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Erin Rose Ronstadt, SBN 028362

Kevin Koelbel, SBN 016599

OBER & PEKAS, PLLC

3030 North 3rd Street, Suite 1230

Phone: (602) 277-1745

Fax: (602) 761-4443

erin@oberpekas.com kevin@oberpekas.com 

Attorneys for Plaintiff

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA

Christopher Winterberg, a single man,

Plaintiff,

v.

Metropolitan Life Insurance Company, an 

ERISA plan fiduciary,

Defendant.

No.

COMPLAINT

For his claims against Defendant Metropolitan Life Insurance Company (“MetLife”

or “Defendant”), Plaintiff Christopher Winterberg (“Mr. Winterberg” or “Plaintiff”) alleges 

as follows:

JURISDICTION, VENUE AND PARTIES

1. This action arises under the Employee Retirement Income Security Act of 

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

2. Mr. Winterberg’s employer provided long-term disability (“LTD”) benefits to 

its employees under an ERISA benefit plan (the “Plan”).

3. Mr. Winterberg was and continues to be a participant and beneficiary of the 

Plan. 

4. Mr. Winterberg is a single person and continues to be a resident of Maricopa 

County, Arizona since becoming a participant and beneficiary of the Plan.

5. At all times that Mr. Winterberg has been eligible for LTD benefits under the 

Plan, MetLife administered claims under the Plan, acted on behalf of the Plan, and acted as 

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an agent of the Plan administrator.

6. MetLife fully insured LTD benefits under the Plan with a Policy, Group 

Policy Number 90280-G.

7. MetLife is either a “named fiduciary” of the Plan, pursuant to 29 U.S.C. § 

1133(2); a “deemed fiduciary” pursuant to 29 U.S.C. § 1002 (21)(A); or a “designated 

fiduciary,” pursuant to 29 U.S.C. § 1105(c)(1)(B).

8. MetLife administered the Plan and made final decisions regarding the 

payment of disability benefits under the Plan

9. MetLife had actual or apparent authority to act as a fiduciary on behalf of the 

Plan. 

10. This Court has jurisdiction over the subject matter of this action under 

ERISA, 29 U.S.C. §§ 1132(a), 1132(e)(1), and 28 U.S.C. §§ 2201-02 (declaratory judgments). 

11. Venue is proper in this Court under ERISA, 29 U.S.C. § 1132(e)(1) and 28 

U.S.C. § 1391(b).

GENERAL ALLEGATIONS

12. Mr. Winterberg was and continues to be eligible for LTD coverage as of 

2004. 

13. Mr. Winterberg worked as an Operations Store Manager, which is considered 

a light-duty job, until his last day of work on December 11, 2007.

14. Mr. Winterberg stopped working on December 11, 2007 due to disabling 

conditions.

15. He qualified for and received short-term disability (“STD”) benefits through 

a salary continuance program. Thereafter, after meeting a concurrent elimination period, 

MetLife awarded LTD benefits effective March 11, 2008. 

16. After paying Mr. Winterberg’s claim for nearly a decade, MetLife terminated 

benefits without demonstrating significant changed circumstances in Mr. Winterberg’s

medical conditions and by ignoring his entire clinical picture.

17. Since March 11, 2010, MetLife applied the “any gainful work or service” 

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definition of Disability, i.e., Mr. Winterberg must “be unable to perform each of the material 

duties of any gainful work or service for which [he is] reasonably qualified taking into 

consideration [his] training, education, experience and past earnings;” or “while unable to 

perform all of the material duties of [his] regular job on a full-time basis, [be able to 

perform] at least one of the material duties of [his] regular job or any other gainful work or 

service on a part-time or full-time basis; and [earn] currently at least 20% less per month 

than [his] Indexed Basic Monthly Earnings due to that same Injury or Sickness” (the 

“gainful wage requirement”).

18. “Indexed Basic Monthly Earnings” are the “Basic Monthly Earnings” in 

effect on the date Disability began, increased by 7% annually for cost of living adjustments 

(“COLA”). 

