Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Barnett v. Southern California Edison Co. Long Term Disability Plan

United States District Court, E.D. California

July 5, 2016





         Plaintiff William Barnett (“Barnett”) commenced this action under the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq., challenging the termination of his long-term disability benefits by Defendant Southern California Edison Long Term Disability Plan (“the Plan”). Judgment was previously entered in the Plan’s favor. Doc. 55. Following Barnett’s appeal, the Ninth Circuit vacated the Court’s judgment and remanded for further proceedings on one issue. Barnett v. So. Cal. Edison Co. Long Term Disability Plan, 633 F. App’x 872 (9th Cir. 2015) (Doc. 77); Doc. 82. Upon remand, Barnett has filed a motion for attorney’s fees, benefits and interest (Doc. 85) and the Plan has moved for summary judgment (Doc. 86). This matter is appropriate for resolution without oral argument. See E.D. Cal. Civ. L.R. 230(g). Having carefully considered the record in this case in light of the relevant law, the Court GRANTS the Plan’s motion for summary judgment and GRANTS IN PART and DENIES IN PART Barnett’s motion for attorney fees, benefits and interest.


         I. Facts[1]

         Southern California Edison Company (“Edison”) provides a Long Term Disability (“LTD”) Plan[2] that is “designed to provide partial income replacement to eligible full-time employees who are disabled and unable to perform their regular and customary job for the first two years of disability, and any reasonable job for the company after two years.” A.R. at 3553. Edison employees participating in the Plan become eligible for LTD benefits after they have been unable to perform their regular and customary job for six continuous months. Id. at 3555. After two years of disability, Plan participants must be “totally disabled in order to remain eligible for benefits.” Id.

         The Plan includes the following definitions:

Totally disabled means you are unable to perform any reasonable job for the company due to illness or injury. Your disability must be substantiated by medical evidence from a qualified physician specializing in the area of your disability …
A reasonable job is any gainful activity in any job classification for which you are or may reasonably become fitted by education, training, or experience. However, the meaning of “reasonable job” varies among employee groups depending on where the job is located. For employees of Southern California Edison, a reasonable job is located at any of the company within the zone (Northwestern, Basin, Eastern) in which you were working on your last day of work.

Id. at 3355-56 (emphasis added). Under the Plan, the Southern California Edison Company Benefits Committee (“the Benefits Committee”) “has the full and final power and discretionary authority to determine eligibility for benefits, to determine covered benefits, and to construe the terms and provisions of the plans … [and] may … [i]nterpret, construe and apply the plan provisions to decide all questions that arise.” Id. at 3735.[3] The Benefits Committee delegated its authority to Sedgwick Claims Management Services, Inc. (“Sedgwick” or “the Administrator”), which administered the Plan’s LTD claims at all relevant times. Id. at 104-06, 2512-29, 3729. Sedgwick has the discretion to review and evaluate all medical evidence for Plan participants and make factual determinations as to eligibility for LTD benefits. Id. at 3556. The contract between the Plan and Sedgwick was overseen by Deborah Jacobs (“Jacobs”), a manager in Edison’s Disability Management department. Jacobs 4/29/13 Decl. ¶¶ 1-2; PRMF ¶ 15.

         From 1991 until June 2000, Barnett was employed by Edison as a program manager at the San Onofre Nuclear Generating Station (“SONGS”), located at 500 Pacific Coast Highway, San Clemente, California 92674. A.R. at 1917-18, 2047-48. In June 2000, Barnett left work because he had lower back problems, which had led to surgery during the prior year. PRMF ¶¶ 1-2. Barnett was certified as disabled, and was eligible to participate in the Plan because he was unable to perform his job for six consecutive months. PRMF ¶ 3; A.R. at 904, 3553.

