Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_10-cv-00071/USCOURTS-azd-2_10-cv-00071-0/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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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

TIMOTHY BOLT,

Plaintiff,

vs.

HONEYWELL INTERNATIONAL

INC., a Foreign Corporation;

METROPOLITAN LIFE

INSURANCE COMPANY, a

Foreign Corporation,

Defendants.

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CV. NO. 10-00071 PHX-DAE

ORDER: (1) DENYING PLAINTIFF TIMOTHY BOLT’S

MOTION FOR SUMMARY JUDGMENT AND (2) DENYING WITHOUT

PREJUDICE PLAINTIFF TIMOTHY BOLT’S REQUEST

FOR AN AWARD OF ATTORNEY FEES

Pursuant to Local Rule 7.2(f), the Court finds this matter suitable for

disposition without a hearing. After reviewing the motion and the supporting and

opposing memoranda, the Court DENIES Plaintiff Timothy Bolt’s Motion for

Summary Judgment (Doc. # 41). The Court also DENIES WITHOUT

PREJUDICE Plaintiff’s Request for an Award of Attorney Fees.

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 1 of 40
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BACKGROUND

Plaintiff Timothy Bolt (“Plaintiff” or “Bolt”) seeks an order from this

Court determining that Defendant Metropolitan Life Insurance Company

(“MetLife”) arbitrarily and capriciously terminated his disability payments under a

long-term disability plan governed by the Employee Retirement Income Security

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

I. Bolt’s Benefits Under the ERISA Plan

Plaintiff was employed by Defendant Honeywell International, Inc.

(“Honeywell”) from 1996 until 2003. (“AR,” Docs. ## 25–35, at

MetBCF000661.) When Bolt left Honeywell in 2003 he was Manager of

Information Technology. (Id. at MetBCF000366.) In this position he managed

129 employees, a budget of over 1.5 million dollars, and negotiated corporate wide

contracts for service and support programs. (Id. at MetBCF000366–67.) He was

also responsible for preparing and completing operations, productivity, tactical and

strategic reports, budget oversight and planning. (Id.)

In February 2003, Bolt resigned his position with Honeywell because

of health problems. (“Compl.,” Doc. # 1, ¶ 11.) His initial symptoms included

significant pain, blindness in his left eye, blurred vision in his right eye, and

numbness and weakness on the left side of his body. (AR at MetBCF000661.) 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 2 of 40
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Bolt’s primary care physician, Dr. Jerry Shockey, said Bolt was “unable to work

w[ith] loss of vision.” (Id. at METBCF00591.)

At the time of Bolt’s resignation, Honeywell had an ERISA-governed

Long Term Disability Benefit Plan (the “Plan”). (Id. at MetBPlan000001.) The

Plan gave MetLife discretion to determine entitlement to benefits, (id. at

MetBPlan000054), and defined disability as follows:

Disabled or Disability means that, due to Sickness or as a direct

result of accidental injury:

• You are receiving Appropriate Care and Treatment and

complying with the requirements of such treatment; and 

• You are, during the Elimination Period and the next 24 months

of Sickness or accidental injury:

• Unable to earn more than 80% of Your Predisability

Earnings at Your Own Occupation from any employer in

Your Local Economy; and

• Unable to perform each of the material duties of Your

Own Occupation;

• You are, after such period:

• Unable to earn more than 80% of Your Predisability

Earnings at any gainful occupation for any employer in

Your Local Economy; and

• Unable to perform the duties of any gainful occupation

for which You are reasonably qualified taking into

account Your training, education, and experience. 

(Id. at MetBPlan000022.) Thus, for the first twenty-four months of sickness or

accidental injury, disability is defined in terms of the insured’s own occupation. 

(Id.) After the first twenty-four months, disability is defined as the insured’s

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 3 of 40
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 An “ejection fraction” is the percentage of blood pumped with each heart

beat. (“Opp’n,” Doc. # 47, at 3 n.1.)

4

ability to perform any gainful occupation for which the insured is reasonably

qualified. (Id.) Disability, as defined under the Plan, also requires the insured to

“receiv[e] appropriate care and treatment and [to comply] with the requirements of

such treatment.” (Id.) 

MetLife approved Bolt’s claim for long-term disability under the

“own occupation” standard effective August 24, 2003. (Id. at MetBCF000586.) 

Bolt was also approved for social security disability benefits effective August

2003. (Id. at MetBCF00071.)

In December 2003, Bolt had a pulmonary embolism resulting from a

blood clot in his lung. (Id. at MetBCF000546.) One month later he was diagnosed

with a weakened heart muscle due to inadequate blood supply and was found to

have an ejection fraction of twenty-five percent.1

 (Id. at MetBCF000541,

MetBCF000521.) The ejection fraction rose three months later to between thirtyfive and forty percent and Bolt’s cardiologist, Dr. Ryk Linden, noted that Bolt was

“capable of doing sitting and sedentary activity but even this [was] somewhat

limited based on his symptoms.” (Id. at MetBCF000538, MetBCF000520.) 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 4 of 40
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In May 2004, Bolt submitted a Personal Profile Evaluation (“PPE”) in

which he described his day-to-day activities as well as his conditions. Bolt told

MetLife he was unable to engage in more than twenty to thirty minutes of activity

under Dr. Linden’s rest orders. (Id. at MetBCF000514.) He said he slept through

the day, was unable to do any work around the house and did not go shopping or

driving. (Id. at MetBCF000514–16.) He responded “n/a” when asked what his

hobbies were and stated that aside from his family taking him to medical

appointments, he did not leave the house. (Id.)

In January 2005, MetLife requested updated information on Bolt’s

condition because, per the Plan, Bolt now had to demonstrated he was unable to

work in “any gainful occupation” to continue receiving benefits. (Id. at

MetBCF000497; see also id. at MetBPlan000022.) Bolt submitted a new PPE

dated January 30, 2005, in which he reported suffering consistent with his May

2004 PPE. When asked to provide a detailed description of his daily routine, Bolt

stated:

I wake up at varied times—in the AM I get up, take care of my

personal hygiene needs, take AM medication, and return to bed. In

the PM I eat one meal, take meds, and return to bed.

(Id. at MetBCF000484.) He claimed to sleep so much because of the fatigue he

experienced when awake and “performing minimal functions.” (Id. at

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MetBCF00484–86.) He restated that he did not shop and did not drive “unless

there is no other means of travel.” (Id.) Bolt submitted an attending physician

statement (“APS”) from Dr. Linden which stated that Bolt could only sit two hours

a day intermittently, and could not stand or walk and was unable to work. (Id. at

MetBCF000477–79.) Dr. Linden also stated that Bolt’s “activities of daily living

are substantially limited by his fatigue and loss of stamina.” (Id.) Based on these

documents, MetLife approved Bolt’s claim for continuing benefits under the “any

occupation” standard in the plan. (Id. at MetBCF000474.) MetLife continued to

pay benefits to Bolt for three years while receiving periodic updates on Bolt’s

condition.

