Opinion
CIVIL ACTION NO. 01-CV-4339
September 30, 2003
MEMORANDUM AND ORDER
Presently before this Court is Defendant's Motion for Summary Judgment (Doc. 9). For the reasons set forth below, upon consideration of Defendant's Motion, Plaintiff's Response (Doc. 10), and Defendant's Reply Brief (Doc. 11), this Court will deny Defendant's Motion for Summary Judgment.
BACKGROUND
Plaintiff, Christine P. Smetana, was an employee of PaineWebber Group, Inc., and she participated in an employee welfare benefit plan (the "plan"). The plan provided for Long term disability ("LTD") benefits under Reliance Standard Life Insurance Company's group policy (the "policy"). Plaintiff was involved in an automobile accident on May 14, 1996, and she was treated at the Emergency Room of Bryn Mawr Hospital. The hospital record shows that she was released with minor injuries.
Plaintiff was rear-ended by another vehicle while she was stopped at a red light.
The minor injuries were multiple contusions and soft tissue injury.
Shortly after the accident, Plaintiff followed up with her family physician, Dr. Furman, who referred her to Dr. Esterhai. Dr. Esterhai ordered a cervical and lumbar MRI on or around May 24, 1996. See Def's Mem. at 3. In June of 1996, Plaintiff complained of neck pain, spasms on her right side, headaches, numbness, and tingling in her upper right extremity. On June 7, 1996, Dr. Furman referred Plaintiff to Dr. Joseph V. Vernace for evaluation of her injuries. See Def.' s Admin. Record Part II of II at 405. Dr. Furman then referred Plaintiff to Christopher Reid, a neurologist on June 14, 1996, for an evaluation of her headaches and arm and leg symptoms. Dr. Reid recommended to Dr. Furman that Plaintiff get an "MRI scan of her brain to rule out subdural or other traumatic injury there." See Def's Admin. Record Part I of II at 253. He also recommended that "she have an EMG-nerve conduction study to see if we can localize where the neck, arm, and leg symptoms are coming from." Id.
The Cervical MRI revealed: (1) C4-C5, there is a very small disc bulge; (2) C5-C6, there is a small central disc protrusion, which is effacing some of the CFS in the anterior of the cal sac; and (3) C6-C7, there is mild-to-moderate broad-based central disc protrusion. The lumbar MRI revealed at L3-L4 that there is a mild left paracentral disc protrusion.
Dr. Vernace opined that "she [was] in no acute distress," however, "examination of her neck and lumbar spine reveal decreased range of motion . . . She has mild diffuse paravertebral tenderness in the lumbar spine with no severe spasm. Neurologic exam of the upper and lower extremities is completely normal." See Def's Admin. Record Part II of II at 406.
Dr. Reid opined that "she has a mild post-concussion syndrome with the symptoms of memory loss, shakiness, easy fatigability, dizziness, and headaches . . ." See Def's Admin. Record Part I of II at 253.
Plaintiff saw a physical therapist from June 2-June 30, 1996. Plaintiff saw Dr. Reid for a follow-up evaluation on July 3, 1996. Dr. Reid's assessment of the Plaintiff was that her symptoms related to post concussion syndrome, cervical radiculopathy with sprain and spasm, and lumbar sprain and spasm with right peroneal neuropathy had improved. After the follow-up evaluation, Dr. Reid sent Dr. Furman a letter, which stated that Plaintiff returned to his office for a follow-up evaluation. During this visit, Plaintiff stated that "her energy has been steadily increasing to where she is about [sic] 75% of normal." See Def's Admin. Record Part II of II at 390. She complained about her left arm going numb, headaches, right lateral calf, shakiness, and tinnitus. M. In Dr. Reid's letter, he stated that Plaintiff "is improving from her symptoms related to post concussion syndrome, cervical radiculopathy with sprain and spasm, and lumbar sprain and spasm with right peroneal neuropathy." Id. at 391. Dr. Reid no longer needed to see Plaintiff as long as her symptoms steadily improved. See Def.'s Admin. Record Part n of II at 3 91. Plaintiff saw Dr. Reid again on August 29, 1996, for a follow-up evaluation of her headaches, neck and arm, low back and leg pain. See Def's Admin. Record Part II of II at 387. At this evaluation, Plaintiff complained that her headache frequency had increased. M. In Dr. Reid's assessment after the evaluation, he concluded that Plaintiff "has had an increase in her migraine headaches with apparent new trigger of neck pain." Id. at 3 89.
