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BLASBALG v. MASSACHUSETTS CAS. INS. CO.

April 28, 1997

NACHMAN BLASBALG, Plaintiff, against MASSACHUSETTS CASUALTY INSURANCE COMPANY, Defendant.


The opinion of the court was delivered by: BLOCK

 BLOCK, District Judge:

 Plaintiff Nachman Blasbalg ("Blasbalg") has brought a claim for benefits under the disability policy (the "Policy") issued to him by defendant Massachusetts Casualty Insurance Company ("MCIC"). The case was tried before the Court without a jury on January 13 and 22, 1997. The Court concludes that Blasbalg has been "totally disabled," as defined by the terms of the Policy, since October 1, 1991, and is therefore entitled to the Policy's benefits. In accordance with Rule 52(a) of the Federal Rules of Civil Procedure, the following are the Court's findings of fact and conclusions of law.

 FINDINGS OF FACT

 1. On April 1, 1986, MCIC issued Disability Income Policy 0297059 to Blasbalg. On June 15, 1992, Blasbalg filed a notice of claim with MCIC, seeking disability benefits under the Policy from October 1, 1991 forward. MCIC denied the claim, which precipitated the present litigation, initiated by Blasbalg in 1993.

 2. The Policy provides for the monthly payment of five thousand dollars ($ 5,000) during the period of a continuous total disability if the onset of that disability occurred prior to the insured's 60th birthday.

 3. Blasbalg, who is presently 50 years old, was born on December 5, 1946.

 4. The Policy defines "total disability" as follows:

 
The term "total disability" shall mean your substantial inability to perform the material duties of your work due to injury or sickness. Work means: (1) your regular occupation, trade, or profession; and (2) as such exists at the start of any period of disability for which a claim for benefits is made under this policy.

 5. After college, Blasbalg took courses in computer programming, with a focus on the COBOL language. Following the completion of these computer programming courses, Blasbalg's first three jobs were all computer programming positions.

 6. In 1984, Blasbalg was hired by Mademoiselle Knitwear, Inc. ("Mademoiselle"), a large manufacturer of sweaters and knit fabrics, to computerize its business operations. In 1985, he became a full-time employee and worked for Mademoiselle until the beginning of October 1991. During the last year of his employment he was Vice President of Data Processing.

 7. During his employment at Mademoiselle, Blasbalg was in charge of the design, implementation, writing and maintenance of all of its computer programs. In total, he oversaw the writing of between 500-600 computer programs. Blasbalg wrote a majority of those programs, and knew the codes of the majority of the remainder.

 8. Blasbalg's work for Mademoiselle typically required him to spend three-quarters of the day in front of a computer screen programming, coding, debugging and ensuring the correctness of the underlying data. These duties required a substantial amount of scrolling and the intensive use of his eyes. The balance of his time was spent on other computer-related activities, such as bar coding.

 9. During the summer of 1991, Blasbalg started to suffer from headaches due to eye strain, and his normal workday productivity decreased by fifty percent. This loss of productivity precipitated complaints by his employer and resulted in the termination of his employment with Mademoiselle in the fall of 1991.

 10. MCIC did not adduce any testimony from anyone associated with Mademoiselle or put forth any evidence to contravene Blasbalg's uncontroverted testimony that his termination of employment with Mademoiselle was due solely to his physical inability to continue to perform his normal work duties because of his eye strain and headaches. Nor did MCIC contest Blasbalg's testimony that he never had these problems before and that his work with Mademoiselle prior thereto was problem free.

 11. On October 7, 1991, at or about the time of the termination of his employment, Blasbalg consulted Dr. Simcha Ben-David, a board-certified ophthalmologist affiliated with Maimonides Medical Center in Brooklyn, and New York Eye and Ear and Beth Israel, both of which are located in Manhattan. Dr. Ben-David had examined Blasbalg once before, for a routine checkup, in August 1986. As of 1986, although Blasbalg's vision was within normal limits (20/20 and 20/25), Dr. Ben-David noted that Blasbalg had a small linear scar on the right cornea, which did not apparently cause him any vision problems at that time.

 12. At the October 7, 1991 examination, Blasbalg complained of blurred vision in his right eye and continual headaches from eye strain. Dr. Ben-David's examination revealed that in addition to the linear scar diagnosed in 1986, Blasbalg now had "a central ark like linear haze that was concentric to the bottom part of the eye." It was "very much" in his field of vision and was "as if a person would use their fingernail to scratch their eye, but this happens spontaneously."

 13. On November 1, 1991, Blasbalg returned to Dr. Ben-David on an emergency basis complaining of a protracted three-day period of continuous blurred vision in the right eye. Dr. Ben-David sent Blasbalg to a corneal specialist, Dr. Robert Cykiert, who examined him on November 7, 1991. He essentially agreed with Dr. Ben-David's findings. As Dr. Ben-David explained: "Bottom line is that we were both talking about an irregularity of the right eye in the center of ...


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