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Pamela Hinz v. Hewlett Packard Company Disability Plan

March 30, 2011

PAMELA HINZ,
PLAINTIFF,
v.
HEWLETT PACKARD COMPANY DISABILITY PLAN, DEFENDANT.



The opinion of the court was delivered by: Lucy H. Koh United States District Judge

ORDER DENYING PLAINTIFF'S MOTION FOR DE NOVO STANDARD OF REVIEW; ADOPTING HEIGHTENED ABUSE OF DISCRETION REVIEW

(re: docket #25)

the standard of review. See Dkt. #25. Plaintiff seeks a de novo standard of review because Defendant Hewlett-Packard Company Disability Plan (Defendant or "the Plan") has yet to issue a 19 decision on appeal in connection with the termination of Plaintiff's long-term disability benefits. 20

Court finds this matter appropriate for resolution without oral argument, and vacates the March 31, 22 2011 motion hearing. See Civ. L.R. 7-1(b). The March 31, 2011 Case Management Conference 23 remains as set. For the reasons set for below, the Court DENIES Plaintiff's motion for a de novo 24 standard of review, and instead finds a heightened abuse of discretion review appropriate. 25

Presently before the Court is Plaintiff Pamela Hinz's motion for summary adjudication of Defendant has filed an opposition, arguing for an abuse of discretion standard of review. The

I.BACKGROUND

Plaintiff filed suit on August 17, 2010 under the Employment Retirement Income Security Act of 1974, 29 U.SC. §1001 et seq. ("ERISA"). See Compl. Plaintiff became an employee of the Hewlett-Packard Company in August 1982, and is a beneficiary of the Plan. Id. at ¶¶ 7-8. Plaintiff 2 alleges that she became disabled on or about May 1, 2005, with injuries to her hands, wrist, and 3 cervical spine due to long hours sitting and working on a keyboard. Id. at ¶¶ 10-12. Plaintiff 4 received short-term disability benefits from May 1, 2005 through October 30, 2005. Id. at ¶ 13. 5

Plaintiff's claim for long-term disability benefits under the Plan was approved on December 23, 2005. Id. From December 23, 2005 through August 15, 2009, Sedgwick CMS ("Sedgwick"), 7 the Plan's claims administrator, periodically reviewed and approved Plaintiff's claim for long-term 8 disability benefits. Id. at ¶ 14. The Plan provides Sedgwick with discretionary authority to decide 9 any appeal of denial of benefits. Under the Plan, after receipt of the request for an appeal, 10 Sedgwick has 45 days to act upon that request, with a potential additional 45 day extension if necessary. Section 8(c) of the Plan. In amendment to the Plan effective April 1, 2006 entitled "Limitations on Actions," no suit or legal action may be filed more than one year after the earlier 13 of: i) the date of the final decision on review; or ii) the date a final decision on review "should have 14 been issued." Section 9(f) of the Plan. 15

By a letter dated August 20, 2009, Sedgwick advised Plaintiff that her claim for long-term disability benefits was denied as of August 16, 2009 because Plaintiff's medical documents failed 17 to validate her inability to engage in full-time regular work. Id. at ¶ 15. Defendant based this 18 initial denial on the report of Dr. Robert Y. Pick. After reviewing Plaintiff's administrative file, 19 but not examining Plaintiff herself, Dr. Pick concluded that Plaintiff's "multiple diagnoses are not 20 supported by objective medical information." The August 20, 2009 letter also notified Plaintiff 21 that if she did not receive notice of Sedgwick's decision by the end of the 90-day period, "the 22 appeal can be considered denied." Plaintiff appealed the denial on January 20, 2010, and Sedgwick 23 acknowledged receipt of the appeal in a letter dated to Plaintiff on February 9, 2010. Id. at ¶¶ 15-24 . In that appeal, Plaintiff submitted additional medical information and documents in support of 25 her claim. Id. 26 To date, Defendant has not responded to Plaintiff's appeal.
or any part" of a claim "shall be rendered forthwith if the pleadings, depositions, answers to 4 interrogatories, and admissions on file, together with the affidavits, if any, show that there is no 5 genuine issue as to any material fact and that the moving party is entitled to judgment as a matter 6 of law." See Fed. R. Civ. P. 56(b), (c). Material facts are those that may affect the outcome of the 7 case. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A dispute as to a material 8 fact is "genuine" if the evidence is such that "a reasonable jury could return a verdict for the 9 nonmoving party." See id. "[A]ll justifiable inferences must be drawn in [the non-movant's] 10 favor." See United Steelworkers of Am. v. Phelps Dodge Corp., 865 F.2d 1539, 1542 (9th Cir. for its motion and identifying those portions of the pleadings, depositions, interrogatory answers, 14 admissions and affidavits, if any, that it contends demonstrate the absence of a genuine issue of 15 material fact. See Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). A party opposing a properly 16 supported motion for summary judgment "may not rest upon the mere allegations or denials of 17 [that] party's pleading, but . . . must set forth specific facts showing that there is a genuine issue for 18 trial." See Fed. R. Civ. P. 56(e); see also Liberty Lobby, 477 U.S. at 250. The opposing party need 19 not show the issue will be resolved conclusively in its favor. See Liberty Lobby, 477 U.S. at 248-20 49. All that is necessary is submission of sufficient evidence to create a material factual dispute, 21 thereby requiring a jury or judge to resolve the parties' differing versions at trial. See id. 22

Defendant's termination of her disability benefits. Defendant argues that, despite the failure to rule 26 on Plaintiff's appeal, an abuse of discretion standard of review is appropriate. 27 28

II. LEGAL STANDARDS

Rule 56 of the Federal Rules of Civil Procedure provides that summary judgment as to "all 1989) (en banc) (citing ...


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