Plaintiff returned to Dr. Reid on January 14, 1997, complaining about her neck pain and headaches (the pain gets worse if she is active, such as, swimming, snorkeling, diving, or lifting her hands over head). See Def.'s Admin. Record Part II of II at 3 86. She also complained about her low back pain, her right shoulder, and numbness in the first two fingers on her left hand. Id. Plaintiff saw Dr. Reid again on July 25, 1997, and she complained of problems with headaches, shoulder, neck, arm, and leg pain. See Def.'s Admin. Record Part II of II at 384. Dr. Reid recommended that she try some medications to improve her pain. M. Dr. Reid wrote a letter to Plaintiff's Counsel on September 29, 1997, and his diagnoses were the following: (1) post-concussion syndrome; (2) cervical radiculopathy; (3) carpel tunnel syndrome; and (4) lumbar radiculopathy. Id. at 382. Dr. Reid also stated that "all of her symptoms have improved to some extent. She continues to have headaches, neck and arm symptoms, and low back and leg symptoms . . . Although she is back to working a full time schedule, her endurance and limitations because of pain seem to cause her about a 25% decrease in productivity by both her and my estimate." Id.
In 1998, Plaintiff went to see Dr. Marc Oliveri, an orthopedic surgeon, for an evaluation. After consultation with the Plaintiff, Dr. Oliveri decided to start Plaintiff's treatments from scratch. He referred Plaintiff to Dr. Melvin Gerber, whose findings did not comport with any previous determinations of carpal tunnel syndrome, radiculopathy, or neuropathy. See Def.'s Admin. Record Part I of n at 211. Beginning in October of 1998, under the direction of Dr. Oliveri, Plaintiff underwent injections of epidural steroids at the Pain Management Institute of Lancaster. PL's Exhibit J. In a letter to Dr. John F. Brabazon dated November 17, 1998, Dr. Oliveri wrote, "[Plaintiff's] pain is getting to the point where it is difficult for her to function in life and difficult for her to do any sort of activity at all such as walking, or even simple house work or yard work." PL's Exhibit K.
In 1999, Plaintiff underwent numerous examinations and procedures and consulted several doctors. Various results and findings were reached, but Plaintiff's symptoms began to improve until 2000. Around April 2000, Plaintiff went to see Dr. Oliveri because she was having increasingly severe pain in her neck and radiating pain down into her right upper extremity. Dr. Oliveri decided that "at this time [Plaintiff] is getting to the point where she is unable to function and work her normal type of job as a broker . . . I will take her out of work. I suspect that she will have a moderate degree of debility and disability." Pl.'s Exhibit K, Dr. Oliveri's April 6, 2000 letter. In Dr. Oliveri's letters dated from 2000 through the beginning of 2001, Dr. Oliveri opined that Plaintiff should not continue to work due to her severe pain. See Pl's Exhibit K.
Plaintiff stopped working on April 7, 2000, and made a claim for long-term disability benefits under her employer's coverage by the Defendant, Reliance Standard Life Insurance Company. Among the many doctors Plaintiff continued to see over the next year, Dr. Shailen Jalali noted "a clear psychosocial component to the pain process . . . however, the possibility of a discogenic process or internal disc disruption cannot be ruled out." See Def.'s Admin. Record Part II of II at 522-523. Plaintiff then underwent a cervical facet block injection procedure to decrease her pain, after which Dr. Jalali recommended a radiofrequency denervation, although Plaintiff never followed through with this. In August of 2000, Dr. Paul Marcotte, while noting many similar problems as mentioned previously, wrote that Plaintiff "feels that the pain is in check with her current treatment regiment." See Def's Admin. Record Part n of n at 501. He did not indicate whether or not Plaintiff could continue her work as a stock broker.
Plaintiff's long-term disability claim was approved on February 16, 2001, although the Defendant continued to evaluate her claim. On March 16, 2001, a doctor retained by the Defendant, Dr. William Hauptman, reviewed Plaintiff's medical records but performed no actual examination of her. Dr. Hauptman opined that "within a reasonable degree of medical certainty that the medical records do not support impairment from light work capacity." See Def's Admin. Record Part I of II at 39. Dr. Hauptman based his report primarily on his findings that Plaintiff's claims about her pain were subjective and not supported with objective evidence; that she told Dr. Marcotte she believed her pain was in control; and also, on her failure to follow through with additional treatment with Dr. Jalali.