II. Termination of Benefits

In January 2008, MetLife received a tip on its confidential fraud

hotline that Bolt was “very active and rides [his] motorcycle with [a] club.” (Id. at

MetBCF000124, 135.) MetLife referred Bolt’s claim to its Special Investigations

Unit and hired private investigators Bonnamy & Associates to perform surveillance

on Bolt. (Id. at MetBCF000704, 727–37.) 

The first round of surveillance was conducted on January 27, 28, and

29. (Id.) The surveillance video, which the parties provided to the Court, shows

Bolt grocery shopping. Bolt is seen pushing a cart full of groceries to his vehicle

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 6 of 40
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and helping load the back of the vehicle with groceries. He and his companion

enter the vehicle, and Bolt drives away.

After reviewing the January surveillance, MetLife conducted a second

round of surveillance from February 15–17, 2008. (See id at MetBCF000124, 135;

MetBCF000743–53.) Video surveillance from February 16, 2008 shows Bolt

squatting in his garage near his motorcycle. Video surveillance from February 17,

2008 shows Bolt driving on a seven hour and thirty minute, 170-mile motorcycle

trip with a passenger and a group of friends. The latter video shows that the group

took periodic breaks during the trip. (See id. MetBCF000364–65, 753.)

After reviewing the video surveillance, MetLife telephoned Bolt and

requested further information on March 7, 2008, including an updated PPE and

APS. (Id. at MetBCF000126.) During that phone conversation, Bolt stated that his

condition had not changed. (Id.)

One month after his motorcycle trip, Bolt completed and submitted

another PPE for MetLife. (Id. at MetBCF 000389–94.) Bolt claimed that his

medical conditions caused “fatigue, dizziness, shortness of breath, pain (foot, leg,

hip, lower back, shoulders, arm, hand, neck).” (Id.) He described his daily

activities as follows:

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Morning Hygiene, Shower, Shave, Brush Teeth, Eat Morning Snack

(Toast), Lay in bed till dinner, Back to Resting, Converse with wife

and sleep between 8 & 10 pm. I make doctors appts as early in the

day as possible.

(Id. at MetBCF000390.) Bolt added that his wife drove him on trips “outside of

local” but that he had “not traveled any distance recently.” (Id. at

MetBCF000392.) In response to the question of whether there had been “[a]ny

change in the distance or time you travel,” Bolt responded “I don’t travel.” (Id.) 

Bolt further stated that he was not involved in any activities or hobbies, nor was he

“[a]ctive with family, church, social or other groups.” (Id. at MetBCF000392–93)

Bolt also stated that he did not shop. (Id. at MetBCF000392.) With his PPE, Bolt

submitted another APS from Dr. Linden which stated that Bolt had severe

cardiomyopathy and an ejection fraction of twenty-five percent. (Id. at

MetBCF000413.) Dr. Linden opined that Bolt could only sit for two hours

intermittently during the day and could not stand or walk more than intermittently. 

(Id. at MetBCF000414.) Dr. Linden also stated that Bolt was unable to twist, bend,

or stoop due to “short[ness] of breath, fatigue, chronic severe pain, lack of

stamina.” (Id.)

After receiving Dr. Linden’s APS, MetLife faxed a copy of the

surveillance report to Dr. Linden on April 15, 2007. (Id. at MetBCF000131–33.) 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 8 of 40
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MetLife explained that it did not believe that his report was consistent with the

video surveillance and asked for comment. (Id.) MetLife stated that if it did not

hear back within a week it would “take that to mean that your patient has the

ability to do his light duty occupation as IT Manager.” (Id.) Dr. Linden did not

respond. (Id. at MetBCF000140.)

Subsequently a MetLife nurse consultant reviewed Bolt’s claims and

agreed that Bolt’s activities were inconsistent with his self-reported limitations. 

(Id. at MetBCF000134–36.) MetLife’s Claim Specialist then evaluated all the

information in Bolt’s claim file and concluded that he was not entitled to

continuing benefits under the plan’s “any occupation” standard. (Id. at

MetBCF000139–40.) By letter dated May 15, 2008, MetLife notified Bolt that his

benefits under the Plan were terminated. (Id. at MetBCF000386–88.) MetLife

stated that Bolt “no longer met the plan definition of total disability from your job

based on your observed activities of having the ability to fix, maintain and ride

your motorcycle around town and on road trips.” (Id.) MetLife also stated that the

surveillance was inconsistent with the restrictions described in Dr. Linden’s APS

and Bolt’s PPE. (Id.)

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 9 of 40
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 Bolt also explained that Dr. Linden did not respond as a result of MetLife’s

“underhanded” tactics in video recording him. (AR at MetBCF00067.)

10

III. Bolt’s Appeals

On or about November 5, 2008, Bolt’s counsel filed a timely appeal of

the May 15, 2008 decision. (Id. at MetBCF000359–62.) Bolt included an affidavit

and additional medical records with his appeal. (Id.) Bolt explained that the

motorcycle ride was taken by a group of older adults with health issues and

stopped for breaks every hour or so.2

 (Id. at MetBCF000363–66.) Bolt also

submitted a new APS from Dr. Linden which echoed his May APS except that it

stated Bolt could only sit for one hour a day, and even then, only intermittently. 

(Id. at MetBCF000371, 414.) Bolt submitted further evidence, mostly from Dr.

Linden, which suggested his ejection fraction was at thirty-eight percent and that

he had decreased blood pressure when he stood up. (Id. at MetBCF000377.)

As a part of the appeal process, MetLife had a second nurse consultant

review the file. (Id. at MetBCF000148–54.) She concluded that Dr. Linden’s

restrictions were inconsistent with Bolt’s documented functionality. (Id. at

MetBCF000153.) MetLife also obtained an independent medical review by a

board-certified cardiologist, Dr. Michael Rosenberg, who reviewed Bolt’s medical

records dating back to 2003 and the surveillance video. (Id. at MetBCF000330.) 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 10 of 40
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Dr. Rosenberg then twice attempted to contact Dr. Linden for comment but never

received a response. (Id. at MetBCF000331.)

Dr. Rosenberg subsequently issued an assessment to MetLife based on

the information provided to him. (Id. at MetBCF00033.) The assessment

reviewed Bolt’s medical history and commented that it was a “complicated one.” 

