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Scott E. Davis 

State Bar No. 016160 

SCOTT E. DAVIS, P.C. 

8360 E. Raintree Drive, Suite 140 

Scottsdale, AZ 85260 

Telephone: (602) 482-4300 

Facsimile: (602) 569-9720 

email: davis@scottdavispc.com

Attorney for Plaintiff Catherine Boettcher 

UNITED STATES DISTRICT COURT 

DISTRICT OF ARIZONA 

Catherine Boettcher, 

 Plaintiff, 

 v. 

Metropolitan Life Insurance Company; 

International Business Machines Corporation; 

IBM Long-Term Disability Plan, 

 Defendants. 

Case No. 

COMPLAINT 

 

 Now comes the Plaintiff Catherine Boettcher (hereinafter referred to as “Plaintiff”), 

by and through her attorney, Scott E. Davis, and complaining against the Defendants, she 

states: 

Jurisdiction 

 1. Jurisdiction of the court is based upon the Employee Retirement Income 

Security Act of 1974 (ERISA); and in particular, 29 U.S.C. §§1132(e)(1) and 1132(f). 

Those provisions give the district courts jurisdiction to hear civil actions brought to recover 

employee benefits. In addition, this action may be brought before this Court pursuant to 28 

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U.S.C. §1331, which gives the Court jurisdiction over actions that arise under the laws of 

the United States. 

Parties 

 2. Plaintiff is a resident of Maricopa County, Arizona. 

3. Upon information and belief, International Business Machines Corporation 

(hereinafter referred to as the “Company”) sponsored, administered and purchased a group 

long term disability insurance policy (hereinafter referred to as the “Policy”) which was 

fully insured by Metropolitan Life Insurance Company (hereinafter referred to as 

“MetLife”). The Company’s purpose in sponsoring, administering and purchasing the 

Policy was to provide long term disability insurance for its employees. Upon information 

and belief, the MetLife Policy may have been included in and part of an employee benefit 

plan, specifically named the IBM Long-Term Disability Plan (hereinafter referred to as 

the “Plan”) which may have been created to provide the Company’s employees with 

welfare benefits. At all times relevant hereto, the Plan constituted an “employee welfare 

benefit plan” as defined by 29 U.S.C. §1002(1). 

4. Upon information and belief, MetLife functioned as the claim administrator 

of the policy; however, pursuant to the relevant ERISA regulation, the Company and/or the 

Plan may not have made a proper delegation or properly vested fiduciary authority or power 

for claim administration in MetLife. 

5. MetLife operated under a financial conflict of interest in evaluating her longterm disability claim due to the fact that it operated in dual roles as the decision maker with 

regard to whether Plaintiff was disabled, as well as the payor of benefits if it found she was 

disabled. 

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6. The Company, MetLife and the Plan conduct business within Maricopa 

County and all events giving rise to this Complaint occurred within Arizona. 

Venue 

7. Venue is proper in this district pursuant to 29 U.S.C. §1132(e)(2) and 28 

U.S.C. §1391. 

Nature of the Complaint 

8. Incident to her employment, Plaintiff was a covered employee pursuant to 

the Plan and the relevant Policy and a “participant” as defined by 29 U.S.C. §1002(7). 

Plaintiff seeks disability income benefits in the form of “Own Occupation” benefits from 

the Plan and the relevant Policy pursuant to §502(a)(1)(B) of ERISA, 29 U.S.C. 

§1132(a)(1)(B), as well as any other employee benefits she may be entitled to from the 

Company, the Plan and any other Company Plan as a result of being found disabled in this 

action. 

9. Plaintiff also seeks a determination in this action that she is disabled and 

meets the “Any Occupation” definition of disability set forth in the Plan and the relevant 

Policy as the evidence she submitted to MetLife supports such a determination by the Court. 

Plaintiff alleges whether she meets the “Any Occupation” definition is ripe before the Court 

due to the fact that the “Own Occupation” timeframe in the Plan and Policy has long since 

expired, and Plaintiff has remained disabled and unable to work in any occupation through 

the present date, which includes the time frame for the “Any Occupation” definition in the 

Plan and Policy. 

10. After working for the Company as a loyal employee, Plaintiff became 

disabled on or about October 8, 2013, due to serious medical conditions and was unable to 

work in her designated occupation as a Business Operations Manager. Plaintiff has 

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remained disabled as that term is defined in the relevant Policy continuously since that date 

and has not been able to return to work in any occupation as a result of her serious medical 

conditions. 

11. Following her disability, Plaintiff filed a claim for short term disability which 

her Company, which upon information and belief, contained an “Own Occupation” 

definition of disability. After review, the Company found she was disabled and paid all her 

STD benefits and they have been exhausted. 

12. Plaintiff then filed for long term disability benefits under the relevant Policy 

which was administered by MetLife, meaning that it made the decision with regard to 

whether Plaintiff was disabled. 