Based on Dr. Hauptman's assessment, the Defendant determined that Plaintiff no longer met the criteria for total disability and informed her on April 12, 2001. See Def.' s Admin. Record Part I of II at 42. Plaintiff appealed the Defendant's decision to terminate her long-term disability payment to the Defendant's Quality Review Unit, but her appeal was denied on July 16, 2001. See Def's Admin. Record Part I of II at 27. Thereafter, Plaintiff filed this action.
LEGAL STANDARD
Summary judgment is appropriate "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." FED. R. Civ. P. 56(c). An issue is "genuine" if the evidence is such that a reasonable jury could return a verdict for the non-moving party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 2510, 91 L.Ed.2d 202 (1986). A factual dispute is "material" if it might affect the outcome of the case under governing law. Id.
A party seeking summary judgment always bears the initial responsibility for informing the district court of the basis of its motion and identifying those portions of the record that it believes demonstrate the absence of a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 2552, 91 L.Ed.2d 265 (1986). Where the non-moving party bears the burden of proof on a particular issue at trial, the movant's initial Celotex burden can be met simply by "pointing out to the district court that there is an absence of evidence to support the non-moving party's case." Celotex, 477 U.S. at 325, 106 S.Ct. at 2553-54. After the moving party has met its initial burden, "the adverse party's response, by affidavits or otherwise as provided in this rule, must set forth specific facts showing that there is a genuine issue for trial." FED. R. CIV. P. 56(e). That is, summary judgment is appropriate if the non-moving party fails to rebut by making a factual showing "sufficient to establish the existence of an element essential to that party's case, and on which that party will bear the burden of proof at trial." Celotex, 477 U.S. at 322, 106 S.Ct. at 2552-53. "[I]f the opponent [of summary judgment] has exceeded the `mere scintilla' [of evidence] threshold and has offered a genuine issue of material fact, then the court cannot credit the movant's version of events against the opponent, even if the quantity of the movant's evidence far outweighs that of its opponent." Big Apple BMW, Inc. v. BMW of `North America, Inc., 974 F.2d 1358, 1363 (3d Cir. 1992). Under Rule 56, the Court must view the evidence presented on the motion in the light most favorable to the opposing party. Anderson, 477 U.S. at 255, 106 S.Ct. at 2513-14.
DISCUSSION
A. ERISA Standard of Review
First, this Court must determine what standard should be applied in reviewing Defendant's decision to terminate Plaintiff's disability benefits. In determining the appropriate standard of review under ERISA, the United States Supreme Court in Firestone Tire Co. v. Bruch, 489 U.S.101, 109, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989), rejected the universal application of the arbitrary and capricious standard when reviewing an ERISA administrator' s decision regarding benefits eligibility. Rather, the Firestone Court held that "a denial of benefits challenged under § 1132(a)(1)(B) is to be reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan." Id. (emphasis added). The language of the plan will inform the court whether such discretionary authority was given to the administrator or fiduciary. Id. Where discretion has been given to the administrator or fiduciary, its decisions are reviewed under an "abuse of discretion" or "arbitrary and capricious" standard. See Mitchell v. Eastman Kodak Co., 113 F.3d 433, 437 (3d Cir. 1997). It is not disputed by the parties that the Plan gives the administrator discretion triggering the arbitrary and capricious standard for the review of Defendant's denial of benefits to the Plaintiff.