Dr. Rosenberg went on to state as follows:

The claimant was observed working in his garage on a motorcycle

repair, was noted to make fluid movements at all times, carrying items

that appeared to be of moderate weight, walking freely, and carrying

and loading groceries into a truck. He was noted to ride a motorcycle,

as well as drive other vehicles, and was seen to be taking a “road trip”

with other motorcycle riders. The patient remained active for many

hours at a time.

At all times, his movements appeared fluid, unlabored, and consistent

with at least a medium level of activity, tolerating this for hours at a

time. From the surveillance videotapes made in January and February

2008, it becomes clear that the claimant was capable of doing

mechanical work on his motorcycle, riding the motorcycle, loading

groceries, and at least capable of medium work. The activities

observed are clearly inconsistent with the presence of an objectively

assessed significant functional impairment precluding the employee

from performing a sedentary or light job. 

(Id. at MetBCF000332.) Dr. Rosenberg then responded to a series of questions

submitted to him by MetLife as follows:

1. Does the medical information support functional limitations

(physical) beyond 05/16/08 on going? Functional limitations include

any reduction in the ability to work full time.

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 11 of 40
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Based upon the information reviewed, the medical information does

not support functional limitations beyond 05/16/08. . . . 

3. If no, please describe . . . 

The claimant has demonstrated fluid activity on the surveillance tapes. 

His ejection fraction has been stable since his unrecognized anterior

wall myocardial infarction that occurred presumably in the time frame

between 2003 and 2004. His ejection fractions have been stable in the

30% to 40% range throughout that period of time and he has had no

findings of congestive heart failure. Furosemide has been

discontinued. He is not shown to have any objective evidence of

ongoing myocardial ischemia.

(Id. at MetBCF000332–33.)

MetLife then faxed Dr. Rosenberg’s assessment to Dr. Linden and Dr.

Shockey for comment. (Id. at MetBCF000321–24.) Dr. Shockey responded he

had not seen Bolt in over a year. (Id. at MetBCF000326.) Dr. Linden did not

respond.

Similarly, MetLife had Dr. George Yanik, a board-certified

ophthalmologist, review Bolt’s file. (Id. at MetBCF000336–40.) Dr. Yanik began

by noting that “all records referred to in the ophthalmologic records in regard to

Mr. Bolt are five years old, and as such, any change in his visual status cannot be

inferred or estimated based upon five-year old records.” (Id. at MetBCF000337.) 

Dr. Yanik went on to review Bolt’s medical history before assessing the impact of

the surveillance video, stating as follows:

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 12 of 40
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While [the video] shows that Mr. Bolt . . . has sufficient visual acuity

to operate a motor vehicle at present, the objective notes which detail

what the visual acuity is are not in evidence in the medical record. 

Additionally, the operation of a motor vehicle, either in motorcycle or

car, does prove that he has sufficient visual activity to drive, it does

not in itself prove he has sufficient physical stamina to return to work. 

Since driving, either a car or motorcycle, is relatively a sedentary

activity, many patients who have significant medical impairment are

able to do so without difficulty since very little strenuous work is

required to operate such a vehicle. As to the other comorbid

conditions that Mr. Bolt experiences . . . these would best be reviewed

by a cardiologist or internal medicine specialist more in tune with

those diagnoses.

(Id. at MetBCF000337.) In response to questions asked by MetLife, Dr. Yanik

responded as follows:

1. Does the medical information support functional limitations

(physical) beyond 05/16/08 on going? Functional limitations include

any reduction in the ability to work full time.

As to his visual acuity, which is the reason for this evaluation, the

surveillance videos do show that he has sufficient visual acuity to

operate a motor vehicle safely, whether it be a motorcycle or a motor

vehicle. As to other physical limitations of a medical nature that Mr.

Bolt may have, which include his cardiac status, these are beyond the

scope of this review. . . . Finally, as to Mr. Bolt’s ongoing present

visual status, this cannot be commented upon since the records I

received for review are over five years old.

2. If yes, specify the types of limitations the claimant would have. 

Describe the specific clinical findings/data noted in the records in

support of functional limitations. . . .

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 13 of 40
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What can be seen from the five-year-old record is that Mr. Bolt does

have a significant impairment of vision of his left eye. I have no

doubt that this has remained as such and has not improved given the

extent of damage to the macula of that eye as a result of the choroidal

neovascular membrane. As to the right eye, it is unknown to this

reviewer based on the available information . . . . Therefore, any

greater specificity into the limitation [sic] his vision would be

speculation and not belong in an objective report.

(Id. at MetBCF000338.) Dr. Yanik concluded:

What can be stated from the medical record present and the

surveillance video, is that Mr. Bolt does have sufficient visual acuity

to operate safely a motor vehicle and/or motorcycle. As such, whether

this translates on his being able to return to work from a visual

standpoint, the answer is he could return to work. [As to his cardiac

status,] that will be reviewed by the cardiologist and commented upon

by that specialist.

 (Id. at MetBCF000340 (emphasis added).)

MetLife also conducted an employment analysis, which identified

several occupations, all sedentary, that Bolt could perform based on his education

and training and that would meet the plan’s eighty percent of pre-disability

earnings requirement. (Id. at MetBCF000304–05.)

By letter dated January 14, 2009, MetLife upheld its decision to

discontinue Bolt’s benefits. (Id. at MetBCF000298–302.) MetLife summarized

Dr. Rosenberg and Dr. Yanik’s decisions and relied upon them in reaching its

conclusion. (Id.) MetLife, nonetheless, provided Bolt with another opportunity to 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 14 of 40
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appeal its decision with respect to Bolt’s ophthalmological condition given that the

information on file was over five years old. (See id. at MetBCF000301.)

By letter dated July 9, 2009, Bolt appealed MetLife’s decision that he

was not disabled based on his ophthalmological condition. (Id. at

MetBCF000282–83.) With this letter, Bolt provided medical documentation from

2007 through 2009 which established a diagnosis of “recurrent central serous

retinopathy (CSR) in the right eye and a history of vascular occlusion in the left

eye.” (Id. at MetBCF000285.) The CSR was first diagnosed in March 2003; Bolt

lost the central vision of his left eye to wet abnormal macular degeneration and has

had CSR in his right eye since March 2003. (See id. MetBCF000284–97.) Bolt’s

subjective complaints relating to the ophthalmic conditions, including pain and

blurred vision, are similarly reflected in these retinology records. (See id.)

