.3d 1084, 1094-95 (9th Cir. 1999). 

Accordingly, the Court shall proceed under Fed. R. Civ. P. 52(c). Id.

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III. POLICY REQUIREMENTS

In order for Plaintiff to establish eligibility for long-term disability benefits from

Canada Life,2

 she must establish that she was disabled within the terms of the policy as

of June 21, 2002, the last day she actually worked or, at the latest, July 1, 2002, the date

she retired. AR 87; see also Defs.’ Opp. at 1 (Plaintiff can only recover benefits if “she

was disabled at the time she retired”). Plaintiff must also show that she remained

disabled continuously for a 90-day “elimination period” commencing on the date the

disability is established. AR 79.

To establish that she was disabled, Plaintiff must show that, due to sickness or

injury, she was:

(1) unable to do the Material and Substantial Duties of her Own Occupation. 

(2) receiving appropriate evaluation and treatment from a physician for that injury

or sickness, and

(3) her work earnings were less than 20% of her indexed pre-disability monthly

earnings.

In this case, the dispute focuses on whether Plaintiff was unable to do the

“Material and Substantial Duties of her Own Occupation.” “Material and Substantial

Duties” are defined as those duties that:

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(a) are normally required for the performance of your Own Occupation and

(b) cannot be reasonably omitted or modified.

“Own Occupation” is defined as follows:

Own Occupation means the duties that You regularly performed for which

You were covered under this Policy immediately prior to the date Your

Disability began. The occupation may involve similar duties that could be

performed with Your Employer or any other employer.

AR 27, 541, 842. 

The Plan’s definition of disability changes 24 months after the conclusion of the

elimination period. Once this point in time is reached, claimants must establish that they

are unable to do the material and substantial duties of not just their “Own Occupation”

but of “Any Occupation” which is defined as any occupation “for which they are or may

become reasonably qualified by education, training or experience.” AR 87-88, 541. 

These two separate time periods are referred to by the parties as the “own occupation”

period and the “any occupation period.” 

IV. MEDICAL HISTORY

It is undisputed that Plaintiff worked 8-10 hours a day, and that her position

required extensive use of the computer (approximately 6 hours per day) as well as

prolonged periods of sitting (for 7-8 hours per day). AR 190, 819. In 2000, Plaintiff

began experiencing pain, stiffness, and aching in her neck, shoulders, hands, and wrists. 

She consulted Dr. William Ross, a sports medicine orthopedist, in March 2001. He

diagnosed repetitive stress injury arising out of her work and prescribed physical therapy

twice a week. AR 842. 

Over the next several months Plaintiff showed improvement and by the Fall

reported her condition as 2/10 on a linear pain scale. Her work station was

ergonomically assessed and a number of changes were made. AR 265, 296. 

Nonetheless, Plaintiff continued to have symptoms. AR 265. Dr. Ross concluded,

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however, that she would continue responding to physical therapy. See e.g., AR 320,

848-49, 322, 852. By February of 2002, Plaintiff reports that the symptoms were

primarily limited to the right side. AR 296. 

In the Spring of 2003, however, Plaintiff’s recovery stalls and eventually

deteriorates. In May of 2002, there was no “significant improvement” over the last 3

months and she was experiencing daily pain or aching in her neck, shoulder and wrist

and right thumb. AR 855, 316. In June 2002, her physical therapist states that Plaintiff is

still complaining of right sided neck stiffness and right shoulder pain, forearms and right

thumb aching and notes that the injuries are chronic and seem to be responding slowly. 

In her declaration, dated April 29, 2004, Plaintiff discusses this period as follows: 

Westaff was involved in major litigation arising from an acquisition. 

There was a major refinancing of the Company with GE Capital, a six

month effort with at least a foot high stack of documents and an

international cast of lawyers dealing with subsidiaries. E-mail was

essential as the computer-generated documents were prepared and edited. 