19. Put more plainly, in order for MetLife to find Mr. Winterberg ineligible for 

benefits, Mr. Winterberg must either: 1) be able to perform his regular light duty 

occupation; or else 2) return to work in any occupation where he can earn 80% of his 

Indexed Basic Monthly Earnings.

20. At various times throughout the claim, MetLife found Mr. Winterberg 

Disabled from any gainful occupation based on an inability to meet the gainful wage 

requirement.

21. In 2010, MetLife determined that Mr. Winterberg could not perform his 

regular occupation, because he could not perform light duty work.

22. Thus, on or about February 10, 2010, MetLife requested that MetLife’s 

vendor, “CorVel,” conduct a labor market survey (“LMS”) on a “rush basis” to determine 

whether any “gainful work or service” existed. 

23. Mr. Winterberg is informed and believes that CorVel provided the LMS to 

MetLife on or about March 1, 2010.

24. MetLife determined that no “gainful work or service” existed that would

provide Mr. Winterberg 80% of his Indexed Basic Monthly Earnings. 

25. To date and despite multiple requests, MetLife has not produced the LMS to 

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Mr. Winterberg. 

26. Contemporaneous claim file notes reveal some information about the LMS. 

The LMS involved contacting at least 12 employers, none of whom stated they employ 

people in the identified positions at the required gainful wage.

27. MetLife identified four occupations within Mr. Winterberg’s skills and 

physical capacity, but MetLife concluded“[a]lthough the occupations are within the skills 

and physical capacity of Mr. Winterberg, he is unable to earn a gainful wage based on

[Department of Labor] wage information and a labor market survey. Therefore Mr. 

Winterberg is unable to [return to work] at gainful wage in any occupation.”

(emphasis added). 

28. Accordingly, in March 2010, MetLife approved Mr. Winterberg’s LTD 

benefits under the “any gainful work or service” definition of Disability.

29. At that time, MetLife knew Mr. Winterberg’s inability to earn a gainful wage 

meant that he would qualify for LTD benefits potentially over the life of the claim, or until 

June 2036. 

30. Unless Mr. Winterberg returned to work, or MetLife found another way to 

deny the claim, MetLife understood that it would be facing ongoing liability. 

31. On March 1, 2010, MetLife simultaneously approved the claim for ongoing 

benefits and initiated return to work efforts. 

32. Notably, the Plan does not feature a work incentive program, a rehabilitation 

incentive after the first 24 months on claim, or any type of mandatory vocational 

rehabilitation requirement.

33. Mr. Winterberg completed all required forms about his daily activities and 

abilities as requested.

34. MetLife conducted surveillance on June 8, 9, and 10, 2010. 

35. MetLife determined that the activities observed in the June 2010 surveillance 

did not support the ability to work 8 hours a day in light-duty work capacity.

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36. All of the surveillance MetLife has conducted on this claim consistently 

demonstrated Mr. Winterberg has truthfully and consistently reported his abilities and that 

he is disabled as defined by the Plan. 

37. On October 7, 2010, MetLife concluded benefits should be [paid through] 

“6/9/2036 since [Mr. Winterberg] will continue to have these [medical] issues and there is 

not sedentary work at gainful wage for [him].”

38. MetLife acknowledged in an October 15, 2010 internal note on the claim: 

“Based on [the gainful wage] information and reviewing the file wholistically[sic] nothing 

will change unless [Mr. Winterberg] determines he wants retraining . . . Therefore; [plan of 

action] is to [send to the Special Handling Unit (“SHU”)]. If [Mr. Winterberg] at some point 

determines he wants retraining or will have surgery, [then] file to be referred back to the 

claims team.” 

39. MetLife later explained, “[t]he SHU is designed to maintain long term 

disability claims when there is no question as to the permanent nature of the disability, or a 

return to gainful employment is highly unlikely.”

40. For several years, MetLife’s SHU administered Mr. Winterberg’s claim, 

including monitoring for medical developments, activities of daily living, and the status of 

Mr. Winterberg’s pending Social Security claim. 