However, where an employer purchases a disability plan from an insurance company, and the insurance company is responsible for funding and interpreting the plan, the Court of Appeals for the Third Circuit has determined that a "sliding scale" approach must be utilized to determine the amount of deference a court should give to the insurance company's decisions. See Pinto v. Reliance Standard Life Ins. Co., 214 F.3d 377, 379 (3d Cir. 2000). This approach is necessitated by the inherent conflict created when a company is both charged with interpreting whether to honor claims under the plan, and responsible for incurring the fiscal impact of the decision. See Pinto, 214 F.3d at 388. Under these situations, "insurance carriers have an active incentive to deny close claims in order to keep costs down and keep themselves competitive so that companies will choose to use them as their insurers. . . ." See id. Therefore, in reviewing decisions of "conflicted" insurers, a court should apply a "heightened arbitrary and capricious" standard. See Pinto, 214 F.3d at 392. Under a heightened standard, a court is to consider not only whether the result is supported by reason, but also the process by which the result was achieved. Id. at 393. In reviewing the administrator's decision, a court may show deference, but the greater the evidence of conflict on the part of the administrator, the less deference a court needs to give. Id. Relevant factors in determining deference may include the sophistication of the parties, the information accessible to the parties, the nature of the financial arrangement between the insurer and the company, and the current status of the fiduciary. Id. at 392.
Defendant argues that this Court should apply the modified arbitrary and capricious standard of review because the policy at issue contains a provision that expressly grants Reliance discretionary authority to interpret the Plan and to determine eligibility for benefits. In this case, it is clear to this Court that Defendant Reliance is operating under a conflict of interest as both the administrator and insurer of the Policy. Therefore, under Pinto, this Court must apply the heightened arbitrary and capricious standard of review because Reliance's determination of Smetana's benefits will have a direct impact on Reliance's finances.
See Landau v. Reliance Standard Insurance Company, 1999 WL 171489 (E.D. Pa. Mar. 29, 1999) (reaching the same decision as here in another case against Defendant).
B. Defendant's Motion for Summary Judgment
Under the heightened arbitrary and capricious standard, this court need not give complete deference to the administrator's decision to deny benefits. See Pinto, 214 F.3d at 393. The court must "look not only at the result — whether it is supported by reasons — but at the process by which the result was achieved." Id. The court may consider all evidence available to Reliance during the entire claim process. See Mitchell, 113 F.3d at 440.
Applying the heightened arbitrary and capricious standard, the Third Circuit has suggested that the presence of certain factors may indicate that less deference to the administrator's decision is warranted. See Pinto, 214 F.3d at 393. (discussing the sliding scale). Specifically, the administrator's decision-making process may not be entitled to deference if it reverses an earlier decision without receiving any additional medical information. Id. Additionally, the court need not accept the decision if the administrator uses a self-serving approach to the evidence that selectively relies upon the evidence that supports a denial of benefits, but rejects the evidence that supports the granting of benefits. Id. Finally, if the administrator appears unwilling to listen to advice from its staff that recommends continuation of benefits, the decision may be questioned. Id. at 394.
This Court will address the first and second factor together, and the third factor is not at issue. There is evidence in the record that Reliance reversed its decision to pay the Plaintiff long term disability benefits and used a self-serving approach to deny Plaintiff's benefits. The Defendant relied upon Dr. Hauptman's report to determine that Plaintiff was not totally disabled, and Reliance did not request Plaintiff to submit any additional medical information to prove her disability.
In consideration of the third factor, there is no evidence in the record before this Court that any of Reliance's staff opined that the Plaintiff was eligible for long-term disability benefits.
Defendant argues in support of its motion for summary judgment that the Plaintiff has failed to meet her burden of proving that she is totally disabled for the following reasons: (1) the record does not contain any evidence which would substantiate her claim. See Def's Brief at 12; (2) Plaintiff's medical records fail to demonstrate total disability. See Def's Brief at 12; (3) Plaintiff did not demonstrate any significant change in her physical condition. See Def's Brief at 15; (4) Plaintiff did not demonstrate an inability to perform the duties of her regular occupation. See Def's Brief at 17; and (5) independent re view of Plaintiff s medical records confirmed the opinions reached by it regarding Plaintiff's abilities. See Def's Brief at 19.
Defendant contends that the two X-rays, three EMG studies, and the seven MRIs do not demonstrate any impairment which would prevent Plaintiff from working. See Def's Brief at 13. Defendant also contends that the administrative record demonstrates that Plaintiff's physical examinations found only limited range of motion which was slight or modest in nature. Id. Defendant believes that Dr. Oliveri and Dr. Furman's opinions were unfounded, and the doctors relied solely on Plaintiff's complaint in reaching their decisions that Plaintiff's slightly limited range of motion in her neck is disabling. Id.
