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Lisa Counters, 016436

4506 N 12th Street

Phoenix, AZ 85014-4246

Voice: (602) 266-2667

Fax: (602) 266-0141

Lisa@Schiffmanlaw.com

Attorney for Plaintiff

IN THE UNITED STATES DISTRICT COURT

IN AND FOR THE DISTRICT OF ARIZONA

Jim B. Schmedding,

Plaintiff,

vs.

Hartford Life and Accident Insurance 

Company; The Long-Term Disability Plan

of Medcath, Incorporated,

Defendants.

No. 

COMPLAINT

For his claim against Defendants, Jim B. Schmedding (“Schmedding”) alleges as 

follows:

JURISDICTION AND VENUE

1. Schmedding is a resident of Maricopa County, Arizona.

2. Defendant Hartford Life and Accident Insurance Company (“The Hartford”) is 

an insurance company incorporated in Delaware, with its principal place of business in

Hartford, Connecticut. The Hartford is authorized to do business in Maricopa County, 

Arizona.

3. Defendant Long-Term Disability Plan of Medcath, Incorporated is a purported 

ERISA benefit plan established and maintained by Medcath Incorporated (“MedCath”) for 

the benefit of its employees. The Plan includes long-term disability benefits (“LTD”). 

Medcath is the Plan Administrator.

Case 2:18-cv-00915-DWL Document 1 Filed 03/23/18 Page 1 of 5
SCHIFFMAN 

LAW 

OFFICE, P.C.

4506 N. 12 T H STREET

PHOENIX, AZ 85014 ♦ (602) 266-2667

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4. Medcath is a Plan Fiduciary as that term is defined by ERISA. 

5. This Court has jurisdiction over the Plan pursuant to ERISA 29 U.S.C. § 1132, 

and because the Plan and The Hartford have caused events to occur in Arizona out of which 

Schmedding’s claims arise.

6. This Court has jurisdiction over the subject matter of this action under ERISA, 

29 U.S.C. § 1132(a), (e), 28 U.S.C. § 1331 (federal question); and 28 U.S.C. § 2201-02 

(declaratory judgments). 

7. Defendants reside and are found within this District within the meaning of the 

jurisdiction and venue provisions of the Employee Retirement Income Security Act of 1974 

(“ERISA”), 29 U.S.C. § 1132 and 28 U.S.C. § 1391.

8. The Hartford pays for and administers the Plan’s LTD benefits.

9. The Hartford is the Claim Administrator and is a Plan Fiduciary as defined by 

ERISA for the Plan’s LTD benefits.

GENERAL ALLEGATIONS

10. The Hartford provided certain employees with LTD benefits pursuant to the 

Plan.

11. Under the terms of the LTD benefit, Schmedding is entitled to benefits for the 

first 24 months when The Hartford determines he is unable to perform one or more of the 

duties essential of his own occupation. 

12. After the first 24 months of disability, Schmedding is considered disabled if he

is unable to work in any reasonable occupation solely because of a disease or injury. The 

Plan defines reasonable occupation as any gainful activity for which Schmedding is qualified 

by education, training or experience. 

13. At all relevant times, Schmedding was a Medcath employee, became a 

covered individual under the Plan, and remained continuously employed until his disability 

rendered him unable to work in his regular occupation as an Surgical Technician on October 

23, 2009. 

Case 2:18-cv-00915-DWL Document 1 Filed 03/23/18 Page 2 of 5
SCHIFFMAN 

LAW 

OFFICE, P.C.

4506 N. 12 T H STREET

PHOENIX, AZ 85014 ♦ (602) 266-2667

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14. The material and substantial duties of Schmedding’s occupation or any 

occupation that he is unable to perform, include, but are not limited to:

• Ability to work a regular, 40-hour work week;

• Ability to work a full day due to joint and low back pain; 

• Ability to work due to difficulty standing and walking for more than an 

hour at a time;

• Ability to focus and concentrate due to chronic pain.

15. Schmedding sustained severe trauma in a car accident on October 23, 2009 

and as a result has experienced SI joint pain on the right side, neuropathy in both legs, and 

pain in his right shoulder.

16. Schmedding became disabled on October 23, 2009 and remains disabled from

his own occupation and from any occupation for which he is qualified based on education, 

training or experience and for which he could earn 60% of his pre-disability earnings. 

17. The Hartford initially denied Schmedding’s claim on October 7, 2016 . 

18. Schmedding is entitled to 60% of his Predisability Earnings from October 7, 

2016 through the present. 

19. Schmedding’s is entitled to a monthly LTD disability benefit in the amount of 

$824.72 from October 7, 2016 to the present. 

20. Schmedding provided proof of his debilitating medical conditions. In 

addition, Schmedding provided The Hartford with completed attending physician statements 

and extensive medical records that support his disability. 

21. Schmedding submitted his appeal on July 25, 2017 .

22. The Hartford issued a final denial on September 7, 2017 

23. Schmedding has satisfied the jurisdictional prerequisites to filing a claim in 

federal court.

Case 2:18-cv-00915-DWL Document 1 Filed 03/23/18 Page 3 of 5
SCHIFFMAN 

LAW 

OFFICE, P.C.

4506 N. 12 T H STREET

PHOENIX, AZ 85014 ♦ (602) 266-2667

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COUNT I

RECOVERY OF INSURANCE AND PLAN BENEFITS

24. Schmedding incorporates and realleges all previous allegations. 

25. The Plan contains some language purporting to grant Schmedding discretion 

and to give Schmedding the ability to delegate discretion to others; however, on information 

and belief, the purported delegation is invalid and Schmedding is entitled to de novo review.

26. Schmedding became disabled on October 23, 2009 and remains unable to 

perform the duties of any other occupation for which he is qualified based on education, 

training or experience. 

27. Despite the coverage of Schmedding’s long-term disability, The Hartford

terminated LTD benefits after paying Schmedding LTD benefits for over a year. This 

breach was arbitrary, capricious, an abuse of discretion, not supported by substantial 

evidence and was clearly erroneous.

28. 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, Schmedding is entitled to 

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

of the Plan. 

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

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

30. Schmedding is entitled to prejudgment interest at the highest legal rate on the 

benefits to which he is entitled pursuant to A.R.S. § 20-462.

WHEREFORE, Schmedding prays for entry of judgment against Defendants as 

follows:

A. For all past benefits due Schmedding under the terms of the Plan;

B. For an award of Schmedding’s attorneys’ fees and costs incurred herein;

C. For an award of prejudgment interest on benefits and damages at the highest 

legal rate until paid; and

Case 2:18-cv-00915-DWL Document 1 Filed 03/23/18 Page 4 of 5
SCHIFFMAN 

LAW 

OFFICE, P.C.

4506 N. 12 T H STREET

PHOENIX, AZ 85014 ♦ (602) 266-2667

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D. For such other and further relief as the Court deems just and reasonable.

Dated this 23rd day of March 2018.

SCHIFFMAN LAW OFFICE, P.C.

By: /s/ Lisa J. Counters

Lisa J. Counters

Case 2:18-cv-00915-DWL Document 1 Filed 03/23/18 Page 5 of 5