41. SHU continued to find that Mr. Winterberg was eligible for LTD benefits due 

to the gainful wage requirement and his worsening medical conditions. For example, on 

March 1, 2013 the SHU claim manager noted, “[attending physician] indicates [Mr. 

Winterberg] may do sedentary jobs. However [vocational department] was unable to find 

sedentaty [sic] jobs and wages that were with[in] the defention [sic] of wages.” 

42. Mr. Winterberg is informed and believes that MetLife hired SALT Associates, 

LLC, a consulting firm based in Portland, Maine, to provide risk management services with 

respect to its SHU claims. 

43. Mr. Winterberg is informed and believes that MetLife sets “tasks” and 

“alerts” on claims, which prompt MetLife to review SHU claims. 

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44. Mr. Winterberg is informed and believes that MetLife only authorizes benefit 

payments for limited time periods, even on claims where MetLife has previously accepted 

financial liability that exceeds the limited authority it provides for issuing payments. 

45. Mr. Winterberg is informed and believes that when a claim reaches the end of 

its allotted payment approval authority, MetLife places an alert on the claim for “USER 

EXCEEDED AUTHORITY,” which prompts MetLife to again “review [the] claim –

decision and Benefit [payment].” 

46. Mr. Winterberg is informed and believes that MetLife authorizes benefit 

payments in a way that allows it to report more favorable financial outcomes for the 

company, and which serves as an opportunity for MetLife to look for reasons to reduce or 

terminate otherwise valid claims.

47. On November 12, 2013, MetLife’s system generated a “USER EXCEEDED 

AUTHORITY” alert on Mr. Winterberg’s claim. 

48. Mr. Winterberg is informed and believes that, as a result of the “USER 

EXCEEDED AUTHORITY” alert, April Cloutier, a claims manager with SALT 

Associates, LLC, reviewed Mr. Winterberg’s claim with the goal of generating a “risk 

management” outcome for MetLife. 

49. Ms. Cloutier approached Mr. Winterberg’s claim from a skeptical, adversarial 

perspective. For example, even though MetLife had known for years that Mr. Winterberg 

could perform sedentary work from a physical standpoint (but could not find a job that 

satisfies the wage requirement of the Plan), Ms. Cloutier used Mr. Winterberg’s sedentary 

capacity to justify Internet research on Mr. Winterberg. 

50. Ms. Cloutier learned that Mr. Winterberg had authored a book for sale on 

Amazon and erroneously assumed Mr. Winterberg might be deriving income significant 

enough to create an offset against LTD benefits for MetLife. 

51. Ms. Cloutier interviewed Mr. Winterberg, but instead of asking about income 

from the book, she hid the ball and tried to trap him to make him look dishonest. Had she 

been forthright, she would have learned that Mr. Winterberg actually lost money on the 

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book. And, in fact, his writing was not a secret; he had repeatedly disclosed writing as a 

hobby on his activities of daily living forms. 

52. Ms. Cloutier lamented the “plan doesn’t have mandatory [rehabilitation] and 

no gainful occs were available.” 

53. After Ms. Cloutier’s review, and after offset issues were further resolved, 

MetLife transferred Mr. Winterberg’s claim back to the claims department and out of the 

SHU. 

54. MetLife went on what is best described as a “smear campaign” against Mr. 

Winterberg, which led to its November 8, 2016 adverse benefit determination (the 

“Denial”).

55. MetLife took a considerable amount of time collecting medical records and 

forms from Mr. Winterberg and his treating providers. 

56. In September 2015, MetLife employed Ethos Risk Services (“Ethos”) to 

conduct an investigation. 

57. Ethos surveilled Mr. Winterberg on December 31, 2015, January 1, 2016, and 

January 2, 2016, but only recorded 45 seconds of video footage on December 31, 2015. 

58. The majority of the surveillance report is based on the biased perceptions of 

the Ethos agent. 