Plaintiff's car accident (May 14, 1996) occurred almost four years (April 8, 2000) before she filed her claim of total disability. Defendant contends that there were no reports of a new injury or any other aggravating factors which would render Plaintiff totally disabled on or before April 8, 2000. All the tests, MRIs, and EMGs, taken after the date of the alleged disability were consistent with all prior tests taken since the date of the automobile accident. These tests failed to provide evidence of impairment. See Def's Brief at 16. Further, Defendant argues that prior to the date of the alleged disability, Plaintiff's examinations did not reveal complete impairment but rather limited range of motion which was at times described as only "slightly" limited, "modest" in nature, or "somewhat limited." Id. Defendant also contends that the Doctors' medical notes toward the end of Plaintiff s treatment indicated that she was being less than truthful when reporting her limitations. Id.
Plaintiff was employed as a Stock Broker, which is classified as a sedentary level job. Defendant relied upon the Dictionary of Occupational Titles (the "DOT") to define the requirements of a Stock Broker. See Def's Brief at 17. "The DOT is an objective tool used by vocational rehabilitation specialists when assessing the jobs available to those who claim disability by evaluating the requirements of that position as accepted in the general economy." See Def's Brief at 17 According to the DOT, Plaintiff's sedentary level position requires frequent talking, hearing, and near acuity, but only occasional reaching, handling, and fingering. Id. In completing the February 25, 2001, Physical Capacities Assessment, Dr. Furman indicated that Plaintiff could not sit, stand, walk, bend at waist, squat at knees, climb, reach above shoulder, reach below shoulder, kneel, crawl, use foot controls, or drive. Dr. Furman found that Plaintiff could not perform sedentary level work. Dr. Oliveri also found that Plaintiff could not perform sedentary level work when he completed the August 25, 2000, physicians' statement. Id.
In response, the Plaintiff argues that her duties as a stock broker required driving, ongoing use of a computer, and the ability to sit for long periods of time at meetings. See PL's Brief at 10. Plaintiff also argues that her memory loss, numbness, and tingling in her dominant right hand and radiating neck and low back pain prevented her from engaging in the material duties of her occupation. Id.
On March 16, 2001, Dr. William Scott Hauptman, hired by Defendant, reviewed all of Plaintiff's medical records and issued a report which included his assessment of her condition and abilities. See Def's Brief at 19. In Dr. Hauptman's report, he found that "`within a reasonable degree of medical certainty that the medical records do not support impairment from light work predicated exclusively upon patient complaints of pain." Id. Dr. Hauptman neither evaluated Plaintiff nor talked to her or her doctors regarding her disability.
The policy between the Plaintiff and Defendant defines "total disability" as:
[T]hat as a result of an Injury or Sickness:
(1) during the Elimination period and for the first 24 months for which a Monthly Benefit is payable, an Insured cannot perform the material duties of his/her regular occupation;
(a) "Partially Disabled" and "Partial Disability" mean that as a result of an Injury or Sickness an Insured is capable of performing the material duties of his/her regular occupation on a part-time basis or some of the material duties on a full-time basis. An insured who is Partially Disabled will be considered Totally Disabled, except during the Elimination Period;
(b) "Residual Disability" means being Partially Disabled during the Elimination Period. Residual Disability will be considered Total Disability; and
(2) after a Monthly Benefit has been paid for 24 months, an Insured cannot perform the material duties of any occupation. Any occupation is one that the Insured's education, training or experience will reasonably allow.See Def's Admin. Record Part I of II at 8.
In Dr. Hauptman's report, he reviewed all of Plaintiff's medical records, medical and doctor's notes, and all the tests that were taken, and he opined that "within a reasonable degree of medical certainty that the medical records do not support impairment from light work capacity." See Def's Admin. Record Part I of n at 39. Dr. Hauptman further opined that "the patient may have continued neck pain, however, the medical records do not support impairment from light work predicated exclusively upon patients complaints of pain." Id. Dr. Hauptman believed that the "medical records clearly support a significant psychological component to [Plaintiff's] complaints of pain." Id. Dr. Hauptman also contends that "the medical records do consistently document limited range of motion of the neck in rotation bilaterally due to pain." Id. at 40. In his opinion, "this is the only restriction and limitation placed upon [Plaintiff]. [Plaintiff] is not restricted from any rotation of the neck but rather is limited from maximal rotation of the neck." Id. Furthermore, it is Dr. Hauptman's belief that Plaintiff's restriction does not limit her from light work of 40 hours per week. Id.