13. The MetLife Policy provides the following definition of disability pertaining 

to long-term disability benefits: 

“Under the LTD Plan, ‘disabled’ means that during the elimination period and 

the first 12 months after you complete the elimination period, you cannot 

perform the important duties of your regular job with IBM because of a 

sickness or injury. After expiration of that 12 month period, disability means 

that, because of sickness or injury, you cannot perform the important duties of 

any other gainful occupation for which you are reasonability fit by your 

education, training or experience.” 

14. In support of her claim for long term disability benefits, Plaintiff submitted to 

MetLife medical evidence which supported her allegation that she met any definition of 

disability as defined in the relevant Policy. 

15. Plaintiff submitted to MetLife an April 15, 2014 Attending Physician’s 

Statement completed by her board certified family physician who confirmed it is his 

medical opinion Plaintiff, “...can work a total of zero hours per day.” 

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16. In a letter dated June 12, 2014, MetLife informed Plaintiff it was denying 

her claim for long term disability benefits. 

17. Pursuant to 29 U.S.C. §1133, Plaintiff timely appealed MetLife’s June 12, 

2014 denial of her claim and in support of her claim for long term disability benefits, 

Plaintiff submitted to MetLife additional medical evidence demonstrating that she met any 

definition of disability set forth in the Policy. 

18. Plaintiff submitted to MetLife a July 30, 2014 medical record from her board 

certified treating family physician who concluded, “[Plaintiff] is not ready to return to 

work...She is able to sit for 15 minutes and less than 30 minutes. Then she needs to get up 

to walk around.” 

19. Plaintiff also submitted an October 21, 2014 medical record from the same 

treating physician who concluded she was “Not able to return to work at this time.” 

20. Plaintiff also submitted to MetLife a February 23, 2015 narrative letter from 

her treating physician who confirmed that it is his medical opinion, that “...[Plaintiff] has 

been unable to return to work in her current position with IBM...” 

21. As part of its review of Plaintiff’s claim for long term disability benefits, 

MetLife obtained a medical records only "paper review" from a physician of its choosing, 

Richard B. Evans, M.D. 

22. Upon information and belief, Plaintiff alleges Dr. Evans may be a long time 

medical consultant for the disability insurance industry and/or MetLife. As a result, 

Plaintiff alleges Dr. Evans may have an incentive to protect his own consulting relationship 

with the disability insurance industry and/or MetLife by providing medical records only 

paper reviews, which selectively review or ignore evidence such as occurred in Plaintiff’s 

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claim, in order to provide opinions and report(s) which are favorable to insurance 

companies and which supported the denial of Plaintiff’s claim. 

23. Prior to rendering its final denial in Plaintiff’s claim, MetLife never shared 

with Plaintiff the report authored by Dr. Evans and never engaged Plaintiff in a dialogue so 

she could respond to the report and perfect her claim. MetLife’s failure to provide Plaintiff 

with the opportunity to respond to Dr. Evans’ report precluded a full and fair review 

pursuant to ERISA. MetLife’s action is also an ERISA procedural violation and a violation 

of Ninth Circuit case law. 

24. In a letter dated March 5, 2015, MetLife notified Plaintiff it had denied her 

claim for long term disability benefits under the Policy. In the letter, MetLife also notified 

Plaintiff she had exhausted her administrative levels of review and could file a civil action 

lawsuit in federal court pursuant to ERISA. 

25. Plaintiff alleges that the Company’s approval of her STD claim and MetLife’s 

denial of her LTD claim, so near in time to one another and when both claims contained 

essentially the same definitions of disability, is evidence that MetLife’s financial conflict of 

interest was a motivating factor in why it denied Plaintiff’s LTD claim. Plaintiff alleges 

MetLife was motived to deny her LTD claim as its financial liability to her was much larger 

than the Company’s liability given that if MetLife approved her claim it may have had to 

pay her claim for many years into the future. 

26. Upon information and belief, MetLife’s March 5, 2015 denial letter confirms 

it failed to provide a full and fair review, and in the process committed several procedural 

violations pursuant to ERISA due to among other reasons, completely failing to credit, 

reference, consider, and/or selectively reviewing and de-emphasizing most, if not all of 

Plaintiff’s reliable evidence. 

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27. In evaluating Plaintiff’s claim on appeal, MetLife owed her a fiduciary duty 

and it had an obligation pursuant to ERISA to administer her claim, “solely in her best 

interests and other participants,” which it failed to do. 1

 

28. MetLife failed to adequately investigate Plaintiff’s claim and failed to engage 

her in a dialogue during the appeal of her claim with regard to what evidence was necessary 

so that Plaintiff could perfect her appeal and claim. MetLife’s failure to investigate the 

claim and to engage in this dialogue or to obtain the evidence it believed was important to 

perfect Plaintiff's claim is a violation of ERISA and Ninth Circuit case law, and is a reason 

she did not receive a full and fair review. 