59. Despite Ethos efforts, the surveillance did not reveal any evidence warranting 

a termination of benefits. MetLife continued to pay benefits.

60. Nine months later, determined to find a basis to terminate beneifts, MetLife 

ordered more investigation and surveillance.

61. Ethos conducted an additional Internet Data Investigation Report on 

September 22, 2016 and surveillance on September 13, 2016, September 14, 2016, and 

September 19, 2016 under MetLif’es explicit instruction to “attempt to get images of [Mr. 

Winterberg’s] workout activities,” which Mr. Winterberg reported on his ADL forms.

62. At MetLife’s direction, Ethos invaded Mr. Winterberg’s privacy, trespassed

on private property, and secured some of the requested images.

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63. Ethos obtained approximately 42 minutes of film from the video surveillance. 

And, the surveillance bolsters Mr. Winterberg’s credibility because it is entirely consistent 

with past surveillance, as well as his reported functionality and ADLs.

64. MetLife’s surveillance revealed nothing new. MetLife was well aware of Mr. 

Winterberg’s activities of daily living from the beginning of the claim, yet it used these 

against him in an effort to terminate his benefits. 

65. MetLife cannot penalize Mr. Winterberg for trying to maintain some 

semblance of a normal life. In fact, “several courts . . . have recognized that disability 

claimants should not be penalized for attempting to lead normal lives in the face of their 

limitations.” Reddick v. Chater, 157 F.3d 715, 722 (9th Cir. 1998). The surveillance 

demonstrates that Mr. Winterberg has consistently and accurately reported his capabilities to 

MetLife during the claim.

66. To shore up the Denial, MetLife forwarded Mr. Winterberg’s file to its inhouse medical director, Dr. Tracy C. Barber, on October 5, 2016.

67. Because Dr. Barber is MetLife’s medical director, his review of the file is far 

from “independent” and should be disregarded.

68. Dr. Barber misrepresented the evidence and faulted Mr. Winterberg for issues

he had with health insurance. 

69. Ultimately, MetLife largely based the Denial on Dr. Barber’s medical file 

review.

70. In denying benefits, MetLife did not identify any jobs that meet the gainful 

wage requirement. 

71. MetLife’s rationale for finding that Mr. Winterberg’s medical conditions “[do] 

not support a disability or functional impairment that would preclude [him] from 

performing any occupation which includes [his] former job as an Operations Store 

Manager” is unfounded. 

72. Given that the medical evidence has not changed, termination of benefits is 

both illogical and in direct conflict with MetLife’s prior findings.

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73. MetLife determined for the better part of a decade that Mr. Winterberg could 

not perform light duty work.

74. MetLife has known this for years, which is why they continued to approve 

the claim, and they intentionally misrepresented the Plan language in its efforts to support 

the Denial.

75. On August 14, 2017, with the assistance of counsel, Mr. Winterberg timely 

appealed MetLife’s Denial (the “Appeal”) and supplied MetLife with updated medical 

evidence, declarations, and an updated LMS to support his continued disability. 

76. With his appeal, Mr. Winterberg also submitted a report from Mark Kelman, 

MS. CRC, CVE, who conducted a vocational analysis on June 9, 2017, which included an 

in-person interview of Mr. Winterberg, a review of MetLife’s claim file, a wage analysis 

using Phoenix 2015 Occupational Employment and Wage Hourly Estimate Survey, and a 

labor market survey. 

77. Mr. Kelman concluded that Mr. Winterberg can neither perform the material 

duties of his regular job nor perform any other gainful work or service that meets the wage 

requirement of the Plan.

78. Under ERISA, 29 C.F.R. § 2560.503-1(i)(3)(i) and (i)(4), absent “special 

circumstance,” MetLife had forty-five days from the date Mr. Winterberg filed his Appeal to 

make a decision on the appeal. 

79. MetLife did not notify Mr. Winterberg of any “special circumstance,” 

therefore, MetLife was required to make a decision on Mr. Winterberg’s Appeal no later 

than Friday, September 29, 2017. See 29 C.F.R. § 2560.503-1(i)(4).

