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upholding determination in CFS case where evidence existed in the record that plaintiff's condition was not disabling
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Civil No. 01-0497 (JBS)
August 16, 2002
Patricia A. Barasch, Esquire, Schall Barasch, LLC, Moorestown, New Jersey, Counsel for Plaintiff.
Randi F. Knepper, Esquire, Del Mauro, DiGiaimo Knepper, PC, Morristown, New Jersey, Counsel for Defendant MetLife.
Scott K. McClain, Esquire, Winne, Banta, Rizzi, Hetherington Basralian, P.C., Hackensack, New Jersey, Counsel for Verizon Communications, Inc., The Bell Atlantic Employee Benefit Plan, The Bell Atlantic Long Term Disability Plan, and the Bell Atlantic Plan Administrator.
OPINION
This action is before this Court upon the motion of defendant Metropolitan Life Insurance Company ("MetLife"), incorrectly captioned in the Complaint as MetLife, Inc., for summary judgment on plaintiff Jacqueline Nichols's Complaint [Docket Item 25-1], and also upon the motion of defendants Verizon Communications, Inc., The Bell Atlantic Employee Benefit Plan, The Bell Atlantic Long Term Disability Plan, and the Bell Atlantic Plan Administrator (collectively, the "Verizon defendants") for summary judgment on plaintiff's claims [Docket Item 32-1], and also upon the cross-motion of plaintiff Nichols for summary judgment on her claims against all defendants [Docket Item 29-1]. In the underlying action, plaintiff asserts claims under Section 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001,et seq. ("ERISA") for failure to provide benefits (Count I) and also under Section 502(c) of ERISA for failure to provide plan documents (Count II). Plaintiff seeks the payment of long-term disability benefits under the terms of the Bell Atlantic Long Term Disability Plan (the "Plan") and damages for the failure to provide plan documents.
As discussed more fully herein, it appears that MetLife's motion for summary judgment on Count II against it is unopposed.
A stipulation of dismissal with prejudice as to Count II was filed on May 20, 2002 as to the Verizon defendants. Therefore, this Opinion will not address the ERISA Section 502(c) claim against the Verizon defendants, which has already been dismissed with prejudice. The Verizon defendants' motion for summary judgment on Count I, the motion by MetLife on both counts, and plaintiff's cross-motions will be analyzed herein.
The motion of MetLife, in which the Verizon defendants join in part, asserts that plaintiff's Complaint must be dismissed in its entirety because MetLife's determination, as Claim Administrator of plaintiff's self-insured plan, should be upheld because it is supported by substantial evidence in the record, was not unreasonable, and was not erroneous as a matter of law. Defendant MetLife alternatively argues that because it is the plan's Claim Administrator, it is not responsible for payment of benefits under the plan and cannot be liable under Count I. Finally, MetLife seeks summary judgment on Count II, which has already been voluntarily dismissed with prejudice as to the Verizon defendants, on the basis that it is not the Plan Administrator, and therefore has no responsibility for providing plan documents. Plaintiff asserts that MetLife's denial of plaintiff's claim should be reversed because it is unsupported by the record and is arbitrary and capricious. Plaintiff additionally asserts that MetLife, as a named fiduciary under the terms of the plan, is a proper defendant under Section 502(a)(1)(B).
On March 25, 2002, the Verizon defendants filed a statement in lieu of brief in support of their motion for summary judgment. The statement indicated that the Verizon defendants were relying on MetLife's Memorandum in support of summary judgment (Points I and II only), the affidavit of Laura Sullivan and its exhibits, MetLife's Statement of Undisputed Facts, MetLife's Opposition to plaintiff's cross-motion and reply in support of the summary judgment motion, and MetLife's Opposition to plaintiff's statement of undisputed facts. (See Docket Item 33.) This arrangement was confirmed in a letter from Verizon's counsel, dated April 1, 2002. (See Letter from McClain to the Court, Apr. 1, 2002, at 1-2.)
This argument is unopposed. Plaintiff makes no reference to defendant's argument in her opposition to summary judgment (see Pl.'s Memo. in Support of Cross-Motion and in Opp. to Summ. J. Mot. at 1-16) or in her reply in support of her cross-motion (see Pl.'s Reply in Support of Cross-Motion). Additionally, plaintiff's Section 502(c) claims against the Verizon defendants were voluntarily dismissed by stipulation on May 20, 2002. Therefore, this Court will treat MetLife's motion for summary judgment on plaintiff's claim for relief under Section 502(c) of ERISA for failure to provide plan documents (Count II) as unopposed.
I. BACKGROUND
A. Plaintiff's Claim for LTD Benefits
Plaintiff Jaqueline Nichols ("Nichols") brought this action against defendant MetLife, the claim administrator of the Bell Atlantic Long Term Disability Plan, and the Verizon defendants, after MetLife denied her claim for long-term disability ("LTD") benefits relating to her chronic fatigue syndrome and fibromyalgia.
According to the Center for Disease Control (CDC), chronic fatigue syndrome is "a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS must often function at a substantially lower level of activity than they were capable of before the onset of illness." (Sullivan Aff., Ex. C, Bates No. 0128.) The CDC goes on to indicate that persons with chronic fatigue syndrome often report various non-specific symptoms, "including weakness, muscle pain, impaired memory and/or mental condition, insomnia, and post-exertional fatigue lasting more than 24 hours." (Id.)
Fibromyalgia a Rheumatologist disorder which has been linked to a number of symptoms including generalized aching and stiffness, swollen joints, fatigue, and headaches. Fibromyalgia is diagnosed by its clinical manifestations, specifically, area tenderness.
Plaintiff submitted a claim to MetLife for LTD benefits on June 8, 1998, asserting that she had been totally disabled by chronic fatigue syndrome, asthma, chronic cervical pain and chronic headaches. (Sullivan Aff., Ex. C, Bates No. 0522-24.) Plaintiff reported that she first became disabled on May 8, 1997 and that she attempted to return to her employment at Bell Atlantic as a frame attendant, but was unable to work because of her condition. (Sullivan Aff, Ex. C., Bates No. 0522.) In support of her claim, plaintiff submitted an Attending Physician Statement ("APS") and a personal profile evaluation. The APS, completed by Dr. Andrew Pecora, indicated that plaintiff had a primary diagnosis of chronic fatigue syndrome, with secondary diagnoses of asthma and chronic cervical pain. Dr. Pecora also indicated that plaintiff experienced depression, confusion, and an inability to adapt socially, and experienced severe limitations with concentrated visual attention, climbing, and balancing. (Sullivan Aff., Ex. C, Bates No. 0524.) Dr. Pecora concluded that plaintiff was totally disabled for her own occupation and any occupation. (Id.) Plaintiff's personal profile evaluation indicated that she suffered from depression, anxiety, chronic fatigue, severe allergies, joint pain, confusion, dizziness and muscle weakness. (Sullivan Aff., Ex. C., Bates No. 0525.) Plaintiff also indicated that she needed help with household chores and shopping. (Id.) Plaintiff reported that she was unable to return to her position at Bell Atlantic as a frame attendant and also that she did not think she could ever return to work. (Id. at 0526-27.)