         A letter from the Plan, dated March 13, 2001, informed Barnett that his application for LTD benefits had been approved effective December 20, 2000. A.R. at 1244-45. The letter provided, in relevant part:

You will continue to qualify for LTD benefits providing you remain totally disabled, which is defined as unable to perform any reasonable job for the Company. Periodically, you will be required to submit medical evidence of your total disability status. This may include a physical examination by a doctor of the Company’s choice - one who specializes in the area of your disability.

Id. at 1244.

         In July 2009, based upon its review of Barnett’s medical records, the Plan exercised its right to certify Barnett’s eligibility for LTD benefits by having him undergo an independent medical examination by Dr. Aubrey A. Swartz, an orthopedic surgeon. PRMF ¶ 17; Neylan Decl. ¶ 3. Dr. Swartz prepared an Independent Medical Evaluation detailing Barnett’s medical condition that was subsequently forwarded to John C. Meyers, a vocational rehabilitation consultant, who prepared a Transferable Skills Analysis (“TSA”) report, dated August 2, 2009. Neylan Decl. ¶ 4; A.R. at 1563-73 (copy of Dr. Swartz’s report); A.R. at 1607-11 (copy of Meyers’s TSA report). According to the referral letter, Sedgwick requested a TSA report to help “make a determination as to whether [Barnett] would be eligible for continuing LTD benefits … [meaning that he] must be unable to perform in any occupation as it may be performed within their company based on certain criteria that will ultimately be evaluated by [Edison].” A.R. at 1607. After reviewing Barnett’s medical condition and possible work accommodations, and comparing Edison’s “library of job descriptions” to Barnett’s profile, the TSA concluded Barnett could “reasonably become fitted to perform the following occupation: Customer Specialist 1.” Id. Additionally, “[w]ith an adjustable work station which can be raised or lowered … [Barnett] could perform other office occupations such as Telephone Operator, Joint Pole Clerk and Administrative Aide.” Id.

         In a letter dated August 26, 2009, Sedgwick informed Barnett that it had determined that he was no longer eligible for LTD benefits. Id. at 606-09. The letter explained that pursuant to Dr. Swartz’s report, Barnett had “a permanent incapacity that would require permanent work restrictions, ” and the TSA, taking into consideration these work restrictions, as well as Barnett’s training, education, and experience, concluded that Barnett was capable of performing the positions of Customer Specialist 1, Telephone Operator, Joint Pole Clerk, or Administrative Aide at Edison. Id. at 608-09. Thus, as Barnett was no longer “precluded from performing any reasonable job at [Edison] … [he] no longer [met] the definition of disability.” Id. at 609. Finally, the letter noted that Barnett’s LTD benefits claim would be terminated effective October 1, 2009, and apprised him of his right to appeal the decision. Id.

         On November 16, 2009, Barnett formally appealed the termination of his benefits. Id. at 1320-21. As part of the appeals process, a panel of six doctors reviewed Barnett’s medical records, and Sedgwick requested that Myers prepare a supplemental TSA report, which compared the updated information on Barnett’s medical condition with Edison’s library of job descriptions. Id. at 1043-45. The updated TSA, dated March 30, 2010, found that Barnett could “reasonably become fitted to perform” two occupations: Customer Service Specialist 1 and Telephone Operator. Id. at 1045.

         On March 29, 2010, Dorene Barker (“Barker”), an Appeals Specialist with Sedgwick emailed Bob Kowal, who was at SONGS, to see if SONGS could accommodate Barnett’s work restrictions. Id. at 1352. At some point, it was confirmed that SONGS could accommodate Barnett’s work restrictions, but a job was not immediately available at that time. Id. at 1356. In an email dated April 5, 2010, Jacobs informed Barker that the statement that SONGS could accommodate Barnett could be used as a basis to find that Barnett was no longer disabled, under the Plan. Id. Jacobs further wrote, “[t]he letter does not need to mention anything about job availability - but maybe modify it a bit to not say he is expected to report back to work right away and just that he needs to contact his work location about his return to work.” Id. Barker subsequently prepared a letter upholding the denial of Barnett’s LTD benefits. Id.

