Opinion
Case Number C 03-00538 JF (PVT), [Docket No. 64].
July 15, 2004
ORDER RE MOTION TO AMEND, ALTER, AND VACATE JUDGMENT
The Court has granted summary judgment in favor of Plaintiff in the above-entitled action, concluding that Defendants abused their discretion in denying Plaintiff's claim to certain long-term disability insurance benefits. Defendants move to amend, alter, and vacate the judgment. The Court has considered the moving and opposing papers as well as the oral arguments presented at the hearing on July 12, 2004. For the reasons set forth below, Defendants' motion will be denied in part and granted in part.
I. BACKGROUND
The facts underlying this case are set forth in the Court's "Order Re Cross-motions for Summary Judgment," dated April 13, 2004, and the Court will restate only facts relevant to the present motion. Plaintiff was employed by Adobe Systems, Inc. ("Adobe") as a "Senior Computer Scientist," with duties described as follows: "[w]orks on extremely complex problems of wide scope in analysis, design, and programming," "[a]nalysis of situations or data requires an evaluation of intangible variance factors," [i]nterfaces with marketing," "[e]xercises autonomous judgment," "[p]rovides leadership," and "[a]cts as mentor to engineers." Declaration of Melvyn D. Silver in support of Plaintiff's motion for summary judgment ("Silver Decl."), Ex 17. Adobe obtained long term disability coverage from Defendants. Plaintiff is entitled to receive two-thirds of his basic monthly earnings — or $7,510.78 per month not including offsets — if he is found to be "disabled" under the following terms of the Policy:
i. If the Covered Person is eligible for the 60 Month Own Occupation benefit, "Disability" or "Disabled" means during the Elimination Period and the next 60 months of Disability the Covered Person is unable to perform all of the material and substantial duties of his occupation on an Active Employment basis because of an Injury or Sickness; and
ii. After 60 months of benefits have been paid, the Covered Person is unable to perform, with reasonable continuity, all of the material and substantial duties of his own or any other occupation for which he is or becomes reasonably fitted by training, education, experience, age and physical and mental capacity.
Declaration of Paula McGee in Support of Defendants' motion for summary judgment, Ex. A (Policy, section 2, p. P-007). Defendants denied benefits and the ground that he was not disabled.
The Court concluded that the only basis for Defendants' denial of Plaintiff's claim is their allegation that it was not supported by objective data; they concluded that the "objective medical documentation we have been provided does not support your condition is [sic] of such severity that it would prevent you from performing the material and substantial duties of your occupation as a Computer Scientist. . . . and your reported symptoms are mainly subjective." Silver Decl., Ex. 30. However, Plaintiff's doctor concluded that Plaintiff's "symptoms are consistent with a diagnosis of functional dyspepsia" and that it "is common and expected in patients with functional GI disorders to not have extensive abnormalities on medical testing." Defendants did not point to any doctors' or nurses' findings or conclusions that contradict Plaintiff's complaint of severe pain. Defendants ignored the evidence in the medical records showing both subjective and "objective data," did not indicate what objective evidence they would require, did not provide any facts contradicting, or even argument disputing, the three examining doctors' diagnosis of pain, and did not specifically address whether Plaintiff is able to concentrate to the full extent required by his job description. It appears, instead, that Defendants denied benefits to Plaintiff because Defendants did not believe that Plaintiff really suffers from abdominal pain. The Court concluded that denial of the claim only could occur if Defendants construed provisions of the Policy in a way that "conflicts with the plain meaning of the plan." Taft v. Equitable Life Assur. Soc., 9 F.3d 1469 (9th Cir. 1993).
Defendants now assert that (1) Plaintiff was able to work part-time, and thus summary judgment was improper, (2) the Court should have remanded the case for further resolution by Defendants, and (3) the Court's judgment was premature because the parties had not resolved issues relating to the proper measure of relief warranted.