80. Even though the deadline to do so has passed, MetLife has not yet rendered a 

decision on the Appeal. 

81. Mr. Winterberg is therefore deemed to have exhausted his administrative 

remedies and may file suit. Id. 

82. Mr. Winterberg’s claim for benefits under ERISA, 29 U.S.C. § 1132(a)(1) is 

therefore ripe. 

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COUNT I

(Recovery of Plan Benefits)

83. All previous and subsequent paragraphs are incorporated by reference.

84. The Plan represents LTD coverage and a promise to provide LTD benefits 

until Mr. Winterberg is no longer disabled under the terms of the Plan.

85. Mr. Winterberg became disabled in 2007 and eligible for LTD benefits in 

2008. 

86. He continues to be disabled under the terms of the Plan. 

87. Mr. Winterberg reasonably expected that his conditions met the requirements 

of Disability as defined by the Plan for LTD benefits, and that he would receive benefits 

under the Plan until age 65 or until he was no longer disabled.

88. Despite the coverage of Mr. Winterberg’s disability, MetLife has improperly 

terminated LTD benefits to Mr. Winterberg in breach of the Plan and ERISA. 

89. MetLife acted under a structural conflict of interest in both administering and 

paying out on claims under the Plan. 

90. Mr. Winterberg is entitled to de novo review of his claims, because given 

MetLife’s structural conflict of interest and its “wholesale and flagrant violations of the 

procedural requirements of ERISA,” de novo review is warranted. MetLife should not be 

entitled to any deference in its decision-making in light of the facts and circumstances of 

this claim. 

91. MetLife’s collective conduct was arbitrary, capricious, an abuse of discretion, 

not supported by substantial evidence, and was clearly erroneous.

92. Mr. Winterberg was, and remains, disabled under the Plan. 

93. Because MetLife failed to make a decision on Mr. Winterberg’s LTD appeal 

within the deadlines prescribed by ERISA, Mr. Winterberg is entitled to de novo review of his 

LTD claim. Jebian v. Hewlett-Packard Co. Employee Benefits Organization Income Protection Plan, 

349 F.3d 1098, 1103 (9th Cir. 2003); Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 971 

(9th Cir. 2006); accord Halo v. Yale Health Plan, Dir. of Benefits & Records Yale Univ., 819 F.3d 

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42, 57–58 (2d Cir. 2016); but see Wilson v. Aetna Life Ins. Co., No. 815CV752MADCFH, 2016 

WL 5717370, at *9 (N.D.N.Y. Sept. 30, 2016) (“Having opted to forego taking advantage of 

this provision by bringing her claim prior to receiving the adverse decision, Plaintiff cannot 

now argue that Aetna is stripped of its deferential review simply because she does not agree 

with the decision it rendered.”).

94. Under the de novo standard of review, and even under the abuse of discretion 

standard of review, the decision terminating Mr. Winterberg’s LTD benefits and the failure 

to timely reinstate his benefits is incorrect, contrary to the Plan terms, contrary to the 

overwhelming medical evidence, is arbitrary and capricious, is the product of MetLife’s

numerous procedural irregularities, is the product of MetLife’s and its in-house and/or 

consulting physicians or other personnel’s financial conflicts of interest, and should be 

reversed.

95. MetLife and its consulting physicians or other personnel’s financial conflicts 

of interest infected the claims process and precluded the full and fair review of Mr. 

Winterberg’s claim required by ERISA, 29 U.S.C. 1133(2) and 29 C.F.R. § 2560.503-1(g)(1) 

and (h)(2). Demer v. IBM Corp. LTD Plan, 835 F.3d 893, 901 (9th Cir. 2016); Hangarter v. 

Provident Life & Acc. Ins. Co., 373 F.3d 998, 1010 (9th Cir. 2004). 

