Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-00839/USCOURTS-cand-3_04-cv-00839-7/pdf.json

Parties Involved:
Epicentric, Inc. Health & Welfare Plan
Defendant
Illiena Volynskaya
Plaintiff

Document Text:

United States District Court

For the Northern District of California

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United States District Court

For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

ILLIENA VOLYNSKAYA,

Plaintiff,

 v.

EPICENTRIC, INC. HEALTH & WELFARE

PLAN, an ERISA plan,

Defendant. /

No. C 04-0839 SI

ORDER GRANTING IN PART

PLAINTIFF’S MOTION TO ALTER

JUDGMENT AND GRANTING

PLAINTIFF’S MOTION FOR

ATTORNEYS’ FEES 

On February 15, 2008, the Court heard argument on plaintiff’s motion to alter or amend the

judgment, and plaintiff’s motion for attorneys’ fees and costs. For the reasons set forth below, the Court

hereby GRANTS in part plaintiff’s motion to alter or amend the judgment, and GRANTS plaintiff’s

motion for attorneys’ fees and costs.

DISCUSSION

I. Plaintiff’s motion to alter or amend judgment

In an order filed October 16, 2007, the Court granted summary judgment in favor of plaintiff,

and remanded this case to the plan administrator to determine plaintiff’s eligibility for disability benefits

after August 29, 2003. Plaintiff now moves to alter or amend this Court’s judgment and summary

judgment order so that defendant is required to pay plaintiff benefits from August 29, 2003 through the

date of judgment. Defendant opposes the motion, but also argues that if the Court is inclined to award

any retroactive benefits, those benefits should be awarded only until April 21, 2004, the date on which

the Plan’s definition of “disability” would have changed, and when plaintiff would have been required

Case 3:04-cv-00839-SI Document 70 Filed 02/20/08 Page 1 of 4
United States District Court

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to make a greater showing of disability.

Plaintiff cites numerous cases for the general proposition that “retroactive reinstatement of

benefits is appropriate where ‘but for the insurer’s arbitrary and capricious conduct, the insured would

have continued to receive the benefits’ or where ‘there [was] no evidence in the record to support a

termination or denial of benefits.’” Grosz-Salomon v. Paul Revere Life Ins. Co., 237 F.3d 1154, 1163

(9th Cir. 2001) (quoting Quinn v. Blue Cross & Blue Shield Ass’n, 161 F.3d 472, 477 (7th Cir. 1998)).

In Grosz-Salomon, the plaintiff received long-term disability benefits for four years until the plan

terminated her benefits based upon two in-house medical “consultations” performed by doctors who did

not examine the plaintiff. The district court granted summary judgment in favor of the plaintiff, and

reinstated the plaintiff’s benefits effective the date of termination.

The Ninth Circuit found that the district court did not abuse its discretion in fashioning the

remedy. Id. at 1163. “Paul Revere did not misconstrue the definition of ‘disabled,’ or apply the wrong

standard to evaluate Grosz-Salomon’s claim. It applied the right standard, but came to the wrong

conclusion.” Id. The Grosz-Salomon court noted that cases in which a plan “possessed with discretion

fails to make adequate findings or provide adequate reasoning should be remanded.” Id. at n.44 (citing

Quinn). 

In Quinn, which was cited favorably by the Grosz-Salomon court, a plaintiff was approved to

receive benefits for eight months under a long-term disability plan, and advised that at the end of the

eight month period, her benefits would be terminated but that she could submit additional medical

documentation in support of her claim. Quinn, 161 F.3d at 474. At the end of the eight month period,

the plan found that the plaintiff was not disabled. The district court granted summary judgment in favor

of Quinn, and ordered reinstatement of her benefits. The Seventh Circuit affirmed on the merits, but

reversed the district court’s reinstatement order. The court noted that Quinn was not scheduled to

continue receiving benefits after the eight month period, but rather that Quinn’s eligibility for benefits

was to be reevaluated at the end of that period. “[The plan’s] decision to deny Quinn’s claim was

arbitrary and capricious, but not necessarily wrong. . . . This is not a case where it is clear-cut that it was

unreasonable for Calhoon to deny Quinn’s benefits.” Id. at 478.