         In a letter dated April 7, 2010, Sedgwick denied Barnett’s appeal. Id. at 766-69. The letter noted the TSA’s finding that Barnett could reasonably become fitted to perform the positions of Customer Specialist 1 and Telephone Operator, and that “it was confirmed that Mr. Barnett’s restrictions could be accommodated by his work location.” Id. at 768. The letter continued: “Based on the Independent Medical Examination, the [TSA], the Panel Reviews and the medical documentation in Mr. Barnett’s file, the objective medical evidence failed to support an impairment that precluded him from performing ‘any reasonable job’ at Edison International as of October 1, 2009.” Id. at 769. The letter concluded that because Barnett was no longer precluded from performing any “reasonable job” with Edison, and was no longer eligible to receive LTD benefits, the denial of his LTD benefits was in accordance with the Plan. Id. Finally, the letter apprised Barnett of his right to file a civil action under ERISA § 502(a). Id.

         II. Procedural History

         Barnett filed the original complaint in this case on January 27, 2012, alleging three causes of action under ERISA. Doc. 1. The first cause of action sought to bar the Plan from relying upon the 180-day contractual limitation as a defense against the suit; the second cause of action alleged that the Plan denied Barnett a full and fair review of his claim; and the third cause of action sought equitable relief on account of the Plan’s alleged failure to provide Barnett a full and fair review of his claim. See id. The Court granted summary judgment in favor of Barnett on the first cause of action, and permitted the second and third causes of action to proceed to trial. Doc. 34 at 19.

         In a Pre-Trial Conference Order on July 8, 2013, the Court dismissed Barnett’s third cause of action because it determined that this claim was a “repackaged version of his second cause of action.” Doc. 38 at 1-2. At the Pre-Trial Conference held on July 11, 2013, the parties agreed to forego trial and submit briefs on the one remaining issue of whether, based solely on review of the administrative record, the Plan abused its discretion by terminating Barnett’s LTD benefits. Doc. 40 at 15.

         In Barnett’s reply brief, he raised for the first time the argument that there was no evidence in the record regarding the “zone” in which he worked or that the two jobs identified by Myers in the TSA were in that “zone.” Plaintiff’s Response to Defendant’s Undisputed Material Facts and Supporting Evidence (“PRSSUMF”) ¶¶ 14-15; Doc. 53 at 5. Barnett’s reply brief was the last brief submitted before the Court rendered its first decision in this case. Id.

         On August 26, 2013, the Court issued a memorandum decision finding that the Plan did not abuse its discretion in terminating Barnett’s LTD benefits, and entered judgment in favor of the Plan. Docs. 55, 56. This judgment did not address the “zone” issue.[4]

         Barnett filed a notice of appeal on September 9, 2013. Doc. 59. On appeal, Barnett made, inter alia, the following arguments: (1) that his LTD benefits could not be terminated unless and until he was offered a job by Edison; (2) Sedgwick abused its discretion when it determined that there was a reasonable job Barnett could perform; and (3) Sedgwick abused its discretion when it implicitly determined that the reasonable job was within the proper “zone.” See Doc. 77.

         On November 2, 2015, the Ninth Circuit issued an order directing both parties to file supplemental briefs addressing “whether there is evidence in the record to support a determination that a job Barnett could perform was ‘within the zone (Northwestern, Basin, or Eastern) in which [he was] working on [his] last day of work.’” Doc. 85-2, Ex. 4. The Plan argued that Sedgwick specifically noted that at the appeals denial stage, it determined that that SONGS could accommodate Barnett’s work restrictions and thus, he would be able to work at the same location he worked at previously, and that a job at SONGS would be “within the same zone in which he was working at the time of disability.” Id., Ex. 5. Barnett pointed out that the administrative record contained no mention of the “zone” in which Barnett last worked, and thus, it is impossible for the Plan to prove that the Customer Service Specialist 1 and Telephone Operator positions identified by Myers in the TSA were within the “zone” in which Barnett last worked. Id., Ex. 6.