In response to this appeal, MetLife referred Bolt’s file to Dr. Gary

Edwards, another board-certified ophthalmologist, for further independent medical

review. (Id. at MetBCF000270–73.) Dr. Edwards reviewed and summarized the

medical documentation submitted by Bolt. (Id. at MetBCF000271.) Dr. Edwards

summarized Bolt’s 2009 visits to his own ophthalmologist, Dr. Jamie Gaitan, as

follows:

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On 05/04/09, [Bolt] was seen by Dr. Jaime Gaitan. His vision then

was found to be 20/30 in the right eye and 20/400 in the left eye, and

there is a note made that there is a suspicion of fluid near the optic

nerve in the right eye. His last visit was on 6/15/09 by Dr. Gaitan. He

found no [CSR] in the right eye and poor vision in the left eye due to

old choroidal neovascularization effects in the left. The visions at that

time were 20/30 in the right and counting fingers of two feet in the

left.

(Id. at MetBCF000271.) Dr. Edwards also reached out to Dr. Gaitan who opined

that Bolt “was able to function in his original job as far as his ophthalmological

status [] was concerned.” (Id.) In response to MetLife’s specific questions, Dr.

Edwards responded as follows:

1. Does the medical information support functional limitations

(physical) beyond 05/16/08 on going? Functional limitations include

any reduction in the ability to work full time.

No. . . 

3. If no, please describe . . . 

The patient works at a sedentary job as an IT manager. This involves

looking at a computer monitor. He has good vision in his remaining

right eye compatible with doing this type of work. In fact, there are

blind people who do excellent IT work.

(Id. at MetBCF000272.) Dr. Edwards concluded that Bolt “has had numerous

visits with the retinologists. They all support the fact that he has very good vision

in his right eye and poor vision in his left eye. This is compatible with working at

sedentary work.” (Id. at MetBCF000273.)

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On August 20, 2009, MetLife upheld its May 15, 2008 termination of

Bolt’s benefits. (Id at MetBCF000257.)

On January 13, 2010, Bolt filed his Complaint with this Court. 

(See Doc. # 1.) On September 27, 2010, Bolt filed the instant Motion for

Summary Judgment (“Motion”). (“Mot.,” Doc. # 41.) On December 6, 2010,

MetLife filed its Response to the Motion. (“Resp.,” Doc. # 47.) On December 29,

2010, Bolt filed his Reply. (“Reply,” Doc. # 51.)

STANDARD OF REVIEW

Under ERISA § 502, a beneficiary or plan participant may sue in

federal court “to recover benefits due to him under the terms of his plan, to enforce

his rights under the terms of the plan, or to clarify his rights to future benefits

under the terms of the plan.” 29 U.S.C. § 1132(a)(1)(B); see also Aetna Health

Inc. v. Davila, 542 U.S. 200, 210 (2004). The ususal legal standard for summary

judgment motions does not apply where the Court is asked to review an ERISA

plan administrator’s decision. Harlick v. Blue Shield of Cal., --- F.3d ---, 2011 WL

3796177, at * 4 (9th Cir. August 26, 2011); see also Bendixen v. Standard Ins. Co.,

185 F.3d 939, 942 (9th Cir. 1999) (overruled on other grounds by Abatie v. Alta

Health & Life Ins. Co., 458 F.3d 955, 965 (9th Cir. 2006) (en banc)). Instead, a

motion for summary judgment is “merely the conduit to bring the legal question

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 17 of 40
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before the district court and the usual tests of summary judgment . . . do not apply.” 

 Bendixen, 185 F.3d at 942.

A claim of denial of benefits in an ERISA case “is to be reviewed

under a de novo standard unless the benefit plan gives the administrator or

fiduciary discretionary authority to determine eligibility for benefits or to construe

the terms of the plan.” Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115

(1989); Montour v. Hartford Life & Acc. Ins. Co., 588 F.3d 623, 629 (9th Cir.

2009). If the plan confers such discretion, then the denial is reviewed for an abuse

of discretion. Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105, 110–11 (2008)

(“Glenn ”).

“Commonly, . . . the same entity that funds an ERISA benefits plan

also evaluates claims, as is the case here.” Montour, 588 F.3d at 630 (citing Glenn,

489 U.S. at 108, 111–12). In these circumstances “the plan administrator faces a

structural conflict of interest: since it is also the insurer, benefits are paid out of the

administrator’s own pocket, so by denying benefits, the administrator retains

money for itself.” Id. “[A] reviewing court must take into account the

administrator’s conflict of interest as a factor in the analysis.” Id. (citing Glenn,

489 U.S. at 108, 111–12). The existence of a conflict, however, does not alter the

standard of review, but instead affects only its application. Id. at 631; see also

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 18 of 40
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Saffon v. Wells Fargo & Co. Long Term Disability Plan, 522 F.3d 863, 868 (9th

Cir. 2008). If a conflict exists, “abuse of discretion review applies” and “that

conflict must be weighed as a factor in determining whether there was an abuse of

discretion.” Abatie, 458 F.3d at 965 (internal quotation marks and alteration

omitted); see also Harlick, 2011 WL 3796177, at *4. In effect, the review the court

conducts will be “tempered by skepticism.” Harlick, 2011 WL 3796177, at *4. 

An administrator can mitigate a conflict “by walling off claims

administrators from those interested in firm finances, or by imposing management

checks that penalize inaccurate decision making irrespective of whom the

inaccuracy benefits.” Glenn, 554 U.S. at 117. In addition, “[w]hen an

administrator can show that it has engaged in an ongoing, good faith exchange of

information between the administrator and the claimant, the court should give the

administrator's decision broad deference . . . .” Abatie, 458 F.3d at 972 (internal

quotation marks omitted).

In sum, then, a “court must consider numerous case-specific factors,

including the administrator’s conflict of interest, and reach a decision as to whether

discretion has been abused by weighing and balancing those factors together.” 

Montour, 588 F.3d at 630 (citing Glenn, 128 S. Ct. at 116–19). Factors that

frequently arise in the ERISA context include whether the fiduciary failed to

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 19 of 40
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investigate a claim adequately or ask the plaintiff for necessary evidence, whether

the fiduciary failed to credit a claimant’s reliable evidence, and whether the

fiduciary’s decision is against the weight of evidence in the record. Abatie, 458

F.3d at 972. Other factors courts have found relevant include whether the

administrator acknowledged or distinguished a contrary disability determination by

the Social Security Act (“SSA”), Glenn, 554 U.S. at 118, whether the administrator

presented outside medical reviewers with all the relevant evidence, id., and

whether the administrator conducted an in-person medical evaluation or relied

instead on a paper review, Montour, 588 F.3d at 630.