The complete administrative record maintained by MetLife with respect to plaintiff Nichols is located as Ex. C to the Sullivan Aff., Bates Nos. 0064-0536. All facts considered by this Court are drawn from that administrative record.
B. Administrative Record of Plaintiff's Claim
The Administrative Record contains numerous other medical
and vocational records relating to plaintiff's claim, recounted herein. In addition to the records submitted with the application, plaintiff also submitted a Medical Condition Questionnaire completed by Dr. Andrew Pecora regarding her CFS. (Sullivan Aff., Ex. C, Bates Nos. 0501-04.) Dr. Pecora indicated that plaintiff's fatigue began in October, 1996, that she also had myalgia, muscle weakness, headaches, arthralgia, intolerance for exercise, memory loss, depression, and sleep disorders. (Id. at 502.) Dr. Pecora advised that plaintiff was not responding well to treatment and that she was "unable to do any jobs that require either physical labor or mental activities." (Id. at 0503.)
On September 22, 1997, plaintiff had a neurological consultation with Dr. M.C. Carta-Mangione at the request of Dr. Pecora. Dr. Carta-Mangione noted that plaintiff had been diagnosed by Dr. Pecora as having chronic fatigue syndrome. Plaintiff reported stress due to a custody battle, myalgia, dizziness, memory loss, decreased concentration, photophobia and decreased dexterity. (Sullivan Aff., Ex. C, Bates Nos. 0230-31.) CT and bloodwork was normal. Neurological, cranial, reflex and physical examinations were normal. (Id. at 0231.) Dr. Carta-Mangione concluded that plaintiff had some cognitive impairment related to ongoing depression. (Id.)
On March 5, 1998, plaintiff was seen by Dr. Joseph M. Pitone of the Nephrology and Hypertension Associates of New Jersey. (Sullivan Aff., Ex. C, Bates Nos. 0201-06.) Plaintiff reported dizziness, depression, fatigue, chronic upper respiratory inflammatory responses, and that she had been diagnosed with chronic fatigue syndrome. (Id. at 0201.) Examination revealed no abnormalities. (Id. at 0204.) Dr. Pitone concluded that plaintiff's symptoms were consistent with atypical migraine secondary to Paxil. (Id.) Dr. Pitone advised plaintiff to keep a diary of her symptoms.
On July 2, 1998, at the request of MetLife (see Sullivan Aff., Ex. C, Bates No. 536), Dr. Charles M. Wagner submitted a one page letter indicating he does not release office notes, he had not seen plaintiff since February 24, 1998, he had no treatment plan in place for plaintiff, and that plaintiff's GAF score was 84 (as of April 15, 1998). Also on July 2, 1998, Dr. Linda Brecher authored a report summarizing her June 30, 1998 examination of plaintiff. (Sullivan Aff., Ex. C, Bates Nos. 0483-85.) Plaintiff reported joint and muscle pain, difficulty sleeping, fatigue, headaches, dizziness, memory loss, difficulty swallowing, shortness of breath, constipation, and stiffness and advised Dr. Brecher that she had been diagnosed with chronic fatigue syndrome. (Id., Bates No. 0483.) Plaintiff also indicated that she walked one to two miles approximately three times per week. (Id.) Examination revealed some tender points associated with fibromyalgia. Joint, neurologic and other examinations were normal. (Id. at 0483-84.) Dr. Brecher concurred that plaintiff had a chronic fatiguing syndrome and also that her symptoms were consistent with fibromyalgia. Pamelor and Naprosyn were prescribed and an exercise program was recommended. (Id. at 0484-85.)
A GAF (Global Assessment Functioning) score is a scale used and adopted by the American Psychiatric Association to quantify and qualify mental disorders.
On October 16, 1998, plaintiff had an independent medical examination with Dr. Byron K. Mui, diplomate American Board of Internal Medicine and Infectious Disease. (Sullivan Aff., Ex. C, Bates Nos. 0457-63.) Plaintiff reported fatigue, headaches, dizziness, myalgia, arthralgia, memory loss, allergies and joint pain. (Id. at 0457.) Plaintiff also reported a history of a herniated disc, asthma, and allergic rhinitis. Examination revealed some lower extremity joint tenderness and a positive Epstein Barr antibody. (Id. at 0458-59.) Dr. Mui concluded that plaintiff suffered from fibromyalgia but noted that her complaints were all subjective and that the diagnosis of CFS was difficult to confirm. Dr. Mui further noted that plaintiff did not meet the CDC requirements for diagnosis of CFS. (Id. at 0459.) Dr. Mui recommended exercise and advised plaintiff to quit smoking. Dr. Mui concluded that plaintiff was a suitable candidate for rehabilitation and could return to gainful employment with some training. (Id. at 0460.)
On October 23, 1998, Deanne Denmead conducted a vocational review and transferrable skills analysis in light of plaintiff's medical history and restrictions. (Sullivan Aff., Ex. C, Bates Nos. 0464-66.) Ms. Denmead found seventy jobs that plaintiff could perform with little additional training (see id. at 0464-65) and noted that even with her reduced endurance and stamina, plaintiff could work as a medical administrative assistant or in claims processing (id. at 0466)
On November 17, 1998, Karen Maneen, Met DisAbility Case Management Specialist ("Maneen"), wrote to plaintiff and advised that her claim for LTD benefits had been denied. (Sullivan Aff., Ex. C, Bates Nos. 453-54.) Maneen indicated that plaintiff's application, which included input from Dr. Pecora, Dr. Linda Brecher, Dr. Byron S.K. Mui, and vocational expert Denmead, among others, would have to be denied because MetLife determined that plaintiff was not totally disabled. (Id. at 0454.) Specifically, Maneen noted that Dr. Brecher had not indicated that plaintiff's condition made her unable to work, nor had she listed the type of limitations that might prevent her from working. (Id. at 0453.) Additionally, Maneen noted that Dr. Pecora had included no objective findings in support of her disability in the APS and also that Dr. Mui opined that plaintiff was a suitable candidate for rehabilitation who could return to work with some reasonable education or training. (Id.) Finally, Maneen noted that vocational expert Denmead found plaintiff to have sufficient transferable skills to perform several sedentary occupations, such as customer-complaint clerk (DOT #241.367-014), receptionist (DOT #237.367-038), frame wirer (DOT #822.684-010), and telephone operator (DOT #235.662-022), and therefore that plaintiff was not totally disabled within the meaning of the Plan. (Id. at 0454.)