         In its memorandum decision and order, dated December 7, 2015, the Ninth Circuit found as follows:

After our careful review of the record, we are unable to say that the Administrator abused its discretion when it determined that there was a reasonable job that Barnett could perform. However, the Administrator did abuse its discretion when it implicitly determined that the job in question was within the proper zone. Simply put, there was no evidence of the zone in which the reasonable job was located, nor was there explicit evidence of the zone in which Barnett worked. As a result, the termination of benefits was improper and we must vacate the district court’s determination and remand for further proceedings.

Id. at 5. The mandate of the Ninth Circuit issued on December 30, 2015. Doc. 79.

         On January 25, 2016, this Court requested clarification “as to whether the ‘further proceedings’ called for in the Ninth Circuit’s opinion are limited to calculating back-benefits and fees, or alternatively, whether augmentation of the record is permitted on the merits of the ‘zone’ issue.” Doc. 81. The Ninth Circuit responded:

(1) As the district court indicated, we upheld its prior rulings with the exception of the zone ruling. Our disposition and mandate were not intended to restrict the district court’s sound discretion and judgment as to the handling of any remaining issues presented by the parties as the case proceeds.
(2) We note, in particular, that we do not intend to indicate that the district court may not give further consideration to the zone issue, which may include remand to the Plan Administrator for further exercise of its discretion regarding construction of the Plan document and further explication of its decision in light of that construction, if the district court deems that necessary or appropriate in light of the presentation by the parties.

Doc. 82, at 1-2.

         On February 26, 2016, the parties filed a joint status report regarding the nature and extent of any necessary further proceedings, in which they submitted that cross-motions for summary judgment regarding the “zone” issue are necessary to resolve this case. Doc. 84.

         Barnett filed his motion for attorney’s fees, benefits and interest (Doc. 85), which contains a motion for summary judgment, [5] on March 21, 2016; the Plan cross-moved for summary judgment the same day (Doc. 86). Oppositions were filed April 4, 2016 (Docs. 87, 88), and Barnett filed a reply on April 11, 2016 (Doc. 89).


         I. Standard of Review

         “Traditional summary judgment principles have limited application in ERISA cases governed by the abuse of discretion standard.” Sephan v. Unum Life Ins. Co. of Am., 697 F.3d 917, 929 (9th Cir. 2012) (citing Nolan v. Heald College, 551 F.3d 1148, 1154 (9th Cir. 2009)). Where “the abuse of discretion [standard] applies in an ERISA benefits denial cases, a motion for summary judgment is, in most respects, merely the conduit to bring the legal question before the district court and the usual tests of summary judgment, such as whether a genuine dispute of material fact exists, do not apply.” Id. (internal citation and quotation marks omitted); see also Gilliam v. Nevada Power Co., 488 F.3d 1189, 1192 n.3 (9th Cir. 2007) (internal citation omitted). “Thus, a summary judgment motion resting on the administrative record is not a typical summary judgment, but rather, is a procedural vehicle for determining whether benefits were properly granted or denied.” Nalbandian v. Lockheed Martin Corp., No. 10-cv-1242-LHK, 2011 WL 3881473, at *5 (N. D. Cal. Sept. 1, 2011).