DISCUSSION

I. Structural Conflict

The parties spend much of their briefing debating the extent to which

the Court should afford deference to MetLife’s decision because it operated under

a structural conflict of interest. (See Mot. at 6; Resp. at 13–17; Reply at 2.) 

Plaintiff contends that because MetLife was both the Plan administrator and

insurer, it operated under a structural conflict of interest—i.e. MetLife both paid

benefits and decided whether to issue benefits. (Mot. at 6.) As a result, according

to Plaintiff, “the court is required to weigh a conflict of interest as a factor in abuse

of discretion review” and “must not be so deferential to MetLife in determining if

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 20 of 40
21

MetLife’s decision to terminate Bolt’s . . . benefits was arbitrary and capricious.” 

(Id.) MetLife, for its part, argues that this factor is “less important” and that there

“is simply no basis to afford the mere structural conflict of interest any weight.” 

(Resp. at 16.)

The presence of a structural conflict, as here, is only one of many

factors a Court considers. Montour, 588 F.3d at 630 (holding that a “court must

consider numerous case-specific factors, including the administrator’s conflict of

interest, and reach a decision as to whether discretion has been abused by weighing

and balancing those factors together.”). While the structural conflict factor must be

considered by a court, see id. at 626 (“a reviewing court must take into account the

conflict” (emphasis added)), how much weight this factor is afforded depends on

the facts and circumstances of the case. See Glenn, 554 U.S. at 126 (“The conflict

of interest . . . should prove more important (perhaps of great importance) where

circumstances suggest a higher likelihood that it affected the benefits decision . . . . 

It should prove less important (perhaps to the vanishing point) where the

administrator has taken active steps to reduce potential bias and to promote

accuracy, for example, by walling off claims administrators from those interested

in firm finances, or by imposing management checks that penalize inaccurate

decision making irrespective of whom the inaccuracy benefits.”); see also Abatie,

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 21 of 40
22

458 F.3d at 968 (“The level of skepticism with which a court views a conflicted

administrator’s decision may be low if a structural conflict of interest is

unaccompanied, for example, by any evidence of malice, of self-dealing, or of a

parsimonious claims-granting history. A court may weigh a conflict more heavily

if, for example, the administrator provides inconsistent reasons for denial, fails

adequately to investigate a claim or ask the plaintiff for necessary evidence, fails to

credit a claimant’s reliable evidence . . . .” (internal citations omitted)).

Here, MetLife has produced evidence, which Plaintiff has not

disputed, that suggests the structural conflict “should prove less important” and

“perhaps [reach] the vanishing point.” Glenn, 554 U.S. at 126. MetLife has taken

steps to minimize any bias that may arise from the structural conflict of interest. 

As described in a declaration provided by MetLife to the Court:

MetLife’s finances are kept completely separate from claims.

MetLife’s claims offices are geographically separate from its

finance offices.

Claims specialists do not report up to Finance Department

employees.

Finance Department employees do not make, direct, or have

any association with claim determinations.

Claims specialists do not have access to claim reserve

information

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 22 of 40
23

Claims specialists receive no compensation, awards, bonuses,

other financial benefits or performance recognition based upon either

the value or the number of the claims they deny or terminate

Claims determinations are expected to be accurate regardless of

the outcome of the determination.

MetLife administers all claims consistently, regardless of

whether the plan is funded by the employer or by MetLife.

(“Hafner Decl.,” Doc. # 48-1, at 2.) The declaration makes clear that MetLife has

taken steps to reduce the impact of the structural bias as the Court in Glenn

contemplated. 554 U.S. at 126 (“The conflict of interest . . . should prove less

important (perhaps to the vanishing point) where the administrator has taken active

steps to reduce potential bias and to promote accuracy, for example, by walling off

claims administrators from those interested in firm finances , or by imposing

management checks that penalize inaccurate decision making irrespective of whom

the inaccuracy benefits.”). Indeed, Plaintiff has not pointed to any evidence which

suggests that malice, self-dealing, or a parsimonious claims-granting history was at

issue here, and, accordingly, the Court views MetLife’s structural conflict with a

low level of skepticism. See Abatie, 458 F.3d at 968 (“The level of skepticism

with which a court views a conflicted administrator’s decision may be low if a

structural conflict of interest is unaccompanied, for example, by any evidence of

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 23 of 40
3

 Similarly, the Ninth Circuit has stated that a court should weigh a conflict

more heavily if the administrator provides inconsistent reasons for denial, fails

adequately to investigate a claim or ask the plaintiff for necessary evidence, fails to

credit a claimant’s reliable evidence, has repeatedly denied benefits to deserving

participants, or makes decisions against the weight of the evidence in the record. 

Abatie, 458 F.3d at 968. None of these hallmarks of bias stemming from a

structural conflict are present here. As discussed, infra, the record instead reflects

that MetLife took steps to avoid these potential pitfalls; MetLife’s actions were

consistent with those of a disinterested plan administrator. 

4

 More than two years after the onset of the medical condition, disabled as

defined in the plan means the insured’s inability to perform any gainful occupation

for which the insured is reasonably qualified. (AR at MetBPlan000022.)

24

malice, of self-dealing, or of a parsimonious claims-granting history.”).3

 In sum,

the Court has considered the impact of the structural bias here and, while cognizant

of it, concludes that it should not be afforded much weight in determining whether

MetLife abused its discretion in denying Bolt’s benefits.

II. Abuse of Discretion 

As outlined above, MetLife discontinued Bolt’s benefits because it

found that Bolt’s cardiac and ophthalmic conditions did not suffice to qualify Bolt

as disabled as defined in the Plan.4

 (AR at MetBCF000301.) Bolt argues that

“MetLife did not undertake a full and thorough review of Bolt’s records, and

instead based its decision on the surveillance video and report, which is insufficient

to support MetLife’s decision that Bolt is capable of work” and therefore abused its

discretion. (Mot. at 7.) The Court is not persuaded.

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 24 of 40
5 This illustrates that MetLife did not on its own begin an investigation into

Bolt in the hopes of finding something with which to deny his claim. Bolt’s

activities were rather independently reported to MetLife by a third-party.

25

A. Cardiac Condition

MetLife did not abuse its discretion in concluding that Bolt’s cardiac

condition did not qualify him as disabled within the meaning of the Plan. 

First, MetLife received an anonymous tip stating that Bolt was “very

active” and regularly took motorcycle trips with a club.5

 (Id. at MetBCF000124,

135.) It is clear here that MetLife did not on its own begin an investigation of Bolt

in the hopes of finding “something” upon which to deny his claims. Bolt’s

inconsistent actions were rather independently reported to MetLife by a third party.