On January 3, 1999, plaintiff filed an appeal of MetLife's denial of LTD benefits. (Sullivan Aff., Ex. C, Bates Nos. 0447-450.) Plaintiff indicated that she felt her claim was improperly denied and submitted explanations in response to the comments in the MetLife denial letter. Plaintiff advised that Dr. Pecora knew her and her condition better than any other doctor, that Dr. Mui's opinions did not reflect her condition, and that her cognitive and repetitive motion limitations make any work impossible. (Id., Bates Nos. 0447-48.) In support of her appeal, plaintiff submitted additional medical records. None of the records, discussed in greater detail below, were for treatment received after July, 1998, and some reflected treatment received in 1997. (Id., Bates Nos. 0313-0444.) Only two submissions indicate that plaintiff received treatment after July, 1998, without specific details.
The first supplemental report submitted by plaintiff was from Dr. Robert B. Belaf sky, dated May 27, 1997, who diagnosed chronic allergic rhinitis. (Sullivan Aff., Ex. C, Bates No. 0379.) A head CT scan and brain MRI from 1997 were normal. (Id. at 0403-04.) The next report was from Independence Rehab, drafted by Kevin E. O'Keefe, Psy.D., and Christopher Royer, Psy.D., dated February 10, 1998. (Id. at 0360-70.) Plaintiff reported memory loss and difficulty concentrating and that she had been diagnosed with chronic fatigue syndrome. (Id. at 360.) Plaintiff completed a number of tests over two days and cooperative, diligent and motivated. (Id. at 0362.) Intellectual functioning tests showed plaintiff to be in the average range and neurophychologcal testing revealed plaintiff in the high-average range, which indicates intact cognitive functioning. Drs. O'Keefe and Royer noted that plaintiff's verbal processing, complex attention, and problem solving strengths were inconsistent with her reported memory loss. (Id. at 0366.) The doctors also reported that plaintiff had a low recall of word lists, severe impairment in complex figures, and severe impairment in reproduction of a complex figure after thirty minutes. (Id.) The doctors concluded that plaintiff's "pattern of performance was inconsistent with cerebral dysfunction secondary to Chronic Fatigue Syndrome" and that "[h]er deficits are consistent with a moderate level of emotional distress and depression." (Id. at 0367.) Psychotherapy was recommended.
Plaintiff also submitted a statement from her husband, who is not a medical professional, dated January 7, 1999, that described plaintiff's symptoms. Mr. Nichols reported that plaintiff had difficulty sleeping, difficulty finishing tasks, muscle and joint pain, and a poor memory. (Sullivan Aff., Ex. C, Bates No. 0322.) On January 25, 1999, Kathleen Zakrzewski, R.N., reviewed plaintiff's medical and administrative records. (Id. at 0304-07.) Zakrzewski noted that plaintiff did not meet the full criteria for CFS and that her symptoms were not incapacitating. (Id.) On February 17, 1999, plaintiff's physician, Dr. Ric Garrison, indicated that he had treated plaintiff since October, 1998 for allergies, CFS, asthma, migraine headaches, fibromyalgia, and depression. (Id. at 0192.) Dr. Garrison reported that plaintiff complained of dizziness, depression, confusion and shortness of breath. Dr. Garrison further reported that he believed plaintiff's statements, but could not quantify them. Dr. Garrison concluded that it would be difficult for plaintiff to be gainfully employed. (Id.)
On March 29, 1999, plaintiff's therapist, Dr. Paige Lewis, completed a mental assessment for plaintiff. (Sullivan Aff., Ex. C, Bates Nos. 0157-61.) Dr. Lewis indicated that plaintiff was "markedly limited" or "moderately limited" in every category of understanding and memory, sustained concentration and persistence, social interaction, and adaption. (Id. at 0157-60.) No addiction to drugs or alcohol was reported. Dr. Lewis concluded that plaintiff had debilitating and chronic depression which contributes to her limitations. (Id. at 0160.)
On April 21, 1999, Dr. Mark A. Moyer reviewed plaintiff's records and had a teleconference with Dr. Garrison. Dr. Garrison indicated he had referred plaintiff to a rheumatologist and that her sleep disorders were being treated by a medication adjustment. (Sullivan Aff., Ex. C, Bates No. 0147.) Dr. Garrison admitted that he had not specifically evaluated plaintiff's work limitations. (Id.)
On April 26, 1999, Dr. Robert D. Petrie reviewed plaintiff's medical history. (Sullivan Aff., Ex. C, Bates No. 0143-46.) Dr. Petrie noted symptoms of fatigue, dizziness, and depression, but concluded that there was no medical evidence to suggest these symptoms were completely disabling. (Id. at 0144.) Dr. Petrie noted a history of chronic cigarette smoking and past alcohol abuse. (Id. at 0145.) Dr. Petrie noted that several conditions are exclusionary for a diagnosis of CFS, such as alcohol abuse or a depressive disorder. Dr. Petrie determined that plaintiff's records did not establish CFS, but noted that plaintiff had allergic rhinitis with restrictions on environmental agents such as dust and gasses and allergens. Dr. Petrie concluded that plaintiff was not otherwise limited. (Id. at 0146.)
