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Goble v. Liberty Life Assurance Company of Boston

United States District Court, D. New Jersey

April 25, 2014

WILLIAM GOBLE, Plaintiff,
v.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON, d/b/a LIBERTY MUTUAL, and BNP PARIBAS COMPREHENSIVE WELFARE BENEFITS PLAN, Defendants.

MEMORANDUM

PETER G. SHERIDAN, District Judge.

This matter comes before the Court on Plaintiff William Goble's ("Goble" or "Plaintiff") appeal, pursuant to FED. R. CIV. P. 72(a) and L. CIV. R. 72.1(c), of the October 11, 2013 Order entered by the Hon. Tonianne Bongiovanni, U.S.M.J. denying Plaintiff's Motion to Compel Discovery from Defendants Liberty Life Assurance Company of Boston and BNP Paribas Comprehensive Welfare Benefits Plan (collectively, "Defendants") (ECF No. 21). The Court decides this matter without oral argument pursuant to FED. R. CIV. P. 78(b). For the reasons set forth herein, Magistrate Judge Bongiovanni's Order of October 11, 2013 is affirmed.

I. BACKGROUND

A. Factual Background

Plaintiff William Goble was employed by BNP Paribas as a Senior Information Technology Auditor from April 2005 until January 14, 2010 when symptoms from peripheral neuropathy "forced [him] to cease working[.]" (Compl. at ¶ 35). On February 1, 2010, after subjecting himself to clinical examination and testing by podiatrist Matthew Regulski D.P.M., Plaintiff filed a claim for short-term disability benefits. ( Id. at ¶¶ 36-37). According to Plaintiff, "[h]is claim was approved on or about February 4, 2010 based on his symptoms of peripheral neuropathy and the certification of Dr. Regulski supporting his functional inability to work due to his medical condition." ( Id. at ¶ 37).

On March 10, 2010, after Plaintiff's symptoms persisted, he sought a second opinion from Board-Certified neurologist Edward Spellman, M.D. who confirmed the diagnosis of Dr. Regulski and "diagnosed [Plaintiff] with chronic painful sensory peripheral neuropathy[.]" ( Id. at ¶ 39). In addition, Plaintiff filed an application for Social Security disability benefits which was approved as of July 1, 2010. ( Id. at ¶ 45). Liberty Life Assurance Company of Boston ("Liberty"), the claims administrator of the BNP Paribas Comprehensive Welfare Benefits Plan (the "Plan"), paid Plaintiff's short-term disability benefits for the maximum six-month benefit period allowed under the Plan through July 15, 2010. ( Id. at ¶ 48). Liberty subsequently approved long-term disability ("LTD") benefits via letter dated July 29, 2010 and began paying Plaintiff's LTD benefits as of July 16, 2010. ( Id. at ¶ 49). Liberty continued to pay Plaintiff LTD benefits "through the end of 2010[]" while Plaintiff continued to seek medical assistance. ( Id. at ¶ 58). According to Plaintiff, Liberty also "arranged for [Plaintiff] to be secretly observed and followed on November 8, 10, and 12, 2010[]" by surveillance vendor HUB Enterprises, Inc. ( Id. at ¶¶ 56-57).

In late 2010, Liberty referred Plaintiff's file to physician Gale Brown, M.D. who issued a report on January 5, 2011 concluding that Plaintiff could work in a sedentary occupation. ( Id. at ¶ 59). Plaintiff contends that Liberty "disagreed with Dr. Brown's suggestion that [Plaintiff] was capable of working and continued to pay [him] disability benefits from January 2011 through November 21, 2011." ( Id. at ¶ 61). According to Plaintiff, Liberty arranged for Plaintiff to be further surveilled by HUB Enterprises, Inc. on April 18, 20 and 22, 2011. ( Id. at ¶ 62).

In May 2011, Liberty referred Plaintiff's file for a second peer review by Dr. Brown who reiterated her position that Plaintiff was not disabled. ( Id. at ¶ 65). On or about May 25, 2011, Liberty referred Plaintiff's file to the MLS Group of Companies ("MLS") to schedule Plaintiff for an Independent Medical Evaluation ("IME"). ( Id. at ¶ 67). On June 27, 2011, Plaintiff underwent an IME with Gary Yen, M.D., who determined that Plaintiff could perform full-time sedentary work. ( Id. at ¶ 68). In addition, on or about August 1, 2011, Liberty referred Plaintiff's file for an occupational analysis by Cascade Disability Management ("Cascade"). ( Id. at ¶ 70). In a report dated August 22, 2011, Cascade set forth its conclusion that Plaintiff's occupation could be performed "at the sedentary level with certain accommodations." ( Id. at ¶ 71). Based on these reports, Liberty subsequently terminated Plaintiff's LTD benefits via letter dated November 23, 2011. ( Id. at ¶ 73).