MetLife then hired a private party to investigate Bolt and video

surveillance revealed that Bolt was in fact fully capable of grocery shopping, as

well as taking a seven and one-half hour day trip on his motorcycle which covered

170 miles. 

After the video surveillance was recorded, MetLife asked for an

updated PPE from Bolt. (Id. at MetBCF000126.) At best, Bolt’s response can be

characterized only as misleading. Bolt claimed that his medical conditions caused

“fatigue, dizziness, shortness of breath, pain (foot, leg, hip, lower back, shoulders, 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 25 of 40
26

arm, hand, neck).” (Id. at MetBCF 000389–94.) He described his daily activities

as follows:

Morning Hygiene, Shower, Shave, Brush Teeth, Eat Morning Snack

(Toast), Lay in bed till dinner, Back to Resting, Converse with wife

and sleep between 8 & 10 pm. I make doctors appts as early in the

day as possible.

(Id. at MetBCF000390.) Bolt added that his wife drove him on trips “outside of

local” but that he had “not traveled any distance recently.” (Id. at

MetBCF000392.) In response to the question of whether there had been “[a]ny

change in the distance or time you travel,” Bolt responded “I don’t travel.” (Id.) 

Bolt further stated that he was not involved in any activities or hobbies, nor was he

“[a]ctive with family, church, social or other groups.” (Id. at MetBCF000392–93)

Bolt also stated that he did not shop. (Id. at MetBCF000392.)

Dr. Linden’s updated APS was similarly out of sync with the video

surveillance. The APS stated that Bolt had severe cardiomyopathy and an ejection

fraction of 25 percent. (Id. at MetBCF000413.) Dr. Linden opined that Bolt could

only sit for two hours intermittently during the day and could not stand or walk

more than intermittently. (Id. at MetBCF000414.) Dr. Linden also stated that Bolt

was unable to twist, bend, or stoop due to “short[ness] of breath, fatigue, chronic 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 26 of 40
6

 Indeed, beginning in 2007 and during the course of the investigation and

appeal process MetLife as well as the independent medical investigators reached

out to Dr. Linden no fewer than four times for comment on his various APS reports

due to the inconsistency between the reports and the video surveillance MetLife

obtained. (See id. at MetBCF000140, MetBCF000331, MetBCF000321–24.) Dr.

Linden did not once respond or in anyway attempt to explain or justify his

opinions.

27

severe pain, lack of stamina.” (Id.) When asked to comment on the video

surveillance report, Dr. Linden did not respond.6

Across the investigative and appeal process, MetLife also had two

nurse consultants as well as one board certified cardiologist, Dr. Rosenberg, review

Bolt’s entire file. Both nurse consultants concluded that Bolt’s functionality was

inconsistent with his most recently reported medical information. (See id. at

MetBCF000134–36; MetBCF000148–54.) Dr. Rosenberg concluded similarly. 

He reviewed and outlined Bolt’s medical history, including the most up to date

information provided to MetLife by Bolt and his physician, Dr. Linden. (Id. at

MetBCF000331.) Acknowledging the case was complicated, Dr. Rosenberg found

that “the medical information does not support functional limitations beyond

05/16/08 . . . .” (Id. at MetBCF000332–33.) Dr. Rosenberg explained that his

finding was based on the following facts:

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 27 of 40
28

The claimant has demonstrated fluid activity on the surveillance tapes. 

His ejection fraction has been stable since his unrecognized anterior

wall myocardial infarction that occurred presumably in the time frame

between 2003 and 2004. His ejection fractions have been stable in the

30% to 40% range throughout that period of time and he has had no

findings of congestive heart failure. Furosemide has been

discontinued. He is not shown to have any objective evidence of

ongoing myocardial ischemia.

(Id. at MetBCF000332–33.) Dr Rosenberg ultimately concluded that Bolt was

capable of engaging in sedentary or light work. Relying on Dr. Rosenberg’s

analysis, the video, the anonymous tip, and the review conducted by the two nurse

consultants, MetLife concluded that Bolt’s cardiac condition did not render him

incapable of engaging in light or sedentary work. 

B. Ophthalmic Condition

MetLife did not abuse its discretion in concluding that Bolt’s

opthalmic condition did not qualify him as disabled within the meaning of the Plan.

As outlined above, MetLife received an anonymous tip, obtained

video surveillance of Bolt on a motorcycle day trip, and had two nurse consultants

conclude that Bolt’s ophthalmic condition did not render him incapable of

working. Bolt also had two independent board-certified ophthalmologists as well

as his own ophthalmologist conclude that Bolt was capable of working.

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 28 of 40
7

 Dr. Yanik also cautioned that “driving, either a car or motorcycle, is

relatively a sedentary activity, many patients who have significant medical

impairment are able to do so without difficulty since very little strenuous work is

required to operate such a vehicle.” (Id. at MetBCF000337.) Dr. Yanik also

explicitly stated, however, that these conditions “would best be reviewed by a

cardiologist or internal medicine specialist more in tune with those diagnoses.” 

(Id.) In this case, as discussed, Dr. Rosenberg, a board certified cardiologist,

reviewed the record and concluded that Bolt was capable of working.

29

Dr. Yanik, the first independent board-certified opthamologist,

expressed concern over the age of the medical records at his disposal, noting that

“all records referred to in the ophthalmologic records in regard to Mr. Bolt are five

years old, and as such, any change in his visual status cannot be inferred . . . .” 

(AR at MetBCF000337.) As a result, Dr. Yanik concluded, in part, that “as to Mr.

Bolt’s ongoing present visual status, this cannot be commented upon since the

records I received for review are over five years old.” (Id. at MetBCF000338.) 

Dr. Yanik qualified this conclusion by also finding that “[w]hat can be stated from

the medical record present and the surveillance video, is that Mr. Bolt does have

sufficient visual acuity to operate safely a motor vehicle and/or motorcycle. As

such . . . from a visual standpoint . . . he could return to work.”7

 (Id. at

MetBCF000340 (emphasis added).)

MetLife, rather than just accepting Dr. Yanik’s conclusion that Bolt

could return to work, nonetheless provided Bolt another opportunity to appeal its

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 29 of 40
8

 Indeed, this is one instance where the record is clear that MetLife’s

structural bias had little impact on MetLife’s ultimate decision. Rather than just

resting on Dr. Yanik’s conclusion that Bolt could work and outright deny the

benefits, MetLife instead provided Bolt another opportunity to appeal its decision

and submit up-to-date ophthalmic documentation in support.