         Here, as both parties have moved for summary judgment, the Court must consider each motion on its own merits, and “must consider the appropriate evidentiary material identified and submitted in support of both motions, and in opposition to both motions, before ruling on each of them.” Fair Hous. Council of Riverside Cty., Inc. v. Riverside Two, 249 F.3d 1132, 1134 (9th Cir. 2001). The court also must “rule[] on each party’s motion on an individual and separate basis, determining for each side, whether a judgment may be entered in accordance with the Rule 56 standard.” Tulalip Tribes of Wash. v. Wash., 783 F.3d 1151, 1156 (9th Cir. 2015)

         II. Analysis

         a. Augmentation of the Record Following Remand

         The Plan offers extrinsic evidence for the Court’s consideration on remand-specifically, testimonial and documentary evidence from Jacobs as to how Edison determined zones under the Plan and how Edison determined the zone for SONGS employees; and documentary evidence from Lorie Obal, a senior business analyst at Edison, demonstrating that Customer Specialist I and Telephone Operator positions existed at Edison in a certain zone during the relevant times.[6] In ERISA cases applying the abuse of discretion[7] standard, the district court is generally confined to the evidentiary record before the plan administrator and may not consider extrinsic evidence. Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 970 (9th Cir. 2006) (en banc). While there are some exceptions to this general rule, see id. at 972-73, neither the Plan nor Barnett has objected to augmentation of the record in this case. In fact, both parties premise their legal arguments upon the Plan’s newly submitted evidence. See Doc. 85-1 at 6-7; Doc. 86-1 at 7-17. The parties have therefore waived any objection they may have to the Court’s consideration of this evidence. See FDIC v. Garner, 126 F.3d 1138, 1145, (9th Cir. 1997) (finding that the failure to present any argument or pertinent authority waives the argument); accord Pelfresne v. Village of Williams Bay, 917 F.2d 1017, 1023 (7th Cir. 1990) (“A litigant who fails to press a point by supporting it with pertinent authority, or by showing why it is sound despite a lack of supporting authority… forfeits the point. We will not do his research for him.”). For these reasons, the Court will treat the Plan’s extrinsic evidence as if it were part of the original administrative record in this case. See Abatie, 458 F.3d at 972-73.

         b. The Law of the Case and Rule of Mandate

         A key undisputed fact in this case is that SONGS, the location at which Barnett last worked, “is unique among [Edison] jobsites in that it sits on land leased from Camp Pendleton and as such is located on a federal enclave.” See Doc. 85-1 at 1; Doc. 86-1, at 5; PRSSUF ¶ 39. SONGS is therefore not technically part of any Edison service territory. Jacobs 3/18/16 Decl. ¶ 8. Included as an exhibit to Jacobs’s declaration is a map entitled “Disability Program Geographic Zones, ” which indicates that it is used by Edison’s LTD Plan and depicts three “zones” in the Southern California area: Northern, Eastern, and Central. Jacobs 3/18/16 Decl., Ex. 3. The map does not indicate the location of SONGS. See Id. The Plan advances two possible ways to interpret the zone issue in light of its admission that SONGS is not depicted on the map and does not technically belong to a zone. Doc. 86-1 at 8. First, the Plan argues that “a position existing in a contiguous geographic zone would meet the zone requirement for employees at SONGS.” Id. Second, the Plan argues that “a job that exists at [Barnett]’s own former work location would be considered within the same zone in which he was working on the date of disability.” Id. at 9.

         Barnett contends that the Plan’s post-remand interpretations of the zone issue are impermissible under the rule of mandate and law of the case doctrines. Doc. 85-1 at 5-6 (citing Hall v. City of Los Angeles, 697 F.3d 1059, 1067 (9th Cir. 2012), and United States v. Thrasher, 483 F.3d 977, 982 (9th Cir. 2000)). In light of the Plan’s admission that SONGS does not technically belong to a zone, Barnett submits that the jobs in question are thus not in the zone in which he last worked, by a literal reading of the word. Id. Barnett argues that the Ninth Circuit’s mandate “does not permit [the Plan] to change its theory of the case and argue that it is not necessary to prove that Barnett was in a specific zone” and then interpret the plan “to eliminate the need to place Barnett within one of the three company zones.” Id. at 7; Doc. 89 at 6-7.