On March 28, 2012, Plaintiff underwent a Functional Capacity Evaluation ("FCE") by Ellen Rader Smith, MA, OTR, CPE, CVE, who concluded that Plaintiff "is unable to work even in a sedentary occupation due to symptoms of peripheral neuropathy in his extremities and the effects of his neuropathic pain." ( Id. at ¶ 74). On May 4, 2012, John Sargent, MS, CRC, LCMHC, analyzed Plaintiff's medical conditions and concluded that "he would be unable to work in his own or any occupation." ( Id. at ¶ 75).

On May 18, 2012, Plaintiff submitted an administrative appeal of Liberty's determination in accordance with 29 U.S.C. § 1133. In support of his appeal, Plaintiff submitted the medical records and reports of his treating neurologist, Dr. Spellman, and podiatrist, Dr. Regulski, as well as the vocational analysis by Mr. Sargent and the FCE by Ms. Smith. ( Id. at ¶ 77). Liberty subsequently referred Plaintiff's file for review on appeal to psychiatrist/neurologist Andrew Gordon, M.D. On July 12, 2012, Dr. Gordon issued a report concluding that Plaintiff was capable of performing full-time work provided certain accommodations were made. Despite the medical evidence submitted and the prior findings of the Social Security Administration, Liberty upheld its determination and denied Plaintiff's appeal via letter dated July 20, 2012. ( Id. at ¶ 80).

On September 25, 2012, Plaintiff filed a one count Complaint in the United States District Court for the District of New Jersey alleging that Defendants failed to pay LTD benefits to which Plaintiff was entitled under the BNP Paribas Comprehensive Welfare Benefits Plan in violation of the Employee Retirement Income Security Act of 1974, as amended ("ERISA"), 29 U.S.C. §§ 1000 et seq. Defendants filed their Answer on November 16, 2012.

On January 10, 2013, an Initial Pretrial Conference was held before Magistrate Judge Bongiovanni. After the parties met and conferred and were unable to come to an agreement regarding certain discovery disputes, Plaintiff advised the Court on March 11, 2013 of his intention to file a Motion to Compel Discovery. On April 12, 2013, Plaintiff filed said motion seeking disclosure of: (1) "important relevant data known to Liberty which was [allegedly] withheld from the administrative record[]"; (2) "the specific written rules, guidelines, policies, procedures or like written materials pertaining to [Plaintiff's] LTD claim"; and (3) Liberty's internal "policies and procedures with regard to issues including surveillance, the provision of surveillance footage to IME examiners, and the consideration of a favorable Social Security determination in administering a beneficiary's LTD claim." (Pl.'s Br. in Supp. of Mot. to Compel Discovery ("Pl.'s Br.") at 7-10). Defendants filed their Opposition to Plaintiff's motion on May 6, 2013 arguing that they had satisfied their discovery obligations under ERISA by producing the "complete and unadulterated administrative record[.]" (Defs.' Opp'n to Pl.'s Mot. to Compel Discovery ("Defs.' Opp'n Br.") at 2).

On October 11, 2013, Magistrate Judge Bongiovanni issued a Memorandum Opinion and Order denying Plaintiff's Motion to Compel. The Court first considered the standard of review to be applied to a plan administrator's denial of benefits and noted that "[t]ypically in ERISA cases in which the arbitrary and capricious standard of review is used, the Court limits its review of the plan administrator's denial of benefits to only that evidence that was before the administrator when he or she made the decision being reviewed." Goble v. Liberty Life Assur. Co., 2013 U.S. Dist. LEXIS 147272, at *22 (D.N.J. Oct. 11, 2013) (citing Mitchell v. Eastman Kodak Co., 113 F.3d 433, 440 (3d Cir. 1997)). The Court further noted that "discovery will typically not be permitted beyond the administrative record in ERISA cases unless some extrinsic factor exists, such as structural conflict of interest or significant procedural anomalies." Goble, 2013 U.S. Dist. LEXIS 147272 at *24. After considering the facts of the case, and finding no extrinsic factors to be present, the Court determined that the arbitrary and capricious standard applies. Id. at *24.

After determining that the arbitrary and capricious standard applies to Defendants' denial of Plaintiff's LTD benefits, the Court cited to the Third Circuit case of Mitchell v. Eastman Kodak Co., 113 F.3d 433, 440 (3d Cir. 1997) for the proposition that "claimants are limited only to the administrative record in ERISA cases reviewed under the arbitrary and capricious standard." Goble, 2013 U.S. Dist. LEXIS 147272 at *25. Accordingly, the Court determined that, because Plaintiff's discovery requests go beyond the information contained in the administrative record, Plaintiff is not entitled to production of the requested documents. Moreover, the Court found that because "Plaintiff cannot establish that any of the policies sought in his motion were specifically generated in connection with his particular adverse benefit determination, as required by [29 C.F.R. § 2560.503-1(m)(8)(iii), ]... discovery beyond the administrative record is not warranted." Id. at *26. In addition, the Court found Plaintiff's argument that "Defendants' policies and procedures relating to surveillance, the provision of surveillance footage to IME examiners, and the consideration of favorable Social Security determination in administering a beneficiary's LTD are relevant to Plaintiff's claim[]" to be unpersuasive. Because the Court found that Plaintiff's ...


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