Here, but for defendant’s arbitrary and capricious decision to terminate plaintiff, she would have

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 The Court is sympathetic to plaintiff’s argument that the passage of time may make it difficult

for plaintiff to show that she met the Plan’s definition of “disability” during the 2004-2007 time period.

However, the Court notes that plaintiff’s medical documentation in 2003, and Dr. Targoff’s report dated

February 6, 2004, suggest that plaintiff did meet the more stringent definition. 

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 The Court overrules defendant’s objection to the Elkin declaration. The rates charged by

defense counsel in ERISA cases is relevant to, though not determinative of, the reasonableness of

plaintiff’s counsel’s hourly rate.

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received benefits until April 21, 2004, pursuant to the Plan’s 24-month limitation for mental/nervous

and neuromusculoskeletal disorders. At that time, plaintiff would have been reevaluated under a more

stringent definition of disability. On the record before the Court, it is not “clear-cut” that plaintiff would

be considered disabled under the post-24 month definition of disability.1

 None of the cases cited by

plaintiff, in which courts have awarded full reinstatement of benefits through the date of judgment,

address a situation like the instant case. Accordingly, the Court finds that it is appropriate to award

plaintiff benefits through April 21, 2004, and to remand to the Plan for a determination of plaintiff’s

eligibility for benefits after April 21, 2004, consistent with this Court’s summary judgment order.

II. Plaintiff’s motion for attorneys’ fees

Plaintiff seeks an award of $74,900 in fees and $810.27 in costs. In support of the request,

plaintiff’s attorney has submitted a declaration describing his experience, including his expertise in the

area of ERISA. See generally Fleishman Decl. Mr. Fleishman has also submitted his time records, as

well as several declarations and court orders in support of his hourly rate. See id. at Ex. 1-5.2

Defendant opposes the fee motion on several grounds. First, defendant contends that the motion

should be denied because plaintiff did not (and cannot) demonstrate her entitlement to fees under

Hummell v. S.E. Rykoff & Company, 634 F.2d 446 (9th Cir. 1980). However, as plaintiff correctly

notes, “where, as here, the fact that the plaintiff prevailed is evident from the order of the district court,

it is unnecessary for the court to engage in a discussion of the factors enumerated in Hummell.” GroszSalomon, 237 F.3d at 1164 (internal quotation and citation omitted); see also Canseco v. Construction

Laborers Pension Trust, 93 F.3d 600, 609 (9th Cir. 1996) (“Ordinarily, if a plan participant or

beneficiary prevails in an action to enforce his rights under the plan, recovery of attorney’s fees is

appropriate, absent special circumstances making an award unjust.”). 

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Defendant also objects that a fee and cost award of this magnitude is “contrary to the sound

public policies underlying ERISA to effectuate efficient administration of claims at minimal legal

expense.” Opposition at 2. While this is an important policy, it is equally if not more important to

encourage insurance companies to fulfill their fiduciary obligations to plan participants. 

Defendant also objects that the fees sought are not reasonable. The Court disagrees, and finds

that plaintiff’s counsel has provided ample support both for the reasonableness of his rate, as well as the

time spent on this protracted litigation, which proceeded through district court, to reversal after appeal

and back to trial court litigation and resolution. The Court notes that plaintiff’s counsel’s briefing and

oral advocacy have been consistently of high quality. Defendant’s contention that the Court should

exclude all work completed prior to the Ninth Circuit’s remand ignores the realities of litigation. See

Cabrales v. County of Los Angeles, 935 F.2d 1050, 1053 (9th Cir. 1991) (holding, in a civil rights case,

that “a plaintiff who is unsuccessful at a stage of litigation that was a necessary step to her ultimate

victory is entitled to attorney’s fees even for the unsuccessful stage”). 

CONCLUSION

For the foregoing reasons, the Court hereby GRANTS in part plaintiff’s motion to alter or amend

the judgment, and GRANTS plaintiff’s motion for attorneys’ fees of $74,900 and costs of $810.27.

(Docket Nos. 55 and 56).

IT IS SO ORDERED.

Dated: February 20, 2008 

SUSAN ILLSTON

United States District Judge

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