There were lots of conference calls. 

While all this was going on my symptoms did not go away. They

worsened. My right arm hurt reaching for the phone . . . [or] files and

papers. . . Picking up a ream of paper to fill the printer hurt. Picking up

and carrying my brief case hurt. The replacement mouse made it worse. 

My neck hurt. My shoulder hurt. I was overworked and in pain.

By Spring of 2002, instead of going to the gym after work, I resorted to

going during the day to stretch and sit in the Jacuzzi or steam room trying 

to ease the pain and general discomfort. I was using a heating pad at home

before and after work and bringing it to work with me. I was icing at

home. I had been taking Advil for months. It did not alleviate the pain.

On Memorial Day weekend in May 2002, my husband and I traveled by

plane to Seattle to visit family. I. . . relied on stretches, self massage, my

husband’s massage and moving about on the plane to ease the discomfort

of sitting for the duration of the flight.

AR 266-67.

In June 2002 Dr. Ross reports that “[o]verall, Robin continues to be quite

symptomatic on a daily basis. She is usually very uncomfortable by the end of the

workday. After she has had a day or two of rest, her symptoms are lessened somewhat.”

AR 267. In mid-July, Dr. Ross states that Plaintiff’s daily pain level was down to a 3

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after having stopped work for three weeks and that “[p]reviously it had been at

approximately a 4 or 5 level.” AR 299. 

At the advice of Dr. Ross, Plaintiff took a 6 week leave from work commencing

Monday, June 24, 2006. It was Plaintiff’s understanding, however, that she “would have

no job unless [she] could resume [her] regular duties within six weeks.” AR 268. After

the first week of her leave, Plaintiff concluded that, given the state of her condition

despite months and months of intensive physical therapy, that there was “no way [she]

was going to be well in the six weeks required by the CEO.” AR 270. Accordingly, on

July 1, 2002, she retired as a “polite way of saying I quit.” AR 271. She states that she

felt “physically compelled to quit,” id., although she also indicated in her retirement

letter to the company that she also wanted to spend more time with her family. AR 707.

In August and October 2002, two separate doctors independently examined

Plaintiff: (1) Dr. Ross (her treating orthopedist), and (2) Dr. Anita Roth, a specialist in

physical medicine and rehabilitation who performed a “Qualified Medical Examination.”

Both determined that Plaintiff suffered from work induced repetitive stress injury

(including deQuervain’s, chronic cervical sprain, tendinitis), AR 827, 830, and that she

could not use the computer longer than 30 minutes or sit for longer than 30 minutes. AR

831-32. They further both found that she was disabled and/or could not return to her

usual and customary work duties. AR 827, 830. Both doctors found that while other

objective indicators were negative, Plaintiff tested positive on the Finkelstein bilaterally. 

AR 826, 830. 

Thereafter, Plaintiff continued with various physical therapy treatments and a

doctor-prescribed treatment known as Hellerwork but continued to be symptomatic . In

May 2003, Dr. Ross concluded that Plaintiff’s condition was essentially unchanged and

stated that while her neck area is “perhaps somewhat improved. . . [t]he shoulder and

scapular areas continue to be aching.” He concludes that she is “clearly permanent and

stationary” and that she “needs to accept her problem and move on with her life. She is

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still disabled.” AR 312. Plaintiff asked Dr. Ross for, and later received, a referral to a

neurologist. AR 273.

In August 2003, Plaintiff was examined by a neurologist, Dr. Newkirk, who

began treating her thereafter. He concluded that Dr. Ross and Dr. Roth had missed the

fundamental source of Plaintiff’s injuries. AR 366-67. Specifically, he found that

Plaintiff has a very thin, narrow thorax, which is congenital. AR 341, 367. He further

gives the opinion that (1) as a result of this congenital condition, (2) an improperly

configured work station which led to a poor, round shouldered posture, and (3) working

with her arms in front of her body for extended periods, she developed a chronic

compression of the nerves and blood vessels in the superior thoracic aperture. AR 341,

350, 367. See also id. at 350 (“Accumulated edema plus bony compression of the

neurovascular bundles in the superior thoracic aperture have created continuous venous

and possibly some arterial compression that does not reverse in time due to the severity). 

