United States District Court, D. Massachusetts
MEMORANDUM & ORDER
TALWANI UNITED STATES DISTRICT JUDGE.
Elaine Parnagian brings this action requesting judicial
review of Defendant Metlife Disability Insurance
Company's (“MetLife”) denial of long-term
disability (“LTD”) benefits under the Raytheon
Company Disability Plan Income Policy (“Plan”).
Complaint [#1]. Before the court are cross-motions for
summary judgment. Defs.' Mot. J. on the R. [#58];
Pl.'s Cross Mot. J. on the R. [#63].
Legal Framework and Standard of Review
Plan is covered by the Employee Retirement Income Security
Act of 1974 (“ERISA”), 29 U.S.C. §
1132(a)(1)(B). “Among its panoply of remedial devices
for plan participants, ERISA provides for suits to enforce
rights conferred under the terms of an ERISA-regulated
plan.” Denmark v. Liberty Life Assur. Co. of
Boston, 566 F.3d 1, 5 (1st Cir. 2009). The parties here
agree that in such suits, “summary judgment is merely a
mechanism for tendering the issue and no special inferences
are to be drawn in favor of a plaintiff resisting in summary
judgment.” Liston v. Unum Corp. Officer Severance
Plan, 330 F.3d 19, 24 (1st Cir. 2003). Instead, this
court “sits more as an appellate tribunal than as a
trial court. It does not take evidence, but, rather,
evaluates the reasonableness of an administrative
determination in light of the record compiled before the plan
fiduciary.” Leahy v. Raytheon Co., 315 F.3d
11, 17-18 (1st Cir. 2002).
parties further agree that because the Plan grants MetLife-as
the Plan's Claims Administrator-discretionary authority
to construe the Plan and to make determinations as to benefit
eligibilities, “a decision made under the plan will be
upheld unless it was ‘arbitrary, capricious, or an
abuse of discretion.'” Niebauer v. Crane &
Co., Inc., 783 F.3d 914, 923 (1st Cir. 2015) (quoting
Cusson v. Liberty Life Assur. Co. of Boston, 592
F.3d 215, 224 (1st Cir. 2010). Under this
“generous” standard, the court determines whether
the plan administrator's decision based on the record
before it was “reasoned and supported by substantial
evidence.” See Medina v. Metro. Life Ins. Co.,
588 F.3d 41, 45 (1st Cir. 2009) (citing Stamp v. Metro.
Life Ins. Co., 531 F.3d 84, 88 (1st Cir. 2008)).
Evidence is substantial when it is “reasonably
sufficient to support a conclusion.”
Ortega-Candelaria v. Johnson & Johnson, 755 F.3d
13, 20 (1st Cir. 2014) (citing Cusson, 592 F.3d at
“mere existence” of contradictory evidence does
not render a plan administrator's decision arbitrary and
capricious. “Indeed, when the medical evidence is
sharply conflicted, the deference due to the plan
administrator's determination may be especially
great.” Leahy, 315 F.3d at 19. Additionally,
courts cannot require administrators automatically to accord
special weight to the opinions of a claimant's treating
physician; “nor may courts impose on plan
administrators a discrete burden of explanation when they
credit reliable evidence that conflicts with a treating
physician's evaluation.” Black & Decker
Disability Plan v. Nord, 538 U.S. 822, 834 (2003)
(rejecting importation of the Social Security
Administration's “treating physician rule”
into the ERISA context).
the “single question” before this court is
whether MetLife “exercised its discretion reasonably,
” or abusively. See Colby v. Union Sec. Ins. Co.
& Mgmt. Co. for Merrimack Anesthesia Assocs. Long Term
Disability Plan, 705 F.3d 58, 61 (1st Cir. 2013).
Factual Background and Administrative Decisions
began working at Raytheon Company (“Raytheon”) in
Tewksbury, MA, as a Senior Electrical Engineer II around
December 8, 2008. See MET-01068-01069; Am. Compl.
[#4] ¶¶ 17-20 [“Am. Compl.”]. In March
2010, Plaintiff began to experience a variety of symptoms
including but not limited to headaches, fatigue, muscle and
joint pain, and focus issues. See MET-00322-00323;
MET-00752. For the next six months, Plaintiff was permitted
to work from home. MET-01063-01064. On or about October 13,
2010, when Raytheon no longer permitted Plaintiff to work
from home, she stopped working, and filed a claim for
short-term disability (“STD”) under
Raytheon's STD benefit plan. Am. Compl. [#4] ¶ 23;
Defs.' Statement Undisputed Facts ¶ 5
[“Defs.' St. Undisp. Facts”] [#60]. MetLife
initially denied Plaintiff's STD claim and confirmed its
denial on administrative appeal. MET-01097, 01098. After she
had exhausted the administrative review process, Plaintiff
sued MetLife in this court on February 8, 2012, seeking to
recover both LTD and STD benefits. Am. Compl. [#4] ¶ 34.
In a settlement of that action, MetLife agreed to pay
Plaintiff STD benefits, and to reconsider her LTD claim under
the Plan for the period starting in December 2010. Am. Compl.
[#4] ¶ 35.
of the reconsideration process, Ms. Parnagian submitted
additional documentation of her illness to MetLife, including
her claim file with the Social Security Administration
(“SSA”). See MET-00414. Plaintiff also
submitted updated medical records from her primary care
physician, Dr.___ Silver, and from Dr. ___LaCava, her
“long standing treating doctor and a specialist in
chemical sensitivity.” Am. Compl. [#4] ¶ 22;
see MET-01757 (MetLife's summary of
documentation received in support of benefits application).
In a letter to MetLife dated April 1, 2011, Dr. LaCava
summarizes Plaintiff's relevant medical history, and his
recommendations for treatment. See MET-00370-00372.
He asserts that she “has a personal history of having
been frequently sick from childhood and hypersensitive to
various exposures” and that she suffers from severe
“chemical sensitivities.” MET-00370. He also
describes a variety of lab tests and their results which, in
his opinion, demonstrate physical reactions to a variety of
chemicals. See MET-00371. He asserts that:
[b]ecause Ms. Parnagian cannot drive to work, cannot work
with anyone else, and cannot work in any building but very
old, but clean buildings . . . without experiencing
debilitating headaches, respiratory irritant effects,
fatigue, and cognitive dysfunction . . . she is totally and
permanently disabled from all gainful employment. The
ubiquitous presence of the chemicals to which she reacts and
her debilitating physical and neurological symptoms after
such exposures would render her an unreliable employee in any
capacity and therefore unemployable.
point in the claims process, MetLife enlisted two physicians
to evaluate Plaintiff's medical records. MET-00864-00879;
00828-00834. Dr. Stefanos Kales, a Diplomat on the American
Board of Preventive Medicine (specializing in Occupational
Medicine), opines that “there is no objective evidence
of any occupational or environmental disorder in the records
provided for Ms. ...