96. Under ERISA, if the de novo standard of review does not apply, Mr. 

Winterberg is entitled to discovery to show the extent to which the financial conflicts of 

interest infected the claim process. Id. And, Mr. Winterberg is entitled to a bench trial 

regarding the effects of the inherent financial conflicts of interest on the decision to 

terminate his benefits and the failure to timely reinstate his benefits and/or on the 

credibility of MetLife’s medical and other reviews. Nolan v. Heald College, 551 F.3d 1148 (9th

Cir. 2009); Opeta v. Nw. Airlines Pension Plan for Contract Employees, 484 F.3d 1211, 1217 (9th 

Cir. 2007). 

97. Mr. Winterberg has been injured and suffered damages in the form of lost 

LTD benefits as a result of MetLife’s wrongful decision to deny his disability benefits.

98. Driven by its own financial interests and bias against Mr. Winterberg, 

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including the actions of SALT, MetLife became determined to deny Mr. Winterberg’s claim

after paying the claim for nearly a decade. 

99. MetLife “hid the ball” from Mr. Winterberg by failing to advise him of what 

was needed to prove his LTD claim. 

100. MetLife wrongfully terminated Mr. Winterberg’s disability benefits without 

providing a coherent explanation for its denial, and in a way that conflicts with the plain 

language of the Plan, violating 29 U.S.C. §§ 1109, 1132.

101. Despite multiple requests during the appeal process, MetLife continually 

failed to disclose all of Mr. Winterberg’s relevant documentation, including information that 

was relied upon in support of the Denial. 

102. MetLife’s disclosures have been both untimely and deficient under ERISA, 

requiring significant attorney time to doggedly pursue disclosures and causing undue delay 

and financial harm to Mr. Winterberg.

103. Mr. Winterberg is informed and believes that MetLife has intentionally 

removed documents from the claim file that would otherwise explain MetLife’s 

interpretation of the Plan and further reveal its reasons for continuing Mr. Winterberg’s 

benefits until recently. 

104. Besides the LMS report and other documents containing valuable analysis of 

the Plan as it pertains to this claim, Mr. Winterberg is informed and believes that various 

telephone conversations were either never properly documented or removed from the 

internal notes. 

105. MetLife’s conduct has prejudiced Mr. Winterberg in his ability to expediently 

appeal and perfect his claim, contravening the very purpose of ERISA.

106. MetLife did not properly consider all of the available evidence when 

terminating Mr. Winterberg’s benefits. For example, it did not consider major surgeries and 

conditions. In doing so, MetLife failed to conduct a full and fair review. 

107. MetLife blatantly misstated medical evidence and misrepresented diagnostic 

testing for its own financial benefit. 

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108. MetLife excessively relied on the flawed medical reviews and surveillance that 

actually supported continuation of benefits and ignored substantial evidence to support Mr. 

Winterberg’s disability.

109. MetLife emphasized reports that favored a denial of benefits while 

deemphasizing other reports that suggested a contrary conclusion.

110. Despite ample opportunity to conduct an in-person independent medical 

evaluation (“IME”) before terminating benefits, which would have been consistent with a 

full and fair review of Mr. Winterberg’s claim, MetLife failed to conduct an IME and 

instead relied on unreliable evidence to terminate Mr. Winterberg’s LTD benefits. 

111. Only after Mr. Winterberg submitted his appeal, did MetLife ask for an IME, 

at which time it was improper and unreasonable. Gathering new evidence after a claimant 

has appealed violates ERISA.

112. MetLife failed to reasonably consider Mr. Winterberg’s reported symptoms 

and limitations and gainful wage in determining whether he was disabled under the Plan. 

113. MetLife selectively reviewed Mr. Winterberg’s medical records, relying only 

on those portions of his medical records that supported a denial of benefits.

114. That Mr. Winterberg’s conditions have not changed or improved since 

MetLife initially approved benefits under the “any gainful work or services” definition is 

confirmed by the medical evidence and MetLife’s internal notes. 

115. The collective medical evidence demonstrates Mr. Winterberg’s degenerative 

conditions changed for the worse.

