Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_05-cv-05217/USCOURTS-arwd-5_05-cv-05217-0/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

---

AO72A

(Rev. 8/82)

1

 IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

BRYAN BANKS PLAINTIFF

v. Case No. 05-5217

HARTFORD LIFE AND

ACCIDENT INSURANCE CO. DEFENDANT

MEMORANDUM OPINION AND ORDER

Plaintiff brings this action pursuant to the Employee

Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§

1001 et seq., against his disability insurance provider,

Hartford Life and Accident Insurance Co. (hereinafter

“Defendant” or “Hartford”). Plaintiff challenges Defendant’s

denial of benefits under his employer’s, Wal-Mart Stores, Inc.

(hereinafter “Wal-Mart”), group disability insurance policy

provided by Hartford (hereinafter “The Plan”). He seeks total

disability benefits from January 15, 1999, and forward, as

provided by the policy, twelve percent penalty, reinstatement

of his life, medical, and dental insurance, reasonable attorney

fees, pre-judgment interest, and all other costs or relief to

which he is entitled. The matter is before the Court on the

Stipulated Administrative Record and the parties’ briefs.

(Doc. 8, Doc. 10.) For the reasons set forth herein, we

conclude that the Plaintiff’s suit is barred by the three-year

contractual limitations period contained in the Plan, and is

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 1 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

2

therefore, dismissed with prejudice. Although it is only

necessary to address the filing limitation period issue, the

Plaintiff could not prevail if we considered the merits of his

case. 

A. Background

Plaintiff began employment with Wal-Mart in 1976. (AR

29.) Wal-Mart employed Plaintiff in an executive position as

Senior Vice President of Replenishment and Inventory

Management/Merchandise. (AR 609.) According to Wal-Mart, his

job was primarily a desk job, but was not a “stationary” desk

job; he would be up and down out from his desk, visiting with

areas that needed his assistance, attending meetings, coaching

by walking around, performing some computer and telephone work

and some travel. (AR 62.) During Plaintiff’s employment, he

was included within coverage of Wal-Mart’s group disability

insurance policy provided by Hartford. The insurance policy

included short and long term benefits for total disability. 

In 1998, Plaintiff began complaining of primary upper back

and lower neck pain. On May 6, 1998, Plaintiff saw Dr. Robert

Holder, his family practice physician, for complaints of back

pain. (AR 491.) Dr. Holder noted the Plaintiff had “tender

muscles in the upper back but nothing dramatic”. (Id.) During

the next six months, Dr. Holder treated Plaintiff for problems

with insomnia, high stress, and a golf injury. (AR 497-98.)

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 2 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

3

On December 3, 1998, Plaintiff was seen by Dr. Luke Knox, a

neurosurgeon, with the North West Arkansas Neurosurgery Clinic.

(AR 570.) Dr. Knox found no neurological abnormality.

Although Plaintiff’s plain films were relatively normal, Dr.

Knox noted multiple degenerative disc disease during review of

his MRI scan. However, Dr. Knox also noted these findings did

not correlate with his symptomatic complaints, and that he was

not a surgical candidate. (Id.) 

On December 7, 1998, Plaintiff was evaluated by Dr. Anne

Miller, a rheumatologist. Dr. Miller examined his peripheral

joints, as well as his axial and thoracic spine and found no

evidence of tender points, osteoarthritis or fibromyalgia. (AR

571.) Her opinion was that Plaintiff suffers from muscle

spasms in the mid and upper back areas. (AR 572.) On January

11, 1999, Dr. Holder noted that Plaintiff was “having

increasing back pain... His job require[d] that he have

prolonged frequent sit down meetings... Surprisingly he [was]

able to swim which help[ed] to relieve the pain... Walking

[was] helpful to a point.” (AR 501.) On January 14, 1999,

Plaintiff worked his last day for Wal-Mart. (AR 621.) 