30

findings with respect to this conclusion and to submit further documentation.8

 (See

id. at MetBCF000301.) Bolt so appealed and MetLife retained another boardcertified ophthalmologist, Dr. Edwards, to conduct another independent medical

review. Dr. Edwards reviewed the updated documentation and contacted Bolt’s

own ophthalmologist, Dr. Gaitan, who opined that Bolt “was able to function in his

original job as far as his ophthalmological status [] was concerned.” (Id. at

MetBCF000271.) Dr. Edwards concluded similarly. (Id. at MetBCF000271–73.) 

Relying on the opinions of Dr. Yanik, Dr. Edwards, Dr. Gaitan, the anonymous tip,

and the review conducted by the two nurse consultants, MetLife concluded that

Bolt’s ophthalmic condition did not render him incapable of engaging in light or

sedentary work.

C. Employment Analysis

Finally, MetLife conducted an employment analysis which identified

several occupations, all sedentary, that Bolt could perform based on his education

and training which would meet the plan’s eighty percent of pre-disability earnings

requirement. (Id. at MetBCF000304–05.) Given that all three board certified

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 30 of 40
9 After the first twenty-four months, disability is defined as the insured’s

ability to perform any gainful occupation for which the insured is reasonably

qualified. (AR at MetBPlan000022.)

31

M.D.s who reviewed Bolt’s file concluded that Bolt was capable of doing 

sedentary work, MetLife concluded that Bolt was not disabled as defined in the

Plan.9

Based on the evidence outlined above, the Court cannot conclude that

MetLife abused its discretion in determining that Bolt no longer qualified as

“disabled” as defined in the Plan and thereafter terminating his benefits. 

III. Bolt’s Arguments

A recurring theme in Plaintiff’s briefing is that MetLife and Dr.

Rosenberg “did not speak with or meet with either Mr. Bolt or his cardiologist, Dr.

Linden,” (Mot. at 7), and that MetLife did not “give [Dr. Linden] a reasonable time

frame to respond.” (Reply at 3.) The Court is not persuaded.

As noted, MetLife and Dr. Rosenberg reached out to Dr. Linden four

times for comment. Dr. Linden never responded. Neither Dr. Rosenberg nor

MetLife can be faulted for Dr. Linden’s failure to respond to their repeated

requests for comment. Indeed, Bolt’s attempts to fault MetLife for failing to obtain

the views of Dr. Linden is disingenuous at best. 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 31 of 40
10 Indeed, even if MetLife had not sought comment from Dr. Linden on Dr.

Rosenberg’s report, the Court would be hard pressed to find such conduct

unreasonable given Dr. Linden’s repeated failure to cooperate with the

investigation. 

32

Bolt also complains that the timing of MetLife’s request for comment

from Dr. Linden was unreasonable because MetLife sent “its reports to [Dr.

Linden] a week before Christmas, with a demand for response by Christmas Eve.” 

(Mot. at 11; see also Reply at 3.) While it is true that MetLife sent its final request

for comment on the report provided by Dr. Rosenberg in the midst of the holiday

season, Plaintiff overlooks the fact that this was the fourth request for comment

from Dr. Linden. Given Dr. Linden’s repeated failure to respond to MetLife’s

inquiries into Bolt’s condition, the Court cannot conclude that MetLife acted

unreasonably in providing Dr. Linden the opportunity to comment for the fourth

time during the holiday season.10 

Plaintiff attempts to explain away Dr. Linden’s repeated failure to

respond as disgust at MetLife’s “underhanded” tactics in video recording him. 

(AR at MetBCF00067.) This explanation is misguided for multiple reasons. First,

video surveillance is widely accepted as a means of investigating potentially

fraudulent ERISA claims. See, e.g., Lacour v. Life Ins. Co of N. Am., 200 F.

Supp. 2d 622, 626 (W.D. La. 2002); Mote v. Aetna Life Ins. Co., 502 F.3d 601,

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 32 of 40
33

609–10 (7th Cir. 2007); Giertz-Richardson v. Hartford Life & Accident Ins. Co., F.

Supp. 2d 1280, 1292 (M.D. Fla. 2008). In any event, even assuming Dr. Linden

refused to cooperate with MetLife’s investigation because of the alleged

“underhanded” tactics of video recording Bolt, MetLife was under no obligation to

accept the veracity of Dr. Linden’s report, especially in light of the video

surveillance and the assessments of Dr. Rosenberg, Dr. Yanik, Dr. Edwards, and

Bolt’s own physician, Dr. Gaitan. See Black & Decker Disability Plan v. Nord,

528 U.S. 822, 834 (2003) (“[C]ourts have no warrant to require administrators

automatically to accord special weight to the opinions of a claimant’s physician.”). 

In short, MetLife did not abuse its discretion by failing to confer with Dr. Linden

before terminating Plaintiff’s benefits.

Bolt also complains that MetLife’s May 15, 2008 initial letter

terminating Bolt’s benefits was based solely on the video and that MetLife abused

its discretion by never explicitly stating “why the reviewer determined that the

video was entitled to greater weight than the statements of Bolt or the reports of his

treating cardiologist.” (Mot. at 7.) Bolt, however, provides no support for the

proposition that a plan administrator must explain why it discredited the evidence

provided by Bolt or Dr. Linden. In fact, relevant case law makes clear that

MetLife has no special duty to so explain. See Black & Decker, 528 U.S. at 834

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 33 of 40
34

(holding that courts may not “impose on plan administrators a discrete burden of

explanation when they credit reliable evidence that conflicts with a treating

physician’s evaluation”). Moreover, the evidence and chronology make clear why

MetLife favored the video evidence over the evidence submitted by Bolt or Dr.

Linden. After obtaining the surveillance video which showed Bolt working on his

motorcycle, going grocery shopping, and taking a seven-and-a-half hour

motorcycle ride, MetLife reached out to Bolt to ask for another APS and PPE. 

Bolt, as discussed, grossly misrepresented the impact of his conditions on his every

day life, severely undercutting his credibility. (See AR at MetBCF000389–94.) 

Similarly, Dr. Linden’s report flatly stated that Bolt could at most only sit for two

hours intermittently during the day and could not stand or walk more than

intermittently. (Id. at MetBCF000414.) Moreover, Dr. Linden stated that Bolt was

unable to twist, bend or stoop due to “shortness of breath, fatigue, chronic sever

pain, [and] lack of stamina.” (Id.) Plainly Dr. Linden’s report and Bolt’s selfreporting were clearly inaccurate in light of the video surveillance. MetLife was

well within its rights to determine Bolt’s evidence was not probative of Bolt’s

actual condition.

In any event, MetLife did not simply rely upon the video surveillance

in reaching its conclusion. With respect to Bolt’s cardiac condition, MetLife relied

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 34 of 40
11 MetLife was certainly under no obligation to show Bolt the video first and

then ask for comment.

