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HOTALING v. TEACHERS INS. ANNUITY ASS'N OF AMERICA

August 23, 1999

CYNTHIA HOTALING, PLAINTIFF,
v.
TEACHERS INSURANCE AND ANNUITY ASSOCIATION OF AMERICA, DEFENDANT.



The opinion of the court was delivered by: McAVOY, Chief Judge.

MEMORANDUM — DECISION & ORDER

Plaintiff Cynthia Hotaling, a former employee of Hartwick College, commenced the present action against defendant Teachers Insurance and Annuity Association of America ("TIAA") pursuant to the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001 et seq., to recover benefits claimed under the terms of a long term disability benefit plan (the "Plan"). Defendant now moves the Court for summary judgment dismissing Hotaling's claim for long term disability benefits or, in the alternative, moves in limine requesting that: (1) the action be tried by the Court rather than a jury; (2) the trial be limited to the administrative record upon which TIAA based its decision to discontinue plaintiff's long term benefits; and (3) Hotaling not be entitled to seek recovery for prospective benefits in the event that judgment is entered in her favor after trial. See Def. Mem. of Law at 2.

I. BACKGROUND*fn1

In January 1997, plaintiff, former Director of Student Loans and Internal Collections at Hartwick College, applied for disability benefits alleging that she suffered from lower back pain which prevented her from sitting for extended periods of time. See Def. Notice of Motion, Ex. D, at 2-2A (hereinafter "Administrative Record"). Plaintiff first sought treatment for her back pain from her treating physician, Dr. Del Giacco, in July 1996. At that time, Dr. Del Giacco recommended a two-week leave of absence and physical therapy based on plaintiff's complaints of chronic lower back pain. Although plaintiff's treatment was beginning to provide her relief from her pain, Dr. Del Giacco extended plaintiff's leave of absence until September 1996. Upon re-examination in late August 1996, Dr. Del Giacco concluded that:

  Patient is improving slowly but is still not ready to
  return to full work. I suggested that she discuss
  with her supervisor a trial of 2 hours of work daily
  to see how things go.

Administrative Record at 92; see also Def. 7.1(a)(3) Stat. at ¶ 6.

In October 1996, plaintiff was referred to a second treating physician, Dr. Elting, who determined that Hotaling "[was] disabled and has a good deal of pain." Administrative Record at 94. Shortly thereafter, however, Dr. Elting concluded that plaintiff's condition may not qualify her as disabled, noting that:

  Hotaling returns with subjective complaints. . . .
  This is a rather difficult situation as we move
  along. This woman appears to be making no efforts to
  even consider a return to work. I don't know whether
  she would really qualify as disabled from physical
  infirmity.

Id. at 95; see also Def. 7.1(a)(3) Stmt. at ¶ 7.

Around March 1997, plaintiff's physician noted that she was "doing much better" and that her condition was improving based on plaintiff's participation in an increased exercise program and physical therapy. See Administrative Record at 120. Around that time, defendant had plaintiff's file reviewed by its registered nurse, Joseph Brookes, who concluded that:

  Based on the information in the file . . . [t]here is
  not sufficient documentation to support the
  limitation[] of no return to work. There is
  documentation that [Hotaling] could try a return to
  work for 2 hours per day. The position is sedentary
  without many physical requirements that may result in
  injury or exacerbation. There is also documentation
  regarding [Hotaling's] lack of motivation to consider
  a return to work, which is an area of concern since
  her functional ability is not greatly impacted.

Id. at 167; see also. Def. 7.1(a)(3) Stat. at ¶ 9.

Based on Brookes' recommendation, defendant requested that Hotaling undergo a Functional Capacity Evaluation which would assess her performance levels for a variety of work-related tasks. See Def. 7.1(a)(3) Stmt. at ¶ 10. That evaluation, conducted in May 1997, concluded that:

  [Hotaling] is capable of performing work at the light
  level as defined by the U.S. Department of Labor. . .
  . Based on this evaluation, [Hotaling] is incapable
  of

  sustaining the light level of work for an 8-hour
  day.*fn2

Administrative Record at 127-28.

The evaluation also assessed plaintiff's dynamic strength (ability to lift, carry, pull and push objects of varying weights) as "light"; her position tolerance (ability to stand and kneel) as "sedentary"; and her mobility (ability to climb, walk, and squat) as "medium."*fn3 See id. at 129-31. Significantly, plaintiff's position at Hartwick College was sedentary in nature and generally required her to work at her desk. Accordingly, plaintiff's position did not require her to perform physically demanding tasks on a regular basis. In June 1997, following defendant's review of plaintiff's medical evaluations and her Functional Capacity Evaluation, Hotaling was awarded disability benefits for the period February 1, 1997 through June 1, 1997.*fn4 See id. at 38-40.

After reviewing the findings in plaintiff's Functional Capacity Evaluation, Dr. Del Giacco stated:

  I agree with the findings . . . [regarding] the
  functional ability of Ms. Hotaling. I anticipate an
  ability to return to part-time work with some
  limitations due to pain. She can perform only light
  or sedentary work and must have periodic rest periods
  due to pain.

See id. at 139.

When asked how many hours Hotaling was able to work in a day, Dr. Del Giacco recommended "one hour periods of steady work followed by fifteen minutes of rest." Id. at 144. Dr. Del Giacco further opined that:

  If Ms. Hotaling's work is to be limited strictly to
  sitting at a desk, I do not believe she will need the
  frequent rest periods [previously described]. Based
  upon her Physical Work Performance Evaluation, I
  believe she should be able to work an eight-hour day
  of desk work with the usual breaks for stretching
  afforded to any employee.

Id. at 148.

Plaintiff disagreed with Dr. Del Giacco's findings. See id. at 54; Def. 7.1(a)(3) Stmt. at ΒΆ 14. After examining Hotaling in late ...


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