Davis v. First Union Corp. Long Term Disability, CIV.A.99-30277-MAP.

213 F.Supp.2d 29

Trina Linnette DAVIS, Plaintiff, v. FIRST UNION CORPORATION LONG TERM DISABILITY PLAN, Defendant.

No. CIV.A.99-30277-MAP.

United States District Court, D. Massachusetts.

August 12, 2002.

Judd L. Peskin, Weiner & Rothschild, Springfield, MA, for Trina Linnette Davis, Plaintiff.

Kenneth J. DeMoura, Adler, Pollack & Sheehan, P.C., Boston, MA, for First Union Mortgage, Defendant.

MEMORANDUM REGARDING DEFENDANT'S MOTION FOR SUMMARY JUDGMENT

PONSOR, District Judge.

I. INTRODUCTION

In this case, the plaintiff, Trina Linnette Davis ("plaintiff"), who suffers from multiple sclerosis, claims that she was wrongly denied long-term disability benefits in violation of the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §§ 1001 et seq. The defendant, First Union Corporation Long Term Disability Plan ("defendant"), contends that plaintiff was not eligible to participate in its disability plan because she had not been "actively employed" for three months, as the plan requires, when she became disabled. For the reasons set forth below, defendant's motion for summary judgment will be allowed.

II. FACTUAL AND PROCEDURAL BACKGROUND

Plaintiff was first diagnosed with multiple sclerosis in 1993. (Docket 49, Exhibit B at 8). Nevertheless, she was able to overcome her health problems and to work productively until at least 1998. Id. at 2. Beginning in 1995, plaintiff began working as a loan originator, or loan officer, for several banks and mortgage companies. Id. In 1995, plaintiff worked with Fleet Mortgage Company, and in the summer of 1996, plaintiff moved to National City Mortgage Company ("National City"). Id.

After approximately a year with National City, plaintiff began discussing the possibility of employment with First Union Mortgage Corporation ("First Union"). (Docket 64, Exhibit A at 17). First Union's sales manager at the time, Nanette Cavaleri ("Cavaleri") was "immediately impressed" with plaintiff, and found her to be "[v]ery stylish, classy, well spoken." Id. Plaintiff also showed Cavaleri that she was a good loan officer because plaintiff was writing "at least eight to ten loans a month" with National City. Id. Cavaleri made plaintiff an offer and plaintiff accepted. Id. at 18.

Plaintiff officially starting working with First Union on October 27, 1997. (Docket 49, Statement of Facts at 1). In 1997, First Union provided long-term disability benefits to its employees through defendant, the First Union Corporation Long Term Disability Plan ("defendant"). Id. The terms of the Plan were described in a document entitled "First Union Corporation Long Term Disability Plan," (the "Plan"), and summarized in a document entitled "Summary Plan Description" ("SPD"). The provisions of the Plan most crucial to the present dispute center around eligibility. The Plan provides that,

Each ... Employee shall be eligible to become a Participant in the Plan on the first day he or she is physically at work on or after the date on which he or she completes three months of Active Employment.

Coverage for an Eligible Employee shall commence on the date the Eligible Employee becomes a Participant; provided, however, that coverage will be delayed for an Eligible Employee if he or she is not in Active Employment because of Injury or Sickness. Such coverage shall commence on the date the individual returns to Active Employment.... Whether an Eligible Employee becomes a Participant (and when coverage commences) shall be determined by the Plan Administrator in its sole discretion.

(Docket 35, Exhibit 1 at 7-8). Thus, given her start date of October 27, 1997, plaintiff was due to become eligible for long-term disability benefits on January 27, 1998, provided that she had completed three months of "Active Employment" by that date uninterrupted by "Injury or Sickness."

In its "Definitions" Section, the Plan provides further illumination. It states that,

"Active Employment" means the Employee must be actively at work for the Participating Employer on a full-time or a part-time regularly scheduled basis and paid regular earnings and perform such work either (i) at the Participating Employer's usual place of business, or (ii) at a location to which the Participating Employer's business requires the Employee to travel.

Id. at 1. It further states that,

"Sickness" means illness, disease, pregnancy or complications of pregnancy.

Id. at 6. Obviously, multiple sclerosis is a "sickness" within the meaning of the Plan. As discussed in more detail below, defendant claims that plaintiff was ineligible for long-term disability benefits because she had not completed three months of "active employment" when she became disabled.