Defendant relies heavily on Dr. Hauptman's report and discredits Plaintiff's physicians reports. However, at no time did Dr. Hauptman, himself, make a determination of Plaintiff's disability. His review was confined to the medical records, medical and doctor's notes, and tests that were given to the Plaintiff. Nor did he contact Plaintiff's treating physicians or the Plaintiff herself. Furthermore, Dr. Hauptman's paper review of Plaintiff's case is troubling to this Court. Dr. Hauptman did not examine Plaintiff personally, the Court finds it suspect that Defendant would have so easily accepted his report over the findings of Plaintiff's treating physicians, and Plaintiff's subjective complaints of pain. While Defendant purported to summarize the information it had before it, it did not engage in any discussion of why it credited certain evidence, or how it reconciled Dr. Hauptman's analysis with that of Plaintiff s treating and examining physicians. Furthermore, this Court notes that Reliance has placed considerable weight on the alleged lack of "objective evidence" to support Plaintiff's complaints of pain. Defendant has entirely discounted Plaintiff's subjective complaints of pain as "psychosocial." This Court finds that the strong emphasis on objective evidence to the exclusion of the subjective evidence is improper.
While Dr. Hauptman may have concluded otherwise with regard to Plaintiff's work ability, Defendant was not free to merely disregard Plaintiff's treating and examining physicians and findings in this regard in favor of an outcome more to its liking. Most importantly, although Defendant may have doubted the reliability of the conclusions or diagnoses of Plaintiff s treating physicians, there is nothing in the record to indicate that Dr. Hauptman's opinion was any more supported or reliable. This is particularly true given the fact that he was not an examining physician. There is no rational reason why this Court should give more weight to Dr. Hauptman's conclusion without a thorough and fully-supported discussion of why the conclusions of Plaintiff s treating physicians should be rejected.
Defendant has failed to provide evidence to this Court to show that Plaintiff is capable of performing the material duties of her regular occupation on a part-time basis or some of the material duties on a full-time basis. The conclusion reached by Dr. Hauptman is in direct conflict with the opinions of the Plaintiff's physicians and carry some level of bias. Viewing the evidence in a light most favorable to the plaintiff, a reasonable factfinder could conclude that Defendant's decision to credit Dr. Hauptman's report was the result of self-dealing instead of the result of a trustee carefully exercising its fiduciary duties.
See Pinto, 214 F.3d at 393-94 (discussing the situation in which two doctors favored the plaintiff, and two favored the defendant. The Court of Appeals took an active role in weighing the credibility of each doctors' opinion. Notably, the Court determined that where neither of the doctors retained by defendant-insurer had the same extensive contact with the plaintiff as her own physicians the plaintiff had a more convincing case).
Despite the fact that the Defendant is already acting under a conflict of interest by having discretion over the plan which it funds, it drives Defendant's actions deeper into the realm of suspicion that it relies entirely on the medical testimony most favorable to its position. Again, it should be noted that Dr. Hauptman never personally examined the Plaintiff nor talked to Plaintiff's doctors. Defendant is also quick to dismiss the possibly more informed opinions of Dr. Furman and Dr. Oliveri, whom this Court sees as having no financial stake in the outcome of this decision.
This Court finds that Defendant impermissibly used evidence that supported the denial of Plaintiff's benefits, while failing to satisfactorily explain its rejection of evidence supporting an award of long-term disability benefits. This conflict requires the Court to afford Defendant's decision substantially less deference than it would otherwise apply in a heightened arbitrary and capricious review. Based on the totality of Defendant's action, this Court finds that Defendant's decision was arbitrary and capricious. Therefore, this Court finds that Defendant is not entitled to summary judgment, as a matter of law. However, this Court is not in a position to determine whether Plaintiff is, in fact, totally disabled. There is a genuine issue of material fact as to whether Plaintiff is totally disabled from performing the material duties of her regular occupation on a part-time basis or some of the material duties on a full-time basis. It will be for the factfinder at trial to reconcile the conflicting medical assessments, weigh the evidence, and evaluate the credibility of the witnesses. Thus, this Court will deny Defendant's motion for summary judgment.
CONCLUSION
Based upon the foregoing reasons, this Court will deny the Defendant's motion for summary judgment.