         The Court disagrees with Barnett’s law of the case and rule of mandate argument as precluding the Plan from setting forth its new legal theories following remand. “The law of the case doctrine … generally precludes a court from reconsidering an issue decided previously by the same court or by a higher court in the identical case.” Hall, 697 F.3d at 1067. “The issue in question must have been decided explicitly or by necessary implication in the previous disposition.” Id. The aim of the law of the case doctrine is to promote consistency, finality, and efficiency. Thrasher, 483 F.3d at 982. A related doctrine, the rule of mandate, shares these goals and serves to limit “the district court’s ‘authority’ on remand, ” and obligates the district court to carry the higher court’s order “into execution according to the mandate.” Id. However, the district court “may consider and decide any matters left open by the mandate of [the higher court].” Id. (quoting In re Sanford Fork & Tool Co., 160 U.S. 247, 255-56 (1895)); see also United States v. Kellington, 217 F.3d 1084, 1092-93 (9th Cir. 2000) (“In construing a mandate, the lower court may consider the opinion the mandate purports to enforce as well as the procedural posture and substantive law from which it arises”).

         Here, the parameters of the law of the case and the rule of mandate now before the Court are set forth clearly in the Ninth Circuit’s memorandum decision vacating and remanding the judgment in favor of the Plan (Doc. 77), and its subsequent clarification order (Doc. 82). The Ninth Circuit’s decision held that Sedgwick abused its discretion “when it implicitly determined that the job in question was within the proper zone, ” as there was “no evidence of the zone in which the reasonable job was located, nor was there explicit evidence of the zone in which Barnett worked.” Doc. 77 at 4. In its clarification request, the Court specifically inquired as to whether further proceedings were either “limited to calculating back-benefits and fees, or, alternatively, whether augmentation of the record is permitted on the merits of the ‘zone’ issue.” Doc. 81 at 2 (emphasis added). The Ninth Circuit responded by expressly permitting the Court to “give further consideration to the zone issue, ” (Doc. 82 at 2), and noted that its “disposition and mandate were not intended to restrict the district court’s sound discretion and judgment as to the handling of any remaining issues presented by the parties as the case proceeds.” Id. The Ninth Circuit also noted in particular that it did not intend to indicate that the Court could not give further consideration to the zone issue. Doc. 82 at 2.

         When considered collectively, the Ninth Circuit’s opinion only addresses the quantum of proof present in the then-existing record and the clarification order permits the Court to resolve the zone issue by considering the Plan’s arguments and evidence on remand concerning the issue. The Plan’s new arguments following remand concerning the zone issue are therefore not foreclosed by the law of the case doctrine or the rule of mandate, because the only issue explicitly decided by the Ninth Circuit is that Sedgwick’s implicit determination that the jobs were within the zone where Barnett last worked was unsupported by the administrative record before the Court. See Doc. 77 at 4. Accordingly, the Ninth Circuit’s decision permits further factual development as to the zone issue on remand and allows the Court to consider the Plan’s submitted evidence and its argument that this evidence provides a reasonable basis for the termination of Barnett’s LTD benefits. The Court must now determine whether the reasonable jobs Barnett was capable of performing were within the zone in which he last worked.

         c. Whether There Were Customer Service Specialist I and Telephone Operator Positions[8] in the Zone Where Barnett Last Worked