Plaintiff saw Dr. David Cannon, a pain-management

physician in February of 1999. (AR 573.) Dr. Cannon noted

that Plaintiff had “undergone chiropractic manipulation with

some improvement and physical therapy with temporary

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 3 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

4

improvement.” (Id.) He also noted that Plaintiff was “not

particularly tender over the mid-portion of the thoracic spine

unless he exaggerate[d] his extension” and that “trigger point

injections would not be beneficial.” (Id.) Dr. Cannon also

pointed out that Plaintiff “has a home exercise program in

which he walks five miles a day and swims up to one mile a day,

as well as some stretching exercises”, and that he [was]

“considering disability but [was] not sure what he would do.”

(AR 575.) In late February 1999, Dr. Holder noted that

Plaintiff had been walking and swimming, his back was “25%

better”, and that he could “sit for an hour at a time without

getting pain which requires him to get up and move around.”

(AR 502.) On March 1, 1999, Dr. Cannon wrote that he felt

that Plaintiff’s “sit down job exacerbates his symptoms of his

upper spine pain... It would be in his best interest if he was

not required to sit for long periods of time, although he can

sit for short periods of time with numerous changes in

position, periods of time where he can get up and walk

around...” (AR 577.) 

On April 21, 1999, Plaintiff filed a claim with Hartford

for long term disability policy benefits. In a portion of the

claim form, Dr. Holder stated that Plaintiff’s back pain was

“related to prolonged sitting over one hour.” (AR 610.) Dr.

Cannon submitted a letter on April 29, 1999, in which he stated

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 4 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

5

that he “believe[d] it would be difficult for him to maintain

his current work status where he is required to sit for long

periods of time, including traveling, sitting at a desk, and

working where he is not able to get up and walk around with

frequent breaks.” (AR 589.) On May 29, 1999, Hartford wrote

letters to Dr. Cannon, Dr. Holder, and Dr. Knox stating that it

was Hartford’s opinion that Plaintiff “would be capable of

performing his occupation. He is able to change positions in

his occupation frequently... If he experiences any pain from

sitting, [he] could alter his sitting position or walk and

stand.” (AR 515-16.) Hartford requested the physicians to

respond if they disagreed with the holding. (Id.) Dr. Holder

responded that he believed that the “nature of his profession”

would prevent him from walking or standing when necessary. (AR

427.) Dr. Cannon responded that he does not make the

determination whether a patient is disabled and unable to work.

(AR 512.) Dr. Knox did not respond. 

On June 14, 1999, Hartford inquired about Plaintiff’s

ability to change postural positions in his job. Wal-Mart

responded that, per its chief executive officer, Plaintiff

“does have the capability to change postural positions in his

job.” (AR 476.) On June 15, 1999, the Social Security

Administration denied Plaintiff’s request for disability

benefits as his “condition [was] not severe enough to keep him

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 5 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

6

from working.” (AR 418-21.) On June 17, 1999, Plaintiff wrote

a letter to Hartford claiming that it was not only sitting that

bothered him in January 1999 but standing had also caused pain.

(AR 478-79.) Plaintiff further wrote that exercising three

times a day, seven days a week has gradually improved his

condition. He also stated that although he stood for two and

one-half hours at his going away party, he could not have

stood for more than four hours. (Id.) 

On July 1, 1999, Hartford advised Dr. Holder that Wal-Mart

stated Plaintiff had the capability to change postural

positions in his job. (AR 475.) Hartford asked Dr. Holder if

he still believed Plaintiff to be disabled and unable to work.

(Id.) Dr. Holder requested a copy of Wal-Mart’s statement.

(AR 473.) On July 2, 1999, Plaintiff called Hartford and

stated that he wished to withdraw his benefits claim. (AR

469.) Plaintiff later explained in a letter that he was

withdrawing his claim due to an improvement in his health

problem and that he believed he would eventually make a 

complete recovery. (Id.) On July 30,1999, Dr. Holder wrote in

a letter that Plaintiff’s condition appears to be more of an

“inflammatory condition” and that “he should do well with

regular exercise and stretching.” (AR 334.) 