35

primarily on Dr. Rosenberg’s report which, as discussed, cited a variety of reasons

for concluding Bolt was capable of sedentary work. (Id. at MetBCF000332–33.) 

With respect to Bolt’s ophthalmic condition, MetLife relied upon the opinions of

Dr. Yanik, Dr. Edwards, and Bolt’s own physician, Dr. Gaitan to determine Bolt

was capable of light or sedentary work. (Id. at MetBCF000271–73;

MetBCF000340.)

Plaintiff complains that MetLife did not “[d]iscuss with Bolt the video

surveillance or termination of benefits.” (Reply at 2.) This assertion, however, is

belied by the record. As discussed, Bolt requested an updated PPE from Bolt after

the video surveillance in which Bolt could have explained his trip.11 Moreover, as

Bolt recognizes in his briefing, during his appeal he submitted an affidavit

explaining “in great detail all of his activities on the video surveillance.” (Mot. at

8.) Instead, it seems Bolt’s real complaint here is not that MetLife did not provide

Bolt the opportunity to explain himself, but that MetLife did not afford Bolt’s

explanation sufficient weight. (See id. at 10.) The Court, however, cannot

conclude MetLife abused its discretion in giving little weight to Bolt’s self-serving 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 35 of 40
36

affidavit, especially in light of his misrepresentations on the PPE he filled out

immediately after MetLife obtained the video surveillance.

In sum, Bolt’s arguments are without merit.

IV. ERISA Factors

As noted, a “court must consider numerous case-specific factors,

including the administrator’s conflict of interest, and reach a decision as to whether

discretion has been abused by weighing and balancing those factors together.” 

Montour, 588 F.3d at 630 (citing Glenn, 128 S. Ct. at 116–19). Factors that

frequently arise in the ERISA context include whether the fiduciary failed to

investigate a claim adequately or ask the plaintiff for necessary evidence, whether

the fiduciary failed to credit a claimant’s reliable evidence, and whether the

fiduciary’s decision is against the weight of evidence in the record. Abatie, 458

F.3d at 972. Other factors courts have found relevant include whether the

administrator acknowledged or distinguished a contrary disability determination by

the SSA, Glenn, 554 U.S. at 118, whether the administrator presented outside

medical reviewers with all the relevant evidence, id., and whether the administrator

conducted an in-person medical evaluation or relied instead on a paper review, 

Montour, 588 F.3d at 630.

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 36 of 40
37

The Court finds that these factors weigh in favor of concluding that

MetLife did not abuse its discretion. The Court has already addressed the first two

factors. With respect to the first, the impact of the structural conflict of interest, 

the Court concludes for the reasons discussed supra that it should be afforded little

weight. With respect to the second factor, whether MetLife sufficiently

investigated the claim, the Court concludes that, as outlined above, MetLife’s

investigation was sufficient. 

The third factor, whether MetLife asked the plaintiff for necessary

evidence, also weighs in favor of finding MetLife did not abuse its discretion. 

During Bolt’s first appeal, Dr. Yanik explained that the ophthalmological record

was incomplete because it included information that was five years old. Dr. Yanik

nonetheless concluded Bolt was capable of working. MetLife, rather than just

terminating the benefits, provided Bolt with another opportunity to appeal and

invited Bolt to submit as much up-to-date evidence as he saw fit. MetLife then

reviewed that evidence before reaffirming its earlier decision.

The Court finds the next factor, whether MetLife failed to give due

consideration to credible evidence, also weighs in favor of finding MetLife did not

abuse its discretion. Bolt did not provide MetLife with any evidence it had to find 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 37 of 40
38

credible. As outlined, Dr. Linden’s APS reports were dramatically out of step with

the video surveillance as well as the other doctors’ assessments. Moreover,

MetLife permissively found that Bolt had little credibility in light of the

misrepresentations on his PPE which he provided immediately after the video 

surveillance. In sum, Bolt provided little credible evidence to which MetLife

should have given weight

The next factor, whether the administrator acknowledged or

distinguished a contrary disability determination by the SSA, does not weigh in

favor of finding an abuse of discretion. While it is true that Bolt has qualified for

benefits under the SSA, as MetLife points out in its briefing, the SSA made this

determination before MetLife undertook its investigation into Bolt. Accordingly,

the SSA may very well have based its decision on Dr. Linden’s APS reports as

well as Bolt’s PPEs without the benefit of the video surveillance and subsequent

investigation.

Whether the administrator presented outside medical reviewers with

all the relevant evidence also weighs in favor of finding that MetLife did not abuse

its discretion. MetLife provided the entire file to each of its board-certified 

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 38 of 40
39

doctors. When one, Dr. Yanik, protested that some of the information was

outdated, MetLife reached out to Bolt to provide up-to-date information. This

factor weighs in favor of finding that MetLife did not abuse its discretion.

The final factor, whether MetLife conducted a paper only review, is

the only factor which can be said to weigh in Bolt’s favor. The Court, however, 

cannot conclude, looking at all the evidence before it and weighing all the

appropriate factors, that MetLife abused its discretion based on this factor alone.

V. Attorney’s Fees

In his Motion, Bolt also requested an award of attorney’s fees. (Mot.

at 13–14.) The Court finds that this request was premature as the Court had not yet

reached a decision on Bolt’s Motion for Summary Judgment when it was filed. 

Accordingly, the Court DENIES WITHOUT PREJUDICE, Bolt’s request for an

award of attorney’s fees. Bolt is invited to refile his request, if he so chooses, in

light of the Court’s decision to deny his Motion for Summary Judgment.

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 39 of 40
40

CONCLUSION

For the foregoing reasons, the Court DENIES Plaintiff Timothy

Bolt’s Motion for Summary Judgment (Doc. # 41). The Court also DENIES

WITHOUT PREJUDICE Plaintiff’s Request for an Award of Attorney Fees.

IT IS SO ORDERED.

DATED: Honolulu, Hawaii, September 9, 2011.

_____________________________

DAVID ALAN EZRA

UNITED STATES DISTRICT JUDGE

Bolt v. Honeywell International, Inc., et al., CV. NO. 10-00071 DAE-RLP;

ORDER: (1) DENYING PLAINTIFF TIMOTHY BOLT’S MOTION FOR

SUMMARY JUDGMENT AND (2) DENYING WITHOUT PREJUDICE

PLAINTIFF TIMOTHY BOLT’S REQUEST FOR AN AWARD OF ATTORNEY

FEES

Case 2:10-cv-00071-DAE Document 55 Filed 09/12/11 Page 40 of 40