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Brock v. AT&T Services, Inc.

United States District Court, E.D. Kentucky, Northern Division, Ashland

January 9, 2018

JUDITH BROCK, PLAINTIFF,
v.
AT&T SERVICES, INC., DEFENDANT.

          MEMORANDUM OPINION AND ORDER

          Henry R. Wilhoit, Jr. United States District Judge.

         This matter is before the Court upon the parties' cross Motions for Summary Judgment [Docket Nos. 14 and 15]. For the reasons set forth below, the Court finds that Defendant AT&T Services, Inc. is entitled to judgment as a matter of law.

         I.

         Judith Brock filed this civil action against her employer, AT&T Services, Inc. (hereinafter "AT&T") pursuant to 29 U.S.C. § 1132(A)(1)(B), challenging the denial of her application for short-term disability benefits.

         A.

         Plaintiff Judith Brock ("Brock") worked for AT&T Mobility Services, LLC ("AT&T") as a Clerk from October 10, 2001 through November 21, 2015 [Docket No. 12-1, Administrative Record 000059]. As an AT&T employee, Brock was an eligible employee in the AT&T Mobility Disability Program ("DP"), which is regulated by the Employee Retirement Income Security Act, 29 U.S.C. §1001 et. seq. ("ERISA"). [Docket No. 12-5, Plan 087]. The short-term disability ("STD") portion of the DP provides for benefits for up to 26 weeks after an eligible employee has been determined to be partially or totally disabled. [Docket No. 12-3, Plan 056].

         Under the terms of the DP, disability determinations are made by a third-party Claims Administrator, Sedgwick Claims Management Services, Inc., through the Integrated Disability Service Center ("IDSC"), which Sedgwick operates. [Docket No. 12-1, AR 000172]. The Claims Administrator is the only entity which determines whether or not a participant is disabled and is granted complete discretion to make such a decision. [Docket No. 12-5, Plan 068]. The plan participant must be under the care of a physician, provide their medical providers with a release and ensure that they submit medical information to the Claims Administrator in a timely manner. Id. at 067. After a review of the medical information, if the Claims Administrator denies the claim, the participant must be provided with an explanation as to the reason for denial of disability benefits. Id. at 084. A plan participant has the right to appeal the denial and can file a lawsuit if the claim is denied on appeal. Id. The Claims Administrator is granted complete discretion to grant or deny appeals for disability benefits under the Plan. Id. As with the initial claim decision, on appeal, the Claims Administrator must provide the participant with specific reasons why the disability benefits claim is denied. Id.

         B.

         Plaintiff was employed by AT&T as a Clerk from October 1, 2001 until November 22, 2015. [Docket No. 12-1, AR 000059]. Her job was essentially sedentary and included filing, answering the phone, typing, precessing mail and providing general office support. Id. at 000012 and 000068.

         As an AT&T employee, Plaintiff was a participant in the DP, described supra. During her tenure at AT&T, Plaintiff was diagnosed as having restless leg syndrome, essential tremors and mild carpal tunnel syndrome [Docket No. 12-1 AR 000091, 000093].

         On April 2, 2014, Plaintiffs treating physician, Dr. Suresh Kumar, saw the Plaintiff for her history of essential tremors and peripheral neuropathy which she indicated were made worse with stress or loud music. During that visit, he refilled her medication and told her to follow up in four - six months. [Docket No. 12-2, AR 000147-148].

         She saw Dr. Kumar a little over two weeks later, August 20, 2014. She told Dr. Kumar that medication was controlling her restless syndrome and tremors. He, again, recommended a follow up visit in four-six months. Id. at 000143-144.

         Plaintiff saw Dr. Kumar again, about seven months later on May 5, 2015, for a follow up of her restless leg syndrome and tremors. His prescription at that time was for an over the counter medication and he advised Plaintiff to continue the medication. He recommended a follow up in six months. Id. at 000140.

         On November 16, 2015, Sedgwick, through the AT&T Integrated Disability Center, opened a disability claim for the Plaintiff. Id. at 000152-153.

         Pursuant to Plaintiffs authorization, Sedgwick received the Initial Physician Statement ("IPS") which Dr. Kumar, Plaintiffs treating physician, completed on November 16, 2015 in which he stated that Plaintiff had been diagnosed with essential tremors which were "exacerbated with loud noise". He noted that he had increased the dosage on Plaintiffs medication which was expected to improve her functioning and suggested that Plaintiff be allowed to work away from loud noise "if possible". [Docket No. 12-1, AR 00016]

         An initial review of Plaintiff s claim on November 23, 2015 indicated that the medical information did not support ...


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