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Morgan v. Hartford Life and Accident Insurance Co.

United States District Court, W.D. Washington, Tacoma

January 26, 2017

TRACIE D. MORGAN, Plaintiff,
v.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY, Defendant.

          ORDER DENYING DEFENDANT'S MOTION FOR SUMMARY JUDGMENT

          Benjamin H. Settle United States District Judge

         This matter comes before the Court on Defendant Hartford Life and Accident Insurance Company's (“Hartford”) motion for summary judgment. Dkt. 20. The Court, having considered the pleadings filed in support of and in opposition to the motion and the remainder of the file, denies the motion for the reasons stated herein.

         I. PROCEDURAL HISTORY

         On March 9, 2016, Tracie Morgan (“Morgan”) filed a complaint for long-term disability benefits against Hartford. Dkt. 1. Morgan's sole claim is wrongful denial of benefits under the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (“ERISA”). Id.

         On November 16, 2016, Hartford moved for summary judgment. Dkt. 20. On December 5, 2016, Morgan responded. Dkt. 22. On December 9, 2016, Hartford replied. Dkt. 23.

         II. FACTUAL BACKGROUND

         Morgan filed a claim with Hartford for long-term disability benefits claiming a disability date of April 8, 2015. AR000082.[1] To support her claim, Morgan presented records from Drs. Cornelia Moynihan, ND, and Larry Stonesifer, MD. See AR000242- 47, AR000254-57, AR000264-68. On May 11, 2015, Dr. Moynihan indicated that Morgan was suffering chronic fatigue from infectious mononucleosis or a “flare up of EBV [Epstein-Barr Virus].” AR000242. However, follow-up serologies revealed results indicating former infection with no current illness. AR000244-46. Morgan continued to suffer symptoms of fatigue and an inability to concentrate. AR000255. On June 18, 2015, Dr. Moynihan referred Morgan to Dr. Stonesifer for an endocrine evaluation. AR000253.

         Morgan continued to visit Dr. Moynihan for follow-up appointments. On June 26, 2015, Dr. Moynihan authorized Morgan to work four hours per day. AR000343. On July 1, 2015, Dr. Moynihan increased Morgan's work capacity to 4.5 hours each day. AR000347. On July 22, 2015, Dr. Moynihan noted that Morgan continued to suffer fatigue and added nausea. AR000352.

         On July 28, 2015, Morgan met with Dr. Stonesifer. AR000265. Dr. Stonesifer assessed Morgan with chronic fatigue and possible reactive hypoglycemia. Id. Dr. Stonesifer ordered additional tests, including an insulin tolerance test. Id. On July 29, 2015, Dr. Moynihan ordered that Morgan not work from July 30, 2015, through August 21, 2015. AR000374. In the same note, Dr. Moynihan stated that Morgan could return to work for 3 hours per day beginning on August 24, 2015. Id.

         On August 19, 2015, Morgan returned for a follow-up with Dr. Stonesifer. AR000267. Reviewing Morgan's lab results, Dr. Stonesifer noted that Morgan's “insulin tolerance test was diagnostic of growth hormone deficiency.” Id. However, he noted that “for definitive diagnosis, we will need the Cortrosyn Stim study.” Id.

         On August 24, 2015, Morgan returned to work on a three-hour-per-day schedule. AR000405. On August 28, 2015, Dr. Moynihan authorized Morgan to increase her schedule on Mondays and Fridays from three hours to four. AR000308.

         On September 18, 2015, Dr. Ifeanyi Nwaneshiudu, MD, NPH, reviewed the medical records submitted to support Morgan's claim to Hartford. AR 000278-81. Dr. Nwaneshiudu did not include the records of Dr. Stonesifer in his review. AR000278-79. Dr. Nwaneshiudu assessed that “[w]ithout any evidence of a diagnosis causing physical impairment, there is no need for medical necessary work restrictions.” AR 000280. On September 30, 2015, Dr. Nwaneshiudu completed an addendum to his initial review after discussing Morgan's functional status with Dr. Moynihan. AR 000270. In the addendum, Dr. Nwaneshiudu noted that his “impression of no impairment diagnosis is unchanged.” AR000270.

         On October 6, 2015, Hartford denied Morgan's application for long-term disability benefits based on Dr. Nwaneshiudu's review. AR000102-06. Morgan appealed and Hartford submitted her medical records to Dr. Charles Fisher, Jr., MD, for another review.

         On November 18, 2015, Morgan met with Dr. Stonesifer, who noted in his records: “I have written a letter today asking [Hartford] to give us more time to get her growth hormone to a more appropriate level. I think she is significantly disabled and growth hormone deficiency can certainly cause these symptoms . . . .” AR000173. His letter, dated November 12, 2015, stated: “[Morgan] was recently diagnosed with adult growth hormone deficiency. She has been on ...


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