On May 20, 1999, Kim Ferguson, Met DisAbility Senior Case Management Specialist ("Ferguson"), wrote to plaintiff and advised her that MetLife's denial of LTD benefits would be upheld. (Sullivan Aff., Ex. C., Bates Nos. 0135-36.) Ferguson indicated that all of plaintiff's medical and vocational information in the record was thoroughly reviewed, and that an independent physician consultant, Dr. Mark A. Moyer, conducted a record review and teleconference with plaintiff's primary provider, Dr. Garrison. (Id., Bates No. 135.) Ferguson explained that although the medical records indicate complaints of fatigue, dizziness and depression, plaintiff did not meet the C.D.C. criteria for a diagnosis of chronic fatigue syndrome. Ferguson indicated that certain conditions, such as the diagnosis of a major depressive disorder, bipolar disorder, schizophrenia, or "alcohol and other substance abuse within two years before the onset of the chronic fatigue, and any time after," would be exclusionary for the diagnosis of chronic fatigue. (Id.) Ferguson went on to note that plaintiff had been diagnosed with depression and that neuropsychological test reports concluded that "the pattern of performance was inconsistent with cerebral dysfunction secondary to chronic fatigue syndrome . . . [plaintiff's] deficits are consistent with a moderate level of emotional distress and depression." (Id.) Additionally, Ferguson noted that plaintiff's psychological records do not support a conclusion that her depression left her totally disabled, specifically referring to Dr. Garrison's note that plaintiff did not appear fatigued or disheveled during examinations and instead acted and moved normally. (Id., Bates No. 135-36.) Ferguson then advised plaintiff that this decision represented the final decision on review. (Id., Bates No. 136.)
The telephone conference between Dr. Moyer and Dr. Garrison was as follows. (Sullivan Aff., Ex. C, Bates No. 0147.) Dr. Garrison advised that his last visit with plaintiff occurred on April 7, 1999, and that her symptoms of muscle pain, sleep disorder and aching had remained unchanged. (Id.) Dr. Garrison noted that the sleep disorder was being treated with adjustments to her anti-depressant medications. (Id.) Dr. Garrison also indicated that while he had referred plaintiff to a rheumatologist in California, she had not yet seen the specialist. (Id.) Dr. Garrison admitted that he had not specifically addressed whether plaintiff was disabled or capable of returning to work and indicated that he would be unable to determine such a thing. Dr. Garrison did indicate that he believed plaintiff's subjective complaints were valid and consistent with an inability to return to full-time employment, but noted that plaintiff was not fatigued or disheveled during any office examinations. (Id.)
Ferguson, tracking the report of Dr. Petrie, noted that "[c]hronic fatigue syndrome is a diagnosis of exclusion, which requires a careful and thorough assessment to rule out other conditions known to cause fatigue." (Sullivan Aff., Ex. C., Bates No. 0135.)
On June 4, 1999, plaintiff wrote a letter to Ferguson in response to the denial of her appeal. (Sullivan Aff., Ex. C., Bates No. 0111-13.) Plaintiff questioned why Ferguson referred to the exclusionary exception related to alcohol and/or drug abuse and advised that she had not had an alcoholic drink in fifteen years and had never abused any substance. (Id., Bates No. 0111.) Plaintiff additionally noted that while she suffers from depression related to her chronic illnesses (she states chronic fatigue syndrome, fibromyalgia, allergies, asthma, chronic obstructive pulmonary disorder), she has never been diagnosed with a major depressive disorder, bi-polar disorder, or schizophrenia. (Id.) Plaintiff finally challenged the vocational expert's determination that she could perform other work, stating that her reduced stamina was not considered. (Id. at 0112.)
The reference in Ferguson's letter appears to come from the report of Dr. Petrie, which noted plaintiff's problems with alcohol in her youth. (See Sullivan Aff., Ex. C, Bates Nos. 152-53.) Dr. Petrie did not state or imply that plaintiff currently had a problem with either drugs or alcohol, but merely indicated that such a specific problem must be definitively ruled out before a diagnosis of CFS can lie. (Id.)
On February 1, 2002, plaintiff filed the instant action, seeking LTD benefits pursuant to her ERISA plan. On March 22, 2002, defendant MetLife filed a motion for summary judgment, arguing that the denial of plaintiff's LTD benefits should be affirmed. Also on March 22, 2002, plaintiff filed a cross-motion for summary judgment, arguing that MetLife's denial of benefits was wholly unsupported by the record and she should be awarded benefits. On March 25, 2002, defendant Verizon filed a motion for summary judgment, joining in portions of the arguments submitted by MetLife in its briefs. For the reasons stated herein, the motions of defendants MetLife and Verizon will be granted, and plaintiff's cross-motion will be dismissed. Plaintiff's Complaint will also be dismissed.
II. DISCUSSION
Presently before this Court is defendant MetLife's motions for summary judgment on Counts I and IT of plaintiff's Complaint, the Verizon defendants' motion for summary judgment which seeks to have MetLife's claim determination upheld, and plaintiff's cross-motion for summary judgment on her Complaint. Plaintiff stipulated to a voluntary dismissal of Count II as to the Verizon defendants and did not oppose MetLife's motion for summary judgment on Count IT. As discussed herein, defendants' motions for summary judgment will be granted, and MetLife's claim determination will be upheld. Plaintiff' cross-motion for summary judgment will be dismissed. There being no genuine issue of material fact about the administrative record, and considering the deferential standard to be given to the determinations made by claim administrators, plaintiff's Complaint will likewise be dismissed.
A. Summary Judgment Standard for Cross-Motions
Summary judgment is appropriate when the materials of record "show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Fed.R.Civ.P. 56(c). A dispute is "genuine" if "the evidence is such that a reasonable jury could return a verdict for the non-moving party." See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986) A fact is "material" only if it might affect the outcome of the suit under the applicable rule of law.Id. Disputes over irrelevant or unnecessary facts will not preclude a grant of summary judgment. Id.