It doesn’t appear from the administrative record that

Plaintiff saw Dr. Cannon for pain therapy after April 1999.

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 6 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

7

However, Plaintiff continued to see Dr. Holder. On August 2,

2000, Dr. Holder noted that Plaintiff’s “degenerative disc

disease had pretty much burned itself out”, and that “he walks

almost four miles a day and swims several days a week.” (AR

283.) On June 26, 2001, Dr. Holder reported that Plaintiff had

a completely normal physical and no muscle complaints. (AR

349.) A hospital note in December 2001 stated that Plaintiff

“walks three miles per day, swims almost a mile a day, four

days a week and tries to play golf one or two times per week.”

(AR 375.) 

On March 8, 2002, Plaintiff submitted a request to

Hartford to reopen his benefits claim. (AR 457.) Plaintiff

stated that his back condition had not improved and that he had

withdrawn his claim only because he was told by his “primary

care physician” that “the insurance company would harass [him],

use intimidation tactics, try to discredit [him], have people

follow [him] around, watch [his] home, and that in the end the

insurance company would deny [him].” (AR 458.) Plaintiff

stated that he “did not have the physical or mental strength to

fight a very large company” and “had the feeling that it was

probably inappropriate for a member of Wal-Mart management at

[his] level to be on disability”. (AR 459.) In April 2002,

Dr. Holder wrote Hartford that he would not be able to give a

disability rating, but that he was aware that the Plaintiff

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 7 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

8

continues to complain of subjective pain. (AR 338.) 

On April 15, 2002, Plaintiff was evaluated by Dr. Vincent

Runnels, a neurologist, who reported that his neurological exam

was normal. (AR 242.) 

Dr. Todd Lyon, a physician with the Medical Advisory

Group, was selected and requested by Hartford to perform an

independent medical evaluation of the Plaintiff. Dr. Lyon

reviewed the Plaintiff’s claim file, including medical records,

and interviewed Dr. Holder. On June 7, 2002, Dr. Lyon

submitted an eight page report to Hartford. (AR 202-10.) Dr.

Lyon noted that Dr. Holder would not render a specific opinion

about whether Plaintiff was capable of working. (AR 206.) Dr.

Lyon further stated that Plaintiff “is clearly engaging in a

high level of aerobic activity which would be consistent with

meeting the demands of at least light work on a full-time

basis.” (AR 207.) Dr. Lyon concluded that he believed that

Plaintiff retained the functional capabilities to meet the

demands of full-time sedentary and full-time light work. He

stated that if accommodations can be made at work such that

[Plaintiff] was able to change positions frequently, such as

every fifteen to thirty minutes, he should be able to function

at his previous occupation. (AR 209-10.) 

On June 14, 2002, Hartford determined that Plaintiff was

not Totally Disabled from performing the essential duties of

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 8 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

9

his occupation throughout and beyond the Elimination Period,

and denied Plaintiff’s claim for policy benefits. (AR 191.)

On June 19, 2002, Plaintiff appealed to Hartford’s Appeal Unit.

Hartford selected and requested another independent medical

evaluation from Dr. Barry Turner, an Orthopedic Surgeon with

The University Disability Consortium. Dr. Turner reviewed the

Plaintiff’s claim file, including the medical records, and

interviewed Dr. Cannon and Dr. Holder. (AR 87,96.) In

December 2002, Dr. Turner submitted to Hartford a sixteen page

report. (AR 87-102.) Dr. Turner stated that he seriously

questions the severity of Plaintiff’s alleged symptoms. Dr.

Turner stated it was unusual for Plaintiff to have sought

orthopedic treatment for his elbow pain, but not for his

primary orthopedic complaint. (AR 99.) Dr. Turner also

commented that both Dr. Holder and Dr. Lyon were surprised that

Plaintiff could exercise vigorously but could not perform his

sedentary work. (AR 100.) Dr. Turner stated that “the noted

discrepancies and inconsistencies are obvious”. (Id.) Dr.