II. LEGAL STANDARD
The specific grounds upon which to base a motion to amend or alter the judgment are not set forth in Federal Rule of Civil Procedure Rule 59(e) ("Rule 59(e)"). As such, the Court has considerable discretion in granting or denying the motion. See Edward H. Bohlin Co. v. Banning Co., 6 F.3d 350 (5th Cir. 1993). In general, motions to alter or amend judgment are granted upon four basic grounds: (1) to correct manifest errors of law or fact upon which the judgment is based; (2) to present newly discovered or previously unavailable evidence; (3) to prevent manifest injustice; and (4) to allow for consideration of an intervening change in controlling law. See School District No. 1J, Multnomah County v. ACandS, 5 F.3d 1255, 1263 (9th Cir. 1993); 11 Wright Miller Kane, Federal Practice and Procedure: Civil 2d § 2810.1. A Rule 59(e) motion may not be used to relitigate old matters or to raise arguments or present evidence that could have been raised prior to the entry of judgment. See Wright Miller Kane, § 2810.1; Fuller v. M.G. Jewelry, 950 F.2d 1437, 1442 (9th Cir. 1991). The decision whether to grant reconsideration is committed to the sound discretion of the district court and will be reviewed only for abuse of discretion. See School District No. 1J, Multnomah County, 5 F.3d at 1262.
III. DISCUSSION
A. Ability to Work Part TimeThe Court concluded, in its Order Re Cross-Motions for Summary Judgment, that Defendants abused their discretion when determining that Plaintiff was not "disabled," a determination that formed the sole basis for denial of benefits. Defendants had concluded incorrectly that "[m]edical records do not support total disability." Silver Decl., Ex. 18. As stated above, Defendants ignored the available "objective data" in denial of the appeal, did not indicate what objective evidence they would require, did not provide any facts contradicting, or even argument disputing, the three examining doctors' diagnosis of pain, and did not specifically address whether Plaintiff is able to concentrate to the full extent required by his job description. In so doing, Defendants could not have properly assessed whether Plaintiff was capable of working part time. Moreover, Plaintiff provided evidence indicating that he was unable to perform his job adequately, whether full or part time. See, e.g., Silver Decl., Ex. 24. It also is noteworthy that Defendants did not offer Plaintiff a part-time job after his benefits were denied, see Opposition to Plaintiff's Motion for Summary Judgment, p. 7, suggesting that such "part-time" work was insufficient. The record supports the conclusion that Plaintiff suffered from pain that rendered him "unable to perform all of the material and substantial duties of his occupation," as required by the Policy, whether he worked full or part time. Accordingly, he is disabled within the meaning of the Policy. Defendants have provided no new evidence, made no new arguments that they could not have made prior to the granting of summary judgment, and have not set forth an intervening change in law.
B. Remand
Defendants assert that the Court should not have made an independent determination that Plaintiff was disabled, but should have remanded to them "for further factual determination and proof." Motion, p. 10 (emphasis added). It is inappropriate for Defendants to conduct further factual determination and search for proof when they already made their decision based on a complete record. The Court, as it was required to do, reviewed only that record. Apparently, Defendants hope to develop facts to support their theory that Plaintiff is a malingerer. Because the record adequately proves that Plaintiff suffers from disabling pain, there is no basis for remand "Remand to the plan administrator is appropriate where that administrator has construed a plan provision erroneously and therefore has not yet had the opportunity of applying the plan, properly construed, to a claimant's application for benefits." Canseco v. Constr. Laborers Pension Trust, 93 F.3d 600, 609 (9th Cir. 1996) (internal citation omitted). Defendants abused their discretion not by misconstruing the terms of the Policy, but by disregarding medical evidence. Finally, the Court notes that the appropriateness of remand could have been raised in the cross-motions for summary judgment, but was not.
C. Measurement of Damages
At the same time that it granted summary judgment as to liability, the Court ordered the parties to meet and confer concerning the proper calculation of accrued benefits due to Plaintiff. Defendants now assert that the entitlement to, the amount, the duration, and the calculation of benefits owed all remain in dispute. Defendants dispute the admissibility and reliability of Plaintiff's documents in support of his calculation of benefits owed to him. Plaintiff does not address these issues in his opposition brief. It thus is evident that judgment was issued prematurely, and the present motion is well taken to the extent that it seeks to vacate the judgment in order to complete litigation with respect to damages.
The parties shall file cross-motions for summary adjudication concerning any remaining disputes as to the proper calculation of damages and any disputes with respect to the validity of sources in support of such calculations. Consistent with the Order Re Cross-Motions for Summary Judgment, the parties shall assume that Plaintiff was "disabled" within the meaning of the Policy subsequent to the 120-day elimination period as set forth in the Policy.
IV. ORDER
Good cause therefore appearing, IT IS HEREBY ORDERED that:(1) The Rule 59(e) motion is DENIED except as to the issue of the proper measurement of damages; and
(2) The parties shall file cross-motions for summary adjudication limited to disputed issues related to the proper calculation of accrued benefits due to Plaintiff.