In deciding whether there is a disputed issue of material fact, the court must view the evidence in favor of the non-moving party by extending any reasonable favorable inference to that party; in other words, "[T]he nonmoving party's evidence `is to be believed, and all justifiable inferences are to be drawn in [that party's] favor.'" Hunt v. Cromartie, 526 U.S. 541, 552 (1999) (quoting Anderson, 477 U.S. at 255) The threshold inquiry is whether there are "any genuine factual issues that properly can be resolved only by a finder of fact because they may reasonably be resolved in favor of either party." Liberty Lobby, 477 U.S. at 250; Brewer v. Quaker State Oil Ref. Corp., 72 F.3d 326, 329-330 (3d Cir. 1995) (citing Anderson, 477 U.S. at 248) ("[T]he nonmoving party creates a genuine issue of material fact if it provides sufficient evidence to allow a reasonable jury to find for him at trial. ")
The moving party always bears the initial burden of showing that no genuine issue of material fact exists, regardless of which party ultimately would have the burden of persuasion at trial. See Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986); Jalil v. Avdel Corp., 873 F.2d 701, 706 (3d Cir. 1989), cert. denied, 493 U.S. 1023 (1990). However, where the nonmoving party bears the burden of persuasion at trial, "the burden on the moving party may be discharged by `showing' — that is, pointing out to the district court — that there is an absence of evidence to support the nonmoving party's case." Celotex Corp., 477 U.S. at 325. If the nonmoving party fails to oppose the motion by evidence such as written objection, memorandum, or affidavits, the court "will accept as true all material facts set forth by the moving party with appropriate record support." Anchorage Assocs. v. Virgin Islands Bd. of Tax Rev., 922 F.2d 168, 175 (3d Cir. 1990) (quoting Jaroma v. Massey, 873 F.2d 17, 21 (1st Cir. 1989)). If the nonmoving party has failed to establish a triable issue of fact, summary judgment will not be granted unless "appropriate," and only if movants are entitled to a judgment as a matter of law. Fed.R.Civ.Proc. 56(e); see Anchorage Assocs., 922 F.2d at 175.
The standard by which the court decides a summary judgment motion does not change when the parties file cross-motions. Weissman v. United States Postal Serv., 19 F. Supp.2d 254 (D.N.J. 1998) When ruling on cross-motions for summary judgment, the court must consider the motions independently, Williams v. Philadelphia Hous. Auth., 834 F. Supp. 794, 797 (E.D. Pa. 1993), aff'd, 27 F.3d 560 (3d Cir. 1994), and view the evidence on each motion in the light most favorable to the party opposing the motion. See Matsushita, 475 U.S. at 587.
B. Review of the Determination of a Claim Administrator
The defendants, MetLife and the Verizon defendants, assert that the determination made by Claim Administrator NetLife on plaintiff's disability claim was reasonable and supported by substantial evidence in the record. Plaintiff does not contest that the deferential arbitrary and capricious standard applies, but asserts that MetLife's determination should be reversed because their denial of long-term disability benefits was wholly unsupported by the record. Plaintiff also asserts that MetLife improperly required her to present objective evidence of her chronic fatigue syndrome.
It is unclear from her submissions whether plaintiff cross-moves for summary judgment against both MetLife and the Verizon defendants. Plaintiff's briefs address only MetLife's liability.
Where, as here, the ERISA benefit plan gives the Plan's Administrator discretion in the determination of eligibility for benefits and also authority to construe the terms of the Plan, the denial of benefits is reviewed under the arbitrary and capricious standard. Mitchell v. Eastman Kodak Co., 113 F.3d 433, 437-38 and n. 4 (3d Cir. 1997) (citing Firestone Tire Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989)); see also Courson v. Bert Bell NFL Player Retirement Plan, 214 F.3d 136, 142 (3d Cir. 2000) Under the deferential review standard, a plan administrator's interpretation of a plan may be disturbed "only if it is `without reason, unsupported by substantial evidence or erroneous as a matter of law.'" Abnathya v. Hoffman-LaRoche, Inc., 2 F.3d 40, 45 (3d Cir. 1993) (quoting Adamo v. Anchor Hocking Corp., 720 F. Supp. 491, 500 (W.D. Pa. 1989)) A decision is supported by "substantial evidence if there is sufficient evidence for a reasonable person to agree with the decision." Courson, 214 F.3d at 142 (quotingDaniels v. Anchor Hocking Corp., 758 F. Supp. 326, 331 (W.D. Pa. 1991)). The review of a plan administrator's claim determination, therefore, is highly deferential. See Courson, 214 F.3d at 142. A district court may not substitute its own judgment for that of the administrator when reviewing a determination of eligibility for plan benefits. See Mitchell, 113 F.3d at 439.
Plaintiff Nichols argues that MetLife's decision denying her long-term disability benefits was not supported by the record and was therefore arbitrary and capricious. She notes that MetLife's initial denial letter cited a lack of objective medical findings in support of her CFS, which she asserts is contrary to the law of Mitchell v. Eastman Kodak, 113 F.3d 433 (3d Cir. 1997) (ruling that Administrator's requirement for objective medical evidence in support of CFS diagnosis in Mitchell's case under Mitchell's plan was arbitrary and capricious) Plaintiff also contests NetLife's conclusions upon the denial of her appeal, specifically that no diagnosis of CFS could be made because alcohol/drug abuse had not been ruled out and because plaintiff suffered from depression.
1. The Plan
In order to determine whether MetLife's decision to deny plaintiff long-term disability ("LTD") benefits was arbitrary, it is useful to look at what the plan documents require for a disability determination, since the Claims Administrator (MetLife) must "discharge his duties with respect to a plan . . . in accordance with the documents and instruments governing the plan insofar as such documents and instruments are consistent with the provisions of [ERISA]." 29 U.S.C. § 1104 (a)(1)(D). To be eligible for LTD benefits under plaintiff's plan, the claimant must suffer a disability from a non-job-related accidental injury or illness that lasts longer than 53 weeks. Under plaintiff's plan, you are disabled if you are:
• Unable to engage in any occupation or employment for which you are qualified (or may reasonably become qualified based on your education, training or experience) or,
• Incapable of performing the requirements of any job that pays (on a full-time basis) fifty percent or more of your base pay as determined by Mutual of Omaha, the Plan Administrator.[] Note: You cannot limit the scheduled hours of your job simply to keep the pay below fifty percent of your previous base pay and retain LTD benefits.
Mutual of Omaha preceded MetLife as the Administrator of plaintiff's plan. There is no dispute that MetLife is currently the Claims Administrator of plaintiff's plan.
(Sullivan Aff., Ex. B, Bates No. 0059.) LTD benefits are not automatic and claimants are expected to provide proper and continuous proof of disability. (Id. Bates Nos. 0059-61.) Therefore, in order to meet her burden of demonstrating that she became disabled on May 21, 1998, plaintiff was required to demonstrate that she was unable to engage in any occupation or employment for which she was qualified or that she was incapable of performing the requirements of any job that pays (on a full-time basis) fifty percent or more than her base pay.
