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McLean v. Old Dominion Freight Line

June 22, 2007


The opinion of the court was delivered by: Hillman, District Judge


This matter has come before the Court on Defendant's motion for summary judgment on Plaintiff's claim pursuant to 29 U.S.C. § 1132(a)(1)(b) of the Employee Retirement Security Act (ERISA) for the reinstatement of his long term disability benefits. For the reasons expressed below, Defendant's motion will be granted.


Plaintiff, George McLean, was employed as a truck driver for Defendant, Old Dominion Freight Line, Inc., from 1989 until 1995, when he was diagnosed with carcinoma of the tongue and pharynx with metastasis to the neck. On November 13, 1995, Plaintiff filed a claim for long term disability (LTD) benefits through Defendant's employee benefit plan. Defendant was the plan sponsor and plan administrator for its LTD plan, which provided LTD benefits for twenty-four months if a claimant's illness prevented him from performing his regular occupation, and continued benefits thereafter if a claimant was unable to perform any gainful occupation.

On October 17, 2000, Plaintiff's benefits were discontinued, because an independent medical examination (IME) found that, with regard to his otolaryngology problems (tongue, pharynx and neck cancer), Plaintiff was not totally disabled and was able to perform some type of sedentary work. Plaintiff appealed that decision, and Defendant solicited a second IME with regard to Plaintiff's orthopedic complaints. (See R. at 101.) The IME found that Plaintiff was totally disabled due to his thoracic back pain and use of Tylenol with Codeine, finding that both would hinder his ability to drive to work and impair his performance at work. The medical examiner also opined that if Plaintiff was able to "get off the Tylenol with Codeine, he might be able to obtain some gainful employment, but this is doubtful."

(R. at 99.) As a result, on June 6, 2001, Plaintiff's benefits were restored.

In December 2004, Plaintiff was informed that as of November 30, 2004, his benefits were again discontinued. Defendant's review of Plaintiff's medical records from October 21, 2003 through November 4, 2004 revealed that although Plaintiff was receiving treatment for insulin dependant diabetes, orthostatic symptoms, hypertension, and thyroid problems, he was no longer being treated for cancer because he was now "disease-free." (R. at 74.) The letter informing Plaintiff of the discontinuation of his benefits stated that "[n]o other medical problems can be considered with" his file, and should he have any other medical problems that keep him from working, he should complete a new disability claim form. (R. at 57.)

Plaintiff appealed, his treating physicians were each asked to complete an attending physician's statement, and another review of his file was conducted. Defendant upheld the termination of benefits, stating that the "medical information reviewed indicates your original diagnosis is resolved. Although you may have other disabilities that prevent you from working, we cannot consider those with this claim." (R. at 40.)

Plaintiff appealed again pursuant to the LTD plan's two-level appeal process. Defendant employed another IME to conduct a medical records review. The IME doctor found that although Plaintiff did sustain injury to his left neck and shoulder area from surgery and radiation, and that Plaintiff was taking Tylenol with Codeine, both possibly causing a problem for Plaintiff to drive, none of Plaintiff's doctors' notes demonstrated a "clear disqualification" from being able to drive. (R. at 14.) The IME doctor also found that Plaintiff's diabetes may impair his ability to drive, but his diabetes was separate from his LTD benefits claim and could be accommodated by employers. (Id.) Ultimately, the IME doctor stated that although Plaintiff may not be able to perform "DOT driving," he did "not find a preponderance of the evidence" that suggested that Plaintiff's cancer or the treatment for cancer prevented Plaintiff from gainful employment in any occupation. (Id.) As a result, Defendant upheld the termination of Plaintiff's benefits.

Plaintiff filed this action against Defendant pursuant to 29 U.S.C. § 1132(a)(1)(b) of the Employee Retirement Security Act (ERISA), claiming that Defendant abused its discretion in wrongfully terminating Plaintiff's LTD benefits. Defendant has moved for summary judgment on Plaintiff's claim.


A. Summary Judgment Standard

Summary judgment is appropriate where the Court is satisfied that "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Celotex Corp. v. Catrett, 477 U.S. 317, 330 (1986); Fed. R. Civ. P. 56(c).

An issue is "genuine" if it is supported by evidence such that a reasonable jury could return a verdict in the nonmoving party's favor. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A fact is "material" if, under the governing substantive law, a dispute about the fact might affect the outcome of the suit. Id. In considering a motion for summary judgment, a district court may not make credibility determinations or engage in any weighing of the evidence; instead, the non-moving party's evidence "is to be believed and all justifiable inferences are to be drawn in his favor." Marino v. Industrial Crating Co., 358 F.3d 241, 247 (3d Cir. 2004)(quoting Anderson, 477 U.S. at 255).

Initially, the moving party has the burden of demonstrating the absence of a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Once the moving party has met this burden, the nonmoving party must identify, by affidavits or otherwise, specific facts showing that there is a genuine issue for trial. Id. Thus, to withstand a properly supported motion for summary judgment, the nonmoving party must identify specific facts and affirmative evidence that contradict those offered by the moving party. Anderson, 477 U.S. at 256-57. A party opposing summary ...

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