Turner concluded that based on the job description provided by

Wal-Mart, and his ability to change postural positions at will,

it was his opinion that the Plaintiff was capable of performing

his own occupation during the Elimination Period. (AR 102.) 

On December 24, 2002, Hartford’s Appeal Unit denied

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 9 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

10

Plaintiff’s appeal. The unit stated it had reviewed the claim

file and engaged Dr. Turner to perform an independent

evaluation, but had found no basis to overturn the decision

made in June 2002. (AR 59.) Plaintiff exhausted all his

administrative remedies and filed this suit. 

B. Discussion

In response to Plaintiff’s motion, Hartford moved for

summary judgment on alternative grounds, arguing that the claim

is barred “under the Policy’s contractual limitations and under

any applicable statute of limitations”, and that it did not

abuse its discretion in denying Plaintiff’s claim for policy

benefits. In its supporting brief, Hartford cited an Arkansas

case upholding reasonable contractual limitation periods within

disability insurance policies. See Wilkins v. Hartford Life

and Accident Ins. Co., 299 F.3d 945 (2002) (enforcing a threeyear limitations period in an insurance policy). Plaintiff

did not address the contractual limitations issue in his brief

and filed no reply to Defendant’s response. 

Hartford relies upon the following Plan provision: 

Legal action cannot be taken against the Hartford...

after the shortest period allowed by the laws of the

state where the policy is delivered. This is 3

years after the time written proof of loss is

required to be furnished according to the terms of

the policy.

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 10 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

11

This provision appears on page 22 of Hartford’s group insurance

policy. Hartford contends that the policy was delivered in the

State of Delaware. Delaware claims are governed by a threeyear contractual limitations period. Rich v. Zeneca Inc., 845

F. Supp. 162, 164-66 (1994). In Arkansas, a claim for ERISA

benefits based on a written contract is governed by the fiveyear statute of limitations found in Arkansas Code Annotated

§ 16-56-111(a). However, the statute “establishes a maximum,

not a minimum” limitations period. Hawkins v. Heritage Life

Ins. Co., 63 Ark. App. 67, 973 S.W.2d 823, 826 (1998). In

Arkansas, “parties are free to contract for a limitation period

which is shorter than that proscribed by the applicable statute

of limitations, so long as the stipulated time is not

unreasonably short.” Ferguson v. Order of united Commercial

Travelers of America, 307 Ark. 452, 821 S.W.2d 30, 32 (1991).

In Wilkins v. Hartford Life & Accident Ins. Co., the Eighth

Circuit Court of Appeals held that the agreement for a threeyear limitations period in the policy at issue in this case is

reasonable, and that the limitations period begins when

Hartford finally denies the claim. 299 F.3d 945, 948-50 (8th

Cir. 2002). 

Whether applying Delaware law or Arkansas law, the result

is the same. The three-year limitations period set out in the

policy applies in this case. The three-year limitations period

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 11 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

12

in the policy is not unreasonable. It is clear from the record

that Hartford denied Plaintiff’s appeal and released its final

decision, in correspondence to Plaintiff, dated December 24,

2002. Therefore, the three-year limitation period commenced on

December 24, 2002. This suit was filed on December 30, 2005,

more than three years after Hartford issued its final decision.

C. Conclusion

Based on the foregoing reasons, Plaintiff’s ERISA claim is

time-barred and his complaint must be dismissed with prejudice.

Each party is to bear their own fees and costs. 

IT IS SO ORDERED, this 20th day of September, 2006.

/s/ Robert T. Dawson 

 Honorable Robert T. Dawson

United States District Judge

Case 5:05-cv-05217-RTD Document 11 Filed 09/20/06 Page 12 of 12 PageID #: <pageID>