The symptoms resulting from this syndrome, referred to as thoracic outlet syndrome, see

AR 351, can include pain in the areas experienced by the Plaintiff. AR 340-41, 367. Dr.

Newkirk’s diagnosis was confirmed by a sonogram taken in March 11, 2004. AR 361. 

He notes that the syndrome, “which appears to have fixed itself for the last 2 1⁄2 years” 

has progressed to an advanced degree and that the Plaintiff now has pain in many

ordinary daily activities and can not type at all. AR 340. The administrative record does

not contain any evidence disputing Dr. Newkirk’s opinions or diagnosis. 

V. DISCUSSION

A. Whether Plaintiff was disabled during the “Own Occupation” period

1. Whether Plaintiff was disabled as of July 1, 2002.

In order to be eligible for benefits, Plaintiff must demonstrate that she was

disabled no later than July 1, 2002, the date she retired. As such. Plaintiff must thus

show, that as of July 1, 2002, she could no longer do the “Material and Substantial

Duties” of her job, which are those duties that:

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(a) are normally required for the performance of her occupation and

(b) cannot be reasonably omitted or modified.

(a) Duties normally required

While reasonable persons could differ, looking at the record de novo, the Court

concludes that the Plaintiff has shown, by a preponderance of the evidence in the

administrative record, that she could no longer do the duties that are normally required

for the performance of her occupation as of Friday, June 21, 2002, the last day she

actually reported for work.

The Court concludes that Plaintiff was misdiagnosed (or underdiagnosed) in

2001, and was in fact suffering from thoracic outlet syndrome, which is consistent with

the fact that despite months and months of intensive physical therapy treatments for

repetitive stress injury, along with icing, heating treatments, and anti-inflammatories,

Plaintiff was unable to overcome her symptoms. As Dr. Newkirk explains, given that

her neurovascular compression syndrome was not recognized early on, adequate

corrections were not made to the work station, and her treatment course was

unsuccessful because it did not begin to reverse the anatomic basis of her disorder. AR

340, 345. 

 Defendants argue that Dr. Newkirk’s diagnosis is irrelevant and should be

ignored because he did not examine or treat Plaintiff during the “relevant time period.”

See Defs.’ Opp. at 9. Defendants, however, do not cite any authority for the proposition

that courts must ignore a later diagnosis because it was not made contemporaneously

with the date of the claimed disability. Indeed, such a rule would penalize anyone who

is not properly diagnosed by the initial treating physician(s). Further, it is within a

physician’s normal exercise of his or her duties to make medical judgments about the

onset or cause of a condition, disease, or set of symptoms based on a current examination

and review of medical history. The Court also notes that the time gap at issue (between

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 Defendants emphasize that back in June of 2002, Dr. Ross envisioned that

Plaintiff would recover after a 6-week leave and be able to return to work full time

thereafter. As such, they argue, Dr. Ross did not believe that Plaintiff was disabled as

of June 2002. The Court concludes, however, as set forth above, that Dr. Ross had

not accurately diagnosed Plaintiff’s condition, and thus had underestimated the nature

of the problem. Further, Dr. Ross’ projection was clearly wrong as he concluded in

October 2002 that Plaintiff could not return to work even though she had been off

work for over three months at that point. In short, Dr. Ross’ misguided belief in June

2002 that Plaintiff only needed a temporary leave from work is not a persuasive basis

for denying benefits. See also Mixen, 442 F.Supp.2d 903 (overturning denial of

benefits which relied in part on physician’s erroneous belief that the plaintiff would

recover and be able to return to work).