116. Having previously found Mr. Winterberg entitled to benefits, the burden is 

on MetLife to justify a denial of benefits.

117. Federal courts look skeptically at an administrator’s decision to terminate 

benefits where the evidence fails to show significant improvement in the claimant’s 

condition following the administrator’s initial approval.

118. Because Mr. Winterberg was previously found disabled under the “any gainful 

work or service” definition of Disability, to terminate benefits MetLife must demonstrate 

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& PEKAS, PLLC

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Phoenix, AZ 85012

(602) 277-1745

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that his medical condition changed substantially.

119. MetLife has made no attempt to show medical improvement that would 

enable Mr. Winterberg to return to work. This is because Mr. Winterberg has not shown 

any medical improvement.

120. MetLife improperly demanded objective medical evidence of Mr. 

Winterberg’s fatigue and thereby engrafted terms onto the Plan in violation of ERISA.

121. On information and belief, the file reviewers, IPCs, claims managers, 

consultants such as SALT, and vendors used to administer Mr. Winterberg’s claim were 

financially incentivized to deny claims, including Mr. Winterberg’s claim.

122. MetLife used in-house file reviewers, because it knew that the reviews would 

be unfavorable for the continuation of his benefits. 

123. MetLife unreasonably failed to ensure that its in-house file reviewers provided 

unbiased opinions for purposes of its claims administration. 

124. MetLife unreasonably failed to ensure that it maintained claim files that were 

critical to Mr. Winterberg’s claim, and which supported Mr. Winterberg’s claim. This 

includes the original LMS and a report prepared by MetLife’s Medical Director Consultant, 

Dr. Joseph Monkofsky, which supports Mr. Winterberg’s claim. 

125. On information and belief, MetLife has retained its vendors on numerous 

occasions to conduct claims reviews or other evaluations and has a history of bias against 

claimants.

126. MetLife’s review of the file was arbitrary, contrary to the record, and 

unsupported by the medical evidence.

127. Mr. Winterberg continues to meet the definition of disability under the Plan.

128. According to MetLife’s calculation, the maximum duration of Mr. 

Winterberg’s LTD benefits is until June 9, 2036, and he is entitled to benefits through that 

date. 

129. Mr. Winterberg has exhausted his administrative remedies.

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& PEKAS, PLLC

3030 North 3rd Street, Suite 1230

Phoenix, AZ 85012

(602) 277-1745

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130. Pursuant to the coverage provided in the Plan, to ERISA 29 U.S.C. § 

1132(a)(1)(B), and to applicable federal and state common law, Mr. Winterberg is entitled to 

recover all benefits due under the terms of the Plan, and to enforce his rights under the 

Plan. 

131. Mr. Winterberg is entitled to reinstatement of any other employee benefits 

that were terminated, discontinued, or suspended as a result of the termination of his

disability benefits. He is entitled to a restoration of the status quo ante before LTD benefits 

were wrongfully terminated. 

132. Pursuant to 29 U.S.C. § 1132(g), Mr. Winterberg is entitled to recover his 

attorneys’ fees and costs incurred herein from MetLife and the Plan.

133. Mr. Winterberg is entitled to prejudgment interest on the benefits to which he 

is entitled and on his damages at the highest legal rate until paid.

WHEREFORE, on all claims, Mr. Winterberg prays for entry of judgment against

Defendants as set forth in this Complaint, which includes:

A. All past due LTD benefits under the terms of the Plan;

B. Clarifying and determining Mr. Winterberg’s rights to future benefits under 

the terms of the Plan;

C. An award of Mr. Winterberg’s attorneys’ fees and costs incurred herein;

D. An award of prejudgment interest on benefits and damages at the highest 

legal rate until paid; and

E. For such and further relief as the Court deems just, equitable, and reasonable.

Dated this 25th day of October, 2017.

OBER & PEKAS, PLLC

By: s/ Erin Rose Ronstadt

Erin Rose Ronstadt

Kevin Koelbel

Attorneys for Plaintiff

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