2. Plaintiff's Record Support
In order to determine whether plaintiff Nichols has met her burden of showing that the decision of the Claim Administrator (MetLife) was arbitrary and capricious, this Court must view the administrative record as a whole. Mitchell, 113 F.3d at 440 (citing Smith v. Califano, 637 F.2d 968, 970 (3d Cir. 1981)) Under the arbitrary and capricious standard, the whole record consists of the evidence that was before the administrator when the disability determination was made. Mitchell, 113 F.3d at 440 (citing Luby v. Teamsters Health, Welfare, and Pension Trust Funds, 944 F.2d 1176, 1184, n. 8 (3d Cir. 1991)).
The Court notes that the document, dated October 14, 1999, from the Social Security Administration, submitted as Exhibit 7 in plaintiff's Appendix in support of her cross-motion and referred to in paragraphs 26 and 27 of her counter-statement of undisputed facts and at pages 2-3 of her moving brief, is not part of the administrative record reviewed by Claim Administrator MetLife prior to the final denial of plaintiff's application for LTD benefits. Plaintiff does not dispute that this document was never submitted to MetLife and instead asserts that "the Social Security Administration's finding may still be considered as evidence that plaintiff was `totally disabled' during the relevant time period since the [SSA's] award of benefits to plaintiff was retroactive to May 8, 1997." (Pl.'s Reply at 8-9.) As far as the Court is aware from this record, plaintiff never sought MetLife's reopening of her claim denial based upon the subsequent finding of total disability by the Social Security Administration, nor has plaintiff sought an order of this Court to require such reconsideration by MetLife.
Nichols highlights several portions of the administrative record, which she argues clearly demonstrate that she met her burden of showing proof of loss and that MetLife's denial of benefits was clearly erroneous. Specifically, plaintiff points to Dr. Pecora's conclusions on the Medical Condition Questionnaire for Chronic Fatigue Syndrome, stating that plaintiff is "unable to do any jobs that require physical labor or mental activities" (Sullivan Aff., Ex. C, Bates No. 0503), Dr. Pecora's conclusion that plaintiff is not able to be gainfully employed (id., Bates No. 0225), Dr. Lewis's mental capacity evaluation which concluded that plaintiff's impairments were severe enough to seriously affect her ability to function (id., Bates Nos. 0139-42), and Dr. Garrison's statement that plaintiff's condition would make it difficult for her to be gainfully employed (id., Bates No. 0192). Plaintiff also points to various medical records and notes from Dr. Brecher and Dr. Garrison in support of her claim. (Id., Bates Nos. 0182-200.)
Defendants, conversely, point to the independent medical examination performed by Dr. Mui, which concluded plaintiff was a good candidate for rehabilitation, vocational expert Denmead's report which concluded that plaintiff could perform certain sedentary jobs despite her symptoms, the lack of medical records for treatment from July 1998 through February 1999, the conclusion of Nurse Zakrzewski which stated that plaintiff's medical records did not meet the criteria for a diagnosis of fibromyalgia or chronic fatigue syndrome, the record review conducted by Dr. Petrie who concluded that plaintiff did not meet the CDC criteria for chronic fatigue and that her restrictions were limited to environmental and allergic agents, and finally Dr. Moyer's record review and conversation with Dr. Garrison.
In order to properly determine whether MetLife's decision was arbitrary, it is first necessary to analyze the Third Circuit's opinion in Mitchell, upon which plaintiff bases the bulk of her argument. Plaintiff asserts that the Mitchell court held that it is arbitrary and capricious to ever require objective medical evidence in the context of a claim for LTD benefits as a result of CFS. (See Pl.'s Br. at 11-13; Pl.'s Reply Br. at 7-8.) In Mitchell, the Third Circuit was asked to determine whether the denial of a claim for benefits under a LTD plan governed by ERISA made by a participant (Mitchell) suffering from CFS was arbitrary and capricious. Mitchell, 113 F.3d at 435. According to the terms of the Plan involved in Mitchell, a participant is eligible for LTD benefits if he suffers from a disability that renders him "totally and continuously unable to engage in any substantial Gainful Work," defined by the Plan as paid employment. Id. The Claims Administrator in Mitchell, also MetLife, denied LTD benefits on the ground that Mitchell had failed to provide "objective medical evidence that [his] condition made [him] totally and continuously unable to engage in any substantial gainful work for which he was qualified . . ." Id. at 436. The Third Circuit noted that the Administrator's letters denying benefits were terse and ambiguous. Id. at 442. The Third Circuit also noted that because there is no definitive test for CFS, it was impermissible for the Administrator to require clinical evidence of etiology. Id. at 443. Additionally, and significantly for this case, the Third Circuit expressly limited its finding, writing that "[a]lthough in some contexts it may not be arbitrary and capricious to require clinical evidence of the etiology of allegedly disabling symptoms in order to verify that there is no malingering, we conclude that it was arbitrary and capricious to require such evidence in the context of this Plan and CFS." Id. at 443-44. Importantly, the Third Circuit found that Mitchell's diagnosis of CFS was correct and that his symptoms render him incapable of sustaining prolonged activities, including any gainful employment, stating: "There is no evidence to the contrary." Id. at 441 (emphasis added).
The facts of this case are somewhat similar to those in Mitchell, but there are some important differences. Here, plaintiff claims that she is completely disabled as a result of CFS and fibromyalgia. MetLife initially denied benefits on November 17, 1998, stating in part that Nichols's then provider, Dr. Pecora, failed to "provide any objective findings consisting of lab work or diagnostic testing that would give us the etiology behind your diagnosis." (Sullivan Aff., Ex. C, Bates No. 0453-54.) The denial letter, however, went on to detail several other reasons for the denial, specifically including lack of information indicating any inflammatory process or connective tissue disorder (as would be associated with fibromyalgia), Dr. Mui's opinion that plaintiff was a suitable candidate for rehabilitation, and the vocational expert's opinion that plaintiff could perform a number of sedentary occupations despite her reported symptoms. (Id.)
If this were the only basis for denial, MetLife's determination of November 17, 1998 may have been contrary to law, because the Third Circuit held in Mitchell, 113 F.3d at 443, that the etiology of CFS is unknown and requiring medical evidence of CFS's etiology is therefore irrational. In Mitchell, however, unlike the present case, there was no dispute in the record that CFS was Mitchell's diagnosis.