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June 2002 and Dr. Newkirk’s August 2003 examination of Plaintiff) is not a lengthy one

of five or ten years but roughly 14 months.

Plaintiff has also shown that it is more likely than not that she was suffering

sufficient pain and discomfort from the neurovascular compression – as of June 21, 2002

– to support the conclusion that she could no longer do the normal duties of her job at

that point in time. Significantly, Plaintiff credibly presented to both Dr. Ross and Dr.

Roth in August and October 2002. In turn, they both independently concluded, based on

Plaintiff’s statements and the objective findings of a positive Finkelstein test, that

Plaintiff could not use a computer or sit for longer than 30 minutes and could not return

to her usual and customary duties. The fact that Drs. Ross and Roth failed to identify

more objective findings to support these conclusions is less significant given Dr.

Newkirk’s diagnosis and objective findings, as well as the sonogram. Further, if

Plaintiff could not type or sit for more than 30 minutes in August or October 2002 it is

logical to conclude that she also could not perform such functions just a few months

earlier, in June 2002, particularly given that there is no dispute that Plaintiff’s symptoms

were caused or exacerbated by her work duties.3

Defendants argue that just because Plaintiff was in “some pain” at work that this

does not render her disabled. The Court agrees that a minor amount of discomfort or pain

does not render someone disabled. The Court is satisfied, however, that by June 21,

2002, Plaintiff was – despite having had some 60 physical therapy treatments – 

experiencing chronic pain and discomfort, even with icing, heating, breaks, and antiCase 3:04-cv-02423-TEH Document 36 Filed 12/12/06 Page 9 of 15
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inflammatories, that was more than just a minor inconvenience or annoyance, and that

her condition did in fact sufficiently interfere with her ability to work that she

understandably felt “compelled” to quit. 

Defendants also argue that Plaintiff can not establish that she was unable to do her

normal duties as of June 21, 2002 because she was in fact working up until this point in

time, and thus was necessarily performing the duties normally required for her

occupation. The Courts, however, have rejected the argument that plaintiffs are

precluded from establishing that they were disabled because they were in fact working. 

In Locher v. Unum Life Insurance Co. of America, 389 F.3d 288 (2nd Cir. 2004), for

example, the Court held that such an approach would put employees in a “Catch 22" 

because “those claimants who were working could not be considered disabled and yet

claimants who had stopped working would not be covered under the Plan.” Id. at 297. 

“Certainly,” the Court continued, “claimants who can establish absences and resignation

based upon an inability to continue working should be able to claim that their disability

prevented them from performing the duties of their occupation.” See also Mixon v.

Metropolitan Life Ins., 442 F. Supp.2d 903, 909 (C.D. Cal. 2006) (“The fact that [the

plaintiff] was physically at work does not refute the fact that she was disabled on that

date -and earlier”). Indeed, the fact that a claimant might literally be able to perform job

duties, albeit while enduring significant pain, should not preclude a finding of disability.

Finally, Defendants argue that Plaintiff reported that her condition was improving

in the period before her claimed disability, and therefore the record does not support a

finding of disability. It is true that Plaintiff did initially respond favorably to the

physical therapy. The record also indicates, however, that in the Spring of 2002, this

improvement stalled and that, as described above, Plaintiff became more symptomatic in

the period immediately prior to June 21, 2002. Accordingly, and for all of the reasons

set forth above, the Court concludes that Plaintiff has shown that, as of June 21, 2002,

she could not perform those duties “normally required for the performance” of her own

occupation.

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b. Duties that cannot be reasonably omitted or modified

As noted above, the definition of “Material and Substantial Duties” has a second

component. Specifically, “Material and Substantial Duties” are those that are “normally

required” and “cannot be reasonably omitted or modified. Defendants argue that this

language requires the Plaintiff to show not only that she can’t perform the “normally

required” duties but that the duties can’t either be omitted or “modified” in some way to

allow performance. This interpretation appears reasonable. 