         “When reviewing interpretive challenges for abuse of discretion, the Court closely reads contested terms and ‘appl[ies] contract principles derived from state law [, ] … guided by the policies expressed in ERISA and other federal labor laws.’” Tapley v. Locals 302 and 612 of Intern. Union of Operating Engineers-Employers Const. Indus. Ret. Plan, 728 F.3d 1134, 1140 (9th Cir. 2013) (quoting Richardson v. Pension Plan of Bethlehem Steel Corp., 112 F.3d 982, 985 (9th Cir. 1997)). Under the abuse of discretion standard, “the decision of an administrator will not be disturbed unless the court determines that the decision was arbitrary or capricious.” Horn v. Provident Life & Acc. Ins. Co., 351 F.Supp.2d 954, 958 (N.D. Cal. 2004) (citing McKenzie v. General Tel. Co. of Cal., 41 F.3d 1310, 1316 (9th Cir. 1994) and Clark v. Wash. Teamsters Welfare Trust, 8 F.3d 1429, 1431 (9th Cir. 1993)). “The touchstone of ‘arbitrary and capricious’ conduct is unreasonableness.” Clark, 8 F.3d at 1432. An ERISA plan administrator’s decision will be upheld if it is grounded “‘in any reasonable basis.’” Pac. Shores Hosp. v. United Behavioral Health, 764 F.3d 1030, 1041-42 (9th Cir. 2014) (emphasis in original) (quoting Horan v. Kaiser Steel Ret. Plan, 947 F.2d 1412, 1417 (9th Cir. 1991); see also Conkright v. Frommert, 559 U.S. 506, 521 (2010) (internal citations omitted) (“Applying a deferential standard of review does not mean that the plan administrator will prevail on the merits. It means only that the plan administrator’s interpretation will not be disturbed if reasonable.”). On the other hand, “ERISA plan administrators ‘abuse their discretion if they render decisions without any explanation, … construe provisions of the plan in a way that conflicts with the plain language of the plan’ or ‘rel[y] on clearly erroneous findings of fact.’” Day v. AT&T Disability Income Plan, 698 F.3d 1091, 1096 (9th Cir. 2012) (quoting Taft v. Equitable Life Assurance Soc’y, 9 F.3d 1469, 1472-73 (9th Cir. 1994)); see also Salomaa v. Honda Long Term Disability Plan, 642 F.3d 666, 676 (9th Cir. 2011) (finding that the plan administrator abused its discretion where its decision “was illogical, implausible, and without support in inference that could reasonably be drawn from facts in the record”). Finally, the doctrine of contra proferentem, which provides that “ambiguities are to be construed unfavorably to the drafter, ” Black’s Law Dictionary 377 (9th ed. 2009), “does not apply when a plan ‘grants the administrator discretion to construe its terms.’” Day, 698 F.3d at 1098 (citing Blankenship v. Liberty Life Assur. Co. of Boston, 486 F.3d 620, 625 (9th Cir. 2007)).

         The Plan first argues that the existence of Customer Service Specialist I and Telephone Operator positions in the “Central zone”[9] at the relevant times constitutes a sufficiently “reasonable basis” to sustain Sedgwick’s termination of Barnett’s LTD benefits. Conkright, 559 U.S. at 521. In support of this Central zone argument, the Plan has submitted the following evidence, in the form of a sworn declaration from Jacobs, who oversaw the day-to-day administration for the Plan, attesting that:

1) “[f]or purposes of determining ‘zones’ under the Plan, [Edison] relied in part on the Utility Workers Union of America (‘UWUA’) map of ‘Disability Program Geographic Zones, ’” which references a “Northern” zone, an “Eastern” zone, and a “Central” zone;
2) the “Central” zone covers Los Angeles and surrounding areas, extending south to El Toro, and includes Rosemead and Long Beach;
3) SONGS “is not pictured on the zone map because it is technically not part of [Edison] service territory, by virtue of sitting on a federal enclave”;
4) “in practice, SONGS employees were treated as being part of the Central zone as it is contiguous with SONGS and is the zone closest to the SONGS location.”

Jacobs 3/18/16 Decl. ¶¶ 7-9. The Plan then points out that Customer Specialist I and Telephone Operator positions existed within the Central zone at locations within approximately sixty miles from SONGS at the times relevant to the decision to terminate Barnett’s benefits and the appeal. Doc. 86-1 at 8-9. Specifically, the Plan highlights a Customer Specialist I position located in Long Beach, approximately 52.5 miles away from SONGS, ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.