Plaintiff attacks Dr. Mui's opinion as being based on a one time examination and false tests of endurance (stating repeating a task once or twice is not a proper gauge for her ability to conduct "repetitive motions") and attacks the vocational expert's opinion because of the limitations indicated in the transferrable skills report (indicating that "[plaintiff's] [diagnosis] (CFS) by its nature involves endurance and stamina components which are subjective by nature and are not addressed in the DOT, nor can they be factored into a transferrable skills analysis.") (Id. at 0466.) However, immediately after the portion quoted by plaintiff as a limitation on the opinion, appears a conclusion statement by the vocational expert, which opines, "since [plaintiff] has both clerk and medical expertise, she could do a sedentary or light duty job in the administrative/office mgmt. part of a medical office, in addition to claims in either HMO of disability processing . . ." (Id.) This conclusion appears to modify the initial finding that 70 alternate positions are available in light of plaintiff's subjective CFS symptoms.
Additionally, in MetLife's final denial of plaintiff's claim, dated May 20, 1999 (id. at 0135), MetLife no longer indicated that plaintiff must provide medical evidence of the etiology of her illness. There had been further review of the entire file including additional medical and vocational information accumulated since November, 1998, including review by MetLife's "independent physician consultant" (id. at 0135), Network Medical Review Company, through Dr. Petrie and Dr. Moyer. Dr. Petrie is a Diplomat of the American Board of Preventative Medicine and Occupational Medicine and the American Board of Family Practice who evaluated the records regarding Ms. Nichols's functional ability for daily living and occupational abilities (id. at 0143-0146), finding that she does not meet the CDC criteria for a diagnosis of CFS. Dr. Moyer is Board Certified in Internal Medicine and in Infectious Disease, and he gathered additional information by telephone conference with plaintiff's treating physician, Dr. Garrison. (Id. at 0147.)
MetLife determined that plaintiff's medical records contained references to certain symptoms associated with CFS, it was a diagnosis of exclusion which required careful and thorough assessments to rule out other potential causes of fatigue, such as a resumption of plaintiff's severe prior alcohol abuse or substance abuse and pre-existing depression, among other things. (Id. at 0135-36.) Additionally, the letter referred to Dr. Garrison's opinion that plaintiff was unable to return to work, which was based primarily upon plaintiff's reports of subjective symptoms. (Id.) The letter concluded that "the medical information does not support a severe condition that would preclude employment, therefore you do not qualify for benefits as defined by your Group Long Term Disability Plan." (Id. at 0136.) This indicates that MetLife determined, after reviewing all the medical evidence, that plaintiff's condition would not prevent her from "engaging in any occupation or employment for which [she is] qualified" or would not make her "incapable of performing the requirements of any job that pays (on a full-time basis) 50% or more of [her] base pay," and therefore she did not qualify for LTD benefits under the terms of her Plan. Objective medical evidence of the origin of CFS was not the only reason for the denial of benefits in this case, unlike Mitchell. Additionally, plaintiff complained of other symptoms in addition to her CFS, some of which could have been confirmed with objective findings but were not.
Likewise, plaintiff's ultimately favorable Social Security disability determination does not assist in meeting her burden, since it was never submitted to MetLife (again, unlike Mitchell, supra, in which the favorable Social Security award was considered in the administrative record). Plaintiff submitted this favorable determination only to this Court and attempts to rely upon it although there is no dispute it was never submitted to MetLife. In this case, the only Social Security determination that was presented to the Claim Administrator was one, dated February 20, 1998, which denied her claim. (Sullivan Aff., Ex. C, Bates Nos. 0528-29.) The notice stated, "[b]ased on a review of your health problems, you do not qualify for benefits on this claim. This is because you are not disabled under our rules." (Id., Bates No. 0528.) At plaintiff's request, the case was reviewed again, considering additional evidence from November 1998 submitted in support of her claim, and again denied. (Id., Bates No. 0323-27.) The notice, dated December 10, 1998, indicated that plaintiff's symptoms of chronic fatigue, asthma, allergies, neck muscle spasms, back pain, dizzy spells, headaches, and depression were not shown to be severe enough to prevent plaintiff from working and conducting her usual activities. (Id., Bates No. 0323.) The Social Security claim that plaintiff refers to in her moving papers was not before the Administrator and therefore cannot be considered by this Court. See Mitchell, 113 F.3d 433.
Finally, this case differs from Mitchell in that there is ample evidence in the administrative record that plaintiff's condition is not disabling within the meaning of the Plan, whereas in Mitchell there was no such contrary evidence. See Mitchell, 113 F.3d at 441. The doctors inMitchell had a difficult time initially diagnosing the condition and its severity from its onset in 1988 because at the time the condition was not widely known. Ultimately, however, Mr. Mitchell's treating physician, Dr. Gantz, clarified the symptoms and explained CFS and its disabling effect on Mitchell to the Administrator, and the CFS diagnosis inMitchell was not disputed. Id.
Conversely, the record in the present case contains medical and other vocational evidence which supports MetLife's determination that she is not totally disabled within the meaning of her Plan. First, there is Dr. Mui's conclusion that plaintiff suffered from some limitations, but that she could return to work after some rehabilitation. Although plaintiff disagrees with Dr. Mui and some other providers who found no disability, there is nothing in the record that indicated these records and opinions were unsound. Second, there is Ms. Deanmead, the vocational analyst, who determined that there were several sedentary jobs that plaintiff could perform with her limitations. Third, there is the opinion of Nurse Zakrzewski, who concluded that plaintiff had submitted no objective evidence in support of her subjective symptoms of memory loss, joint pain, and muscle weakness. These symptoms, which are associated with CFS and other conditions, could be measured with objective medical tests.Fourth, Dr. Petrie's medical report review concluded that Nichols did not meet the CDC's criteria for a diagnosis of chronic fatigue syndrome and that her demonstrated limitations did not render her completely disabled. Fifth, Dr. Moyer's determination, after discussing plaintiff's administrative record with Dr. Garrison, that no clear work disability arose from plaintiff's subjective complaints. Dr. Garrison, plaintiff's treating physician, stated only that he believed plaintiff's complaints were genuine and that they prevented a return to full-time work. Garrison made no determination about complete disability. (Sullivan Aff., Ex. C, Bates No. 0147.)