Plaintiff argues that the language doesn’t mean that the court must look at

whether the normally required job duties could be done with modifications – it just

means that a duty is only “material and substantial” if it “can’t be modified.” This

interpretation makes little sense. Whether a duty is “material or substantial” to a job

does not logically turn on whether or not it can be modified. Plaintiff also relies on

Saffle v. Sierra Pacific Power Co. Bargaining Unit Long Term Disability Income Plan,

85 F.3d 455, 459 (9th Cir. 1996) for the proposition that it would be error to graft an 

“accommodation” requirement into the Canada Life policy. Saffle is inapposite,

however, because the policy language at issue was completely different – defining

disability simply as the inability to perform “each and every duty.” Here, the policy

language expressly includes a modification provision. Accordingly, the Court turns to

whether Plaintiff could have performed her normally required duties with

“modifications.”

 On this point, Defendants argue that Plaintiff could have continued doing her job

with modifications. They note that Westaff stated on the “Disability Claim Employer

Statement” form that Plaintiffs’ job could be modified with “reasonable

accommodations.” AR 186. The form does not, however, identify any specific 

accommodations that would have been acceptable to Westaff, and Westaff had already

tried ergonomic adjustments without success. See e.g. AR 829 (“no resolution with

ergonomic adjustments”). Defendants emphasize that Dr. Ross noted in October 2002

that Plaintiff could return to a job involving computer use if she was able to use voice

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4 In addition, Drs. Ross and Roth both found that Plaintiff could not sit for

more than 30 minutes. Given that Plaintiff’s position involved sitting 7-8 hours per

day, AR 190, 819, and that most corporate or general counsel jobs involve lengthy

amounts of time sitting at a desk, it is unclear what modifications would address this

issue; nor have Defendants identified any such modification.

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recognition software to operate the computer. AR 426. The only evidence in the record

regarding the actual efficacy of this modification, however, is Plaintiff’s declaration in

which she concludes, after trying such a program, that it was “unsuitable for editing

work because of the time and frustration in dictating simple corrections in the text. 

Heavy editing of documents, which was what I did as a lawyer, in my opinion was

difficult and inefficient.” AR 274.

Even putting aside the voice technology issue, however, Dr. Newkirk states that

the pain caused by the thoracic outlet syndrome is exacerbated or “aggravated by any

work in front of the body above lap level and much more at or above shoulder level.” AR

342 (emphasis added). It is difficult to imagine working in Plaintiff’s “own occupation”

as a general or corporate counsel – either for Westaff or another legal employer –

without doing work in front of the body above lap level since many tasks involved in

almost any professional desk job involve movement of the arms in front of the body

above lap level. An employee is not required to continue working if to do so would

aggravate or worsen the medical condition at issue. See e.g. Herring v. Canada Life

Assur. Co., 207 F.3d 1026, 1028, 1031 (8th Cir. 2000) (upholding grant of benefits to

employee where, inter alia, district court had concluded that a stressful work

environment would aggravate or worsen employee’s fibrositis).4

 Accordingly, and for

all of the reasons set forth above, this Court concludes that Plaintiff has shown that she

was disabled from performing the “material and substantial duties of her own

occupation” as of June 21, 2002. 

2. Whether Plaintiff Satisfies the 90-Day Elimination Period

Once a claimant demonstrates that s/he is disabled as of a specific date, s/he must

also establish that the disability was continuous for 90 days thereafter. Defendants argue

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that Plaintiff can not satisfy this 90-day elimination period requirement because the

reports from Dr. Ross and the physical therapist indicate that Plaintiff improved

following her resignation. For example, Plaintiff’s July 22, 2002 physical therapy status

report states that Plaintiff has continued physical therapy twice weekly and “feels like

she is making progress now with decreased symptoms.” AR 325. The report also states,

however, that Plaintiff “continues to complain of right shoulder pain, right thumb, neck

stiffness. cervical spine stiffness, forearm and wrist stiffness and aching.” Moreover,

Defendants have not disputed that Plaintiff’s symptoms were caused and/or aggravated

by the performance of her work duties. Thus, while the Court agrees that Plaintiff

experienced a reduction of symptoms during the first few months after she stopped

working, this is to be expected and does not demonstrate that she was no longer disabled

from returning to the duties of her “own occupation.” Notably, it was during this time

period or immediately thereafter that both Drs. Ross and Roth found that Plaintiff was

precluded from returning to her work.

