The opinion of the court was delivered by: Lucy H. Koh United States District Judge
ORDER DENYING CROSS-MOTIONS FOR SUMMARY JUDGMENT (re: dkt. #40, 45)
In this action, each party has filed a motion for summary judgment under Federal Rule of Civil Procedure 56. Those motions are currently set for a hearing on August 25, 2011. The Court 18 deems these motions appropriate for resolution without oral argument, and vacates the August 25, 19 2011 motion hearing and case management conference. See Civ. L.R. 7-1(b). For the reasons set 20 forth below, the Court DENIES both parties' motions for summary judgment.
Hewlett-Packard Company in August 1982, and is a beneficiary of Defendant, the Hewlett-Packard 25 Company Disability Plan. Id. at ¶¶ 7-8. Beginning in or around 1996, Plaintiff began to suffer 26 pain in her forearms, and was eventually diagnosed with chronic repetitive stress injury in her wrist 27 and fingers. Plaintiff submitted a worker's compensation claim that resolved on July 24, 2001 28 when Plaintiff and Hewlett-Packard ("HP") stipulated that Plaintiff had a permanent disability of
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 24 52% as of October 8, 1991 based on injuries to Plaintiff's hands, wrists, and cervical spine. See 2 Administrative Record ("AR") at 300. After 2001, Plaintiff continued to work at HP with 3 limitations regarding lifting more than three pounds and sitting or driving more than two hours. 4
AR 301. Plaintiff alleges that she became fully disabled on or about May 1, 2005, with injuries to 5 her hands, wrist, and cervical spine due to long hours sitting and working on a keyboard, combined 6 with stress, depression, and anxiety from the outsourcing of her job. Compl. at ¶¶ 10-12. Plaintiff 7 received short-term disability benefits from May 1, 2005 through October 30, 2005. Id. at ¶ 13.
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"), 10 the Plan's claims administrator, periodically reviewed and approved Plaintiff's claim for long-term disability benefits. Id. at ¶ 14. Plaintiff initially returned to work on August 1, 2005 with various accommodations designed to limit extensive use of her hands and wrists, including speech 13 recognition software, limited requirement to produce written reports, and telecommuting. AR 592. 14
However, Plaintiff's return to work did not last long, apparently due to extreme anxiety and 15 depression. On November 28, 2005, Plaintiff underwent an independent psychiatric examination 16
Shakir. Based on both doctors' finding that Plaintiff was unable to perform her customary work, 18
On January 3, 2007, Defendant informed Plaintiff that her initial 24-month period of 20 disability would end on May 1, 2007, as benefits for disability caused by a nervous or mental 21 disorder had a strict two-year limit. AR 363-363. However, Defendant also allowed Plaintiff an 22 opportunity to provide any additional diagnoses that contributed to her disability. Plaintiff 23 responded with: (1) an explanation of her upper extremity injuries and limitations as noted in her 24 worker's compensation stipulation of a 52% permanent disability; and (2) an additional evaluation 25 by her chiropractor Dr. Thomas Antone that Plaintiff was unable to work. AR 305-308. In 26 addition, Plaintiff provided Defendant with the results of her August 14, 2007 MRI, which found 27 that Plaintiff had "[s]ignificant degenerative disease most severe in C4-C5 with significant nerual 28 foraminal stenosis from the degenerative osteophytes" and that were "also degenerative disc
("IPE") with Dr. Thomas J. Becker, and in August 2006, had a second IPE with Dr. Saad A.
Defendant approved Plaintiff's claim for long-term benefits. 19 disease at C5-C6 and C6-C7." AR 157. Again, Defendant extended Plaintiff's long-term disability 2 benefits. 3
The same pattern continued through 2008 to mid-2009. In February and April 2008, Sedgwick reviewed Plaintiff's medical records, including new evaluations from Plaintiff's 5 chiropractors, and extended Plaintiff's long-term disability benefits. In February and August of 6
2008, Plaintiff's then-current chiropractor, Lynn Peterson, D.C., provided Sedgwick with reports 7 diagnosing Plaintiff with degenerative disc disease, chronic tendonitis in her elbow and wrists, and 8 significant spurring in her spine. AR. 217. On September 5, 2008, Sedgwick extended Plaintiff's 9 long-term disability benefits through March 2009, but also informed Plaintiff that "if there is no 10 marked improvement," it would recommend that Plaintiff undergo an independent medical 11 examination ("IME") by a neurosurgeon. AR 20.
In April 2009, a representative of the Plan sent Plaintiff's medical records for review by a Registered Nurse ("RN"). The RN review concluded that "the medical information does not 14 substantiate disability at this time." AR 22. On May 11, 2009, after being advised by Defendant 15 that her medical records were insufficient to substantiate a permanent disability, Plaintiff was 16 evaluated by Dr. L. Neena Madireddi. Upon a review of Plaintiff's medical records and a physical 17 examination, Dr. Madireddi concluded: 18
Given her multiple medical problems, Ms. Hinz clearly cannot use her upper extremities for any type of sedentary work due to her multiple upper extremity disabilities. In addition, she cannot perform a light, medium, or heavy work job since she cannot be upon her feet due to her lower extremity condition. It is my medical opinion that she is permanently disabled from gainful employment at this time and she should be considered permanently disabled and be eligible for long term disability benefits.
AR 132. On June 16, 2009, Plaintiff provided a new report from an April 15, 2009 appointment 23 with her chiropractor, Anne M. Stephanson, D.C. The report noted Plaintiff's complaints of pain in 24 her spine and neck, and assessed ...