The casenote of the month is from the Disability E-News Alert! a monthly newsletter describing new disability insurance developments. For subscription information, e-mail Mark DeBofsky or visit www.disabilityenewsalert.com .
Hine v. Hewlett-Packard Co.,
2006 U.S.Dist.LEXIS 68716 (N.D.N.Y.
9/25/2006)(Issue: Multiple Chemical Sensitivity, Mental
versus Physical Disability).
The plaintiff in this case became disabled in 1989 due to
multiple chemical sensitivity, chronic fatigue and severe
allergies caused by exposure to chemicals at work. The plan
paid benefits throughout the 1990’s; however, in 2000, a
medical record review performed by Prudential found no basis
for the MCS diagnosis and suggested a somatoform disorder.
Consequently, the plan terminated benefits stating that there
was no physiologic basis for Hine’s disorder and he had long
since exhausted the plan’s 24 month limit for payment of
benefits due to mental disorders.
When Hine appealed, the file was
reviewed by a psychiatrist, Dr. Stephen Gerson, who concluded
that Hine suffered from a somatoform disorder, depression and
anxiety. When Prudential upheld the determination, Hine
filed suit. Applying a de novo standard of review, the court
found that questions of fact precluded the entry of summary
judgment.
Although the court held that neither
the doctrines of waiver nor estoppel prevented Prudential from
challenging the diagnosis, the court also rejected
Prudential’s contention that it was undisputed Hine’s
disability was caused at least in part by a psychiatric
disorder. The court concluded,
The record presents material
questions of fact on the issue of whether plaintiff's total
disability "is caused at least in part by a mental,
psychoneurotic or personality disorder." There is competent
medical evidence from which a fact-finder could conclude that
plaintiff's total disability was and continues to be caused
completely by a physiological condition and that any
psychological problems he has are the result of -- not a cause
of -- his disability. Compare Reid v. Aetna Life Ins. Co.,
393 F.Supp.2d 256, 265 (S.D.N.Y. 2005) (granting summary
judgment to defendant where "the only physicians to certify
Plaintiff as disabled ... cite to psychological factors for
his disability."); O'Sullivan v. The Prudential Ins. Co. of
Am., 2002 WL 484847, *10 (S.D.N.Y.) (granting summary
judgment to defendant because "no rational jury could find
that [plaintiff] established how her medical condition
rendered her totally disabled"). *11-*12.
Thus, both parties’ motions for
summary judgment were rejected.
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