3. The remainder of the “Own Occupation” period

As noted above, the “own occupation” period covers the first 24 months after the

90-day elimination period is over, which in this case consists of the period June 21, 2002

through on or about September 21, 2004. Defendants argue only that Plaintiff was not

disabled as of June 21, 2002 or July 1, 2002, the day she resigned, and that she did not

satisfy the 90-day elimination period. They do not argue that she can not satisfy the

policy requirements with respect to the remainder of the “own occupation” period. 

Accordingly, Defendants implicitly concede that if the Court finds that Plaintiff was

disabled as of July 1, 2002 and satisfied the 90-day elimination period, that she would

qualify as disabled for the remainder of the “own occupation” period. 

Such a conclusion also finds support in the record. For example, in September

2003, Dr. Newkirk states that Plaintiff’s condition has “progressed to the point that she

has numbness, tingling, pain and even weakness at rest aggravated by forward reaching,

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driving, writing or typing, side-lying while sleeping at night or with any reaching at or

above shoulder level.” AR at 344 (emphasis added); id at 340 (“Now that her syndrome

has progressed to such an advanced degree, she experiences significant pain in many

ordinary daily activities such as dressing, meal preparation and driving, simple

manipulation of light objects. She is precluded totally from typing at this time.”); see

also AR 359, 361 (Report by Dr. Newkirk finding Plaintiff disabled through August 1,

2004).

3. Conclusion

For all of the reasons set forth above, the Court concludes, after a de novo review

of the Administrative Record, that Plaintiff has demonstrated, by a preponderance of the

evidence, that she is entitled to Long Term Disability Benefits under the policy with

respect to the “own occupation” period.

B. Whether Plaintiff was disabled during the “any occupation” period

Plaintiff contends that this Court should also find that Plaintiff has been disabled

during the “any occupation” period which starts at the conclusion of the “own

occupation” period. As noted above, a different disability definition governs this period. 

It is appropriate for Canada Life to have an opportunity to address this issue in the first

instance. Saffle, 85 F.3d at 460. Accordingly, the Court agrees with Defendants that

Plaintiff’s claim for benefits during the “any occupation” period should be remanded to

the Plan Administrator for consideration in light of the Court’s rulings on these motions.

VI. CONCLUSION

In light of the foregoing, and good cause appearing, it is HEREBY ORDERED

that:

1. Plaintiffs’ Motion for Judgment On the Administrative Record under Fed. R.

Civ. P. 52(c) is granted in part and denied in part consistent with this Order.

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2. Defendants’ Motion for Judgment is denied.

3. The Court finds that Plaintiff is eligible to recover Long Term Disability

Benefits under the Canada Life policy at issue with respect to the “own occupation”

period. 

3. Plaintiff’s claim for benefits during the “any occupation” period is remanded

to Canada Life for decision “within a reasonable time.” Saffle, 85 F.3d at 461.

4. The parties shall, within 30 days of the date of this Order, (a) meet and confer

to resolve the specific amount of disability benefits due Plaintiff for the “own

occupation” period, including interest, and less any appropriate set-offs, and (b) submit a

proposed judgment, which is approved as to form by Defendants, that is consistent with

this Order.

IT IS SO ORDERED.

Dated: December 12, 2006 

THELTON E. HENDERSON

UNITED STATES DISTRICT

JUDGE

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