29. Plaintiff alleges MetLife provided an unlawful review which was neither full 

nor fair and that violated ERISA, specifically, 29 U.S.C. § 2560.503-1, by failing to 

adequately investigate her claim; failing to credit Plaintiff’s reliable evidence; providing a 

one sided review of Plaintiff’s claim which favored MetLife and that failed to consider all 

the evidence submitted by her and/or which de-emphasized the evidence which supported 

Plaintiff’s claim; disregarding Plaintiff’s self-reported symptoms; failing to consider all the 

diagnoses and/or limitations set forth in her medical evidence as well as the impact the 

combination of those diagnoses and impairments would have on her ability to work, not 

only in her occupation but in any occupation; failing to engage Plaintiff in a dialogue so she 

 

1

 It sets forth a special MetLife of care upon a plan administrator, namely, that the 

administrator "discharge [its] duties" in respect to discretionary claims processing "solely 

in the interests of the participants and beneficiaries" of the plan, § 1104(a)(1); it 

simultaneously underscores the particular importance of accurate claims processing by 

insisting that administrators "provide a 'full and fair review' of claim denials," Firestone, 

489 U.S., at 113, 109 S. Ct. 948, 103 L. Ed. 2d 80 (quoting § 1133(2)); and it 

supplements marketplace and regulatory controls with judicial review of individual claim 

denials, see § 1132(a)(1)(B). Metro. Life Ins. Co. v. Glenn, 128 S. Ct. 2343, 2350 (U.S. 

2008). 

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could submit the necessary evidence to perfect her claim and failing to consider the impact 

the side effects that Plaintiff's medications would have on her ability to engage not only in 

her occupation with the Company, but in any occupation. 

30. Plaintiff alleges a reason MetLife provided an unlawful review which was 

neither full nor fair and that violated ERISA, specifically, 29 U.S.C. § 2560.503-1, is due in 

part to its financial conflict of interest that manifested as a result of the dual roles MetLife 

undertook in her claim as the decision maker and payor of benefits. MetLife’s conflict of 

interest provided it with a financial incentive and a motivation to deny Plaintiff’s claim. 

31. Plaintiff is entitled to discovery regarding MetLife’s aforementioned conflicts 

of interest, the potential conflicts of interest of Dr. Evans, as well as any other individual 

who reviewed her claim and the Court may properly weigh and consider extrinsic evidence 

regarding the nature, extent and effect of any conflict of interest and/or ERISA procedural 

violation which may have impacted or influenced MetLife’s decision to deny her claim. 

32. With regard to whether Plaintiff meets the definition of disability set forth in 

the Plan and/or Policy, the Court should review the evidence in Plaintiff’s claim de novo, 

because even if the Court concludes the Plan and/or Policy confers discretion, the unlawful 

violations of ERISA committed by MetLife as referenced herein are so flagrant they justify 

de novo review. 

33. As a direct result of MetLife’s decision to deny Plaintiff’s disability claim, 

she has been injured and suffered damages in the form of lost long term disability benefits, 

in addition to other potential employee benefits she may have been entitled to receive 

through or from the Plan, any other Company Plan and/or the Company as a result of being 

found disabled in this action. Plaintiff believes other potential employee benefits may 

include but not be limited to, health and other insurance related coverage or benefits, 

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retirement benefits or a pension, life insurance coverage and/or the waiver of the premium 

on a life insurance policy providing coverage for her and her family/dependents. 

34. Pursuant to 29 U.S.C. §1132, Plaintiff is entitled to recover unpaid benefits, 

prejudgment interest, reasonable attorney's fees and costs from Defendants. 

35. Plaintiff is entitled to prejudgment interest at the legal rate pursuant to A.R.S. 

§20-462, or at such other rate as is appropriate to compensate her for losses she incurred 

as a result of Defendants’ nonpayment of benefits. 

 WHEREFORE, Plaintiff prays for judgment as follows: 

 A. For an Order requiring Defendants to pay Plaintiff her long term disability 

benefits in the form of “Own Occupation” benefits as defined in the relevant Plan and/or 

Policy as well as any other employee benefits she may be entitled to as a result of being 

found disabled pursuant to the Plan and/or Policy, from the date she was first denied 

these benefits through the date of judgment and prejudgment interest thereon; 

 B. For an Order directing Defendants to continue paying Plaintiff the 

aforementioned benefits until such time as she meets the conditions for termination of 

benefits; 

 C. For an Order that Plaintiff also meets the “Any Occupation” definition of 

disability set forth in the relevant Plan and/or Policy and is entitled to those benefits along 

with an Order directing Defendants to continue paying Plaintiff those benefits and any other 

employee benefits she may be entitled to as a result of being found disabled, until such time 

as she meets the conditions for termination of benefits; 

 D. For attorney’s fees and costs incurred as a result of prosecuting this suit 

pursuant to 29 U.S.C. §1132(g); and 

 E. For such other and further relief as the Court deems just and proper. 

 

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DATED this 25th day of September, 2015. 

 SCOTT E. DAVIS. P.C. 

 By: /s/ Scott E. Davis Scott E. Davis 

 Attorney for Plaintiff

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