A few words about plaintiff's responsibilities with First Union, and the expectations placed upon her, are necessary. First Union hired plaintiff to develop a new territory in Western Massachusetts where First Union had previously not conducted business. (Docket 64, Exhibit C at 19). Plaintiff was never told that she was expected to work a forty hour week, and First Union did not require employees to use a punch clock. Id. at 26.

On the other hand, plaintiff knew that in the mortgage industry, it was not uncommon to work from eight o'clock in the morning to nine o'clock at night. Id. Plaintiff was expected to continually market herself and to work to develop new loans. She understood that her supervisor could keep track of whether she was working by seeing how many loans she had closed. Id. at 27. As plaintiff explained,

Always your time should be spent marketing yourself or else you're not going to be closing any loans. So if I don't come into the office and I sat at home and I didn't work, then I wouldn't have any business after a while. And then the company would know, she must not be working.

Id. As noted, plaintiff had been writing eight to ten loans a month with National City when she was hired by First Union.

Plaintiff, like other loan officers for First Union, was expected to spend most of her time out of the office, "on the road." Id. at 11. In general, an officer was expected to (1) make appointments and meet with realtors; (2) make appointments and meet with customers interested in buying a home; (3) hand out pamphlets and distribute other advertising; (4) set up seminars; and (5) complete the paperwork associated with a loan. Id. at 12, 31. A great deal of this work could be completed from home. Id. at 16-17. Officers could write up loans at home, make phone calls, and even meet with clients at home. Id. Indeed, at least one officer had a home office equipped with a fax machine, laptop, and phone line. Id. at 17. However, officers were expected to be in the Bloomfield office for sales meetings, training seminars, and some client meetings. Id. at 16.

Defendant does not dispute that in November and at least the first part of December, plaintiff was "actively working." Plaintiff familiarized herself with the area, made contacts with realty offices, and generally kept busy developing new loan avenues. (Docket 64, Exhibit C at 22). She also periodically dropped by the office as expected. Id. at 25.

Unfortunately, in December, 1997, plaintiff developed flu-like symptoms, and began to experience fatigue. Id. at 28. Although plaintiff felt tired, she also felt that she could put in an eight-hour day if she had to. Id. at 29. Plaintiff described December as the "slow season," however, and indicated that an eight-hour day was rarely necessary or appropriate. Id.

By the middle of January, 1998, plaintiff's multiple sclerosis began to flare up more seriously. Id. at 30. She experienced paralysis on the left side of her body, the vision in her left eye was unfocused, and she lost control of her bladder. Id. The bladder problem, in particular, made it impossible for plaintiff to drive in to the office, or to drive to meet realtors or potential new customers. Id. at 31. Plaintiff felt that January-February was also "a dead time for realty," however, and that her debilitation did not cause her any real "down time." Id. at 35.

On January 8, 1998, plaintiff was unable to attend a sales meeting at the office. (Docket 64, Exhibit A at 47). Plaintiff called and explained that her multiple sclerosis was affecting her bladder and therefore her ability to drive. Id. at 31-32. The same day, plaintiff saw Dr. Lawrence Melz for an examination. Id. at 54. She told Dr. Melz that she had lost the vision in her left eye, had no control over her bladder, had acute muscle spasms, and was experiencing fatigue. Id. at 56.

Plaintiff received a note from Dr. Melz, and sent it along with her own letter to Cavaleri at First Union on January 16, 1998. In the first paragraph of the letter, plaintiff wrote the following about her condition:

I was diagnosed with Multiple Sclerosis in 1994. I was told that it was dormant and not to worry [because] the possibility of having an attack was minute. I did have an attack last year during the late spring to summer months but I recovered and never had to cease work. This time however is quite different. I have lost vision in my left eye and therefore unable [sic] to drive. I have no control of my bladder and I have acute muscle spasms at random. For those reasons I am unable to work. I am restricted to bed rest because of the fatigue that is also associated with my illness.

(Docket 35, Exhibit 11). It should be noted that although the letter said, "I am unable to work," a fair reading of the letter shows plaintiff did not mean: "I am unable to work entirely." The next few paragraphs of the letter discuss plaintiff's efforts at work, and give no indication that plaintiff had completely ceased to work as of January 16, 1998. Id.

As noted, plaintiff attached to her January 16th letter a note from Dr. Melz, dated January 12, 1998. It stated:

This is to advise you that, Trina Davis, is under my medical care for Multiple Sclerosis and was advised to remain out of...