There is no dispute about the medical reports or opinions contained in the record; rather there is only a dispute about whether these records demonstrate that plaintiff is impaired from an illness to so great a degree that the administrator's determination is arbitrary and capricious under the Plan. The Claims Administrator in this case, MetLife, twice reviewed the record and determined that plaintiff was not eligible for benefits under the plan. This Court can appreciate plaintiff's position and is sympathetic to her impairments. There is, however, sufficient evidence in the record to support MetLife's denial of benefits and sufficient evidence from which a reasonable person could conclude that the decision was correct. Certainly there is also some evidence that supports a finding of disability. Given the deferential standard to be afforded to Administrator's determinations, this Court will affirm the denial of benefits.
C. Count One — Payment of Benefits Under the Plan
Defendant MetLife alternatively argues that Count I of plaintiff's Complaint against it must be dismissed on summary judgment because MetLife, the Claim Administrator, is not responsible for the payment of any benefits under the plan. Plaintiff contends that because MetLife is a "fiduciary" under the plan, with discretionary power over the award of benefits, it may be sued for "recovery of benefits" pursuant to Section 502(a)(1)(B) of ERISA. See Curcio v. John Hancock Mutual Like Ins. Co., 33 F.3d 226 (3d Cir. 1994); Vaughn v. Metropolitan Life Ins. Co., 87 F. Supp.2d 421, 424-27 (E.D. Pa. 2000).
The Verizon defendants, who join in points I and II only of MetLife's moving brief, relating to the propriety of MetLife's claim determination, make no such alternative argument in support of summary judgment on plaintiff's Complaint. In light of the stipulation of dismissal between plaintiff and Verizon, filed May 20, 2002, it appears that the Verizon defendants seek only to have MetLife's claim determination upheld.
Because this Court found that the decision of MetLife to deny LTD benefits to plaintiff was not arbitrary and capricious, without reason, unsupported by substantial evidence or erroneous as a matter of law, this Court need not address this issue here because no benefits are due under the Plan. A reasonable person could certainly agree with MetLife's conclusion that plaintiff was not totally disabled, and therefore it is of no import to this case who would be responsible for payment of such benefits in a case where same were determined warranted.
D. MetLife's Motion for Summary Judgment on Count II (Section 502(c) of ERISA)
MetLife also moves for summary judgment on Count II of plaintiff's Complaint, which alleges that defendants violated Section 502(c) of ERISA by failing to provide her with plan documents as required by the Statute. The Verizon defendants and plaintiff submitted a signed stipulation of dismissal with prejudice as to Count II against the Verizon defendants. Although no stipulation of dismissal was submitted on this Count for defendant NetLife, plaintiff appears to abandon her Count II claim against MetLife, since she failed to address this portion of MetLife's motion in her opposition to the summary judgment motion or in either her memorandum or reply brief in support of her own cross-motion. Therefore NetLife's motion for summary judgment on this issue will be deemed unopposed.
Section 502(c) reads, in relevant part:
Any administrator who fails . . . to comply with a request for any information which such administrator is required by this subchapter to furnish to a participant or beneficiary by mailing the material requested [to the participant or beneficiary] within 30 days after such request may in the court's discretion be personally liable to such participant or beneficiary in the amount of $100 a day from the date of such failure or refusal, and the court may in its discretion order such other relief as it deems proper.29 U.S.C. § 1132 (c). The Administrative Services Agreement between MetLife and Verizon, formerly Bell Atlantic Corporation, the plan administrator, explicitly provides that Bell Atlantic, not MetLife, is responsible for providing Plan Participants with plan documents. Appendix C to the Administrative Services Agreement provides, in relevant part:
The term "administrator" is defined by the ERISA statute as "(i) the person specifically so designated by the terms of the instrument under which the plan is operated; (2) if an administrator is not so designated, the plan Sponsor; . . ." The Plan itself clearly identifies Bell Atlantic, not MetLife, as the Plan Sponsor and Plan Administrator.See Sullivan Aff., Ex. B., Bates No. 0042. Plaintiff identifies MetLife as a Plan Administrator in her Complaint, see Compl., ¶ 5, which MetLife denies in its Answer, see Answer of Def. MetLife, ¶ 5, but offers no evidence in opposition to MetLife's Motion for Summary Judgment in support of that identification. MetLife, therefore, is not a Plan Administrator as defined in ERISA in this case.
When performing services under this Agreement, MetLife shall rely upon such documents, letters, manuals and other administrative releases as Bell Atlantic may provide or as Bell Atlantic may cause to be provided to MetLife including, but not limited to . . . Bell Atlantic Benefit Publications to Employee (including Summary Plan Descriptions), Highlights Brochures and Inserts, Printed information distributed to benefit administrators . . . [and] such letters, guidelines and releases distributed by Bell Atlantic and Bell Atlantic Payroll, as may be appropriate.
(Sullivan Aff., Ex. A, Administrative Services Agreement ("ASA"), Appx. C.) Additionally, the Plan itself advises participants of their entitlement to plan documents and directs them to "[o]btain [their] own copies of all plan documents and other plan information by writing to the Plan Sponsor in care of the Secretary of the Bell Atlantic Benefit Claims Committee." (Sullivan Aff., Ex. B.)
On three occasions, June 4, 1999, July 2, 1999, and July 5, 1999, plaintiff Nichols wrote to MetLife requesting plan documents. (Sullivan Aff., Ex. B, Bates nos. 0124-26, 0119-20.) MetLife responded to plaintiff in letters dated June 28, 1999 and July 22, 1999, indicating that MetLife was not responsible for the provision of plan documents and directing plaintiff to contact Bell Atlantic for such information. (Sullivan Aff., Ex. B, Bates Nos. 0115, 0118, 0123, and 0099.)
Because MetLife was not the Plan Administrator, and also because both the Plan and the Administrative Services Agreement designated Bell Atlantic, plaintiff's employer and the plan sponsor, as the party responsible for distributing plan documents, there is no genuine issue of material fact in dispute as to whether MetLife can be liable to plaintiff under Section 502(c) of ERISA for failing to provide fund documents. Plaintiff submitted no opposition to MetLife's motion for summary judgment on this point. Therefore, because MetLife had no responsibility to provide plan documents, summary judgment on Count II of plaintiff's Complaint is appropriate, and MetLife's motion on that issue shall be granted. Count II will be dismissed with prejudice.
III. CONCLUSION
For the foregoing reasons, the Court will grant defendant MetLife's motion for summary judgment, will grant the Verizon defendants' motion for summary judgment, and will dismiss plaintiff's cross-motion for summary judgment. Plaintiff's Complaint will also be dismissed.
The accompanying Order is entered.