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Walters v. Odyssey Healthcare Management Long Term Disability Plan

United States District Court, D. Arizona

September 4, 2014

Candace S. Walters, Plaintiff,
v.
Odyssey Healthcare Management Long Term Disability Plan, et al., Defendants.

ORDER

JAMES A. TEILBORG, Senior District Judge.

Pending before the Court is Plaintiff Candace S. Walter's Motion for Remand to Plan Administrator (Doc. 47) requesting that the Court order defendant Plan Administrator to review Plaintiff's long-term disability claim and render a decision in accordance with applicable ERISA rules and regulations and in accordance with the terms of the plan. Also pending is Plaintiff's Motion for Partial Summary Judgment (Doc. 48) on Plaintiff's breach of fiduciary duty claim against defendant Plan Administrator. Plaintiff additionally requests that, as an equitable remedy under ERISA, the Court remand Plaintiff's long-term disability claim to defendant Plan Administrator. ( Id. at 7-9). Likewise pending is defendants Odyssey Healthcare Management Long Term Disability Plan and Plan Administrator's (collectively, the "Defendants") Motion for Summary Judgment (Doc. 50).

The three pending motions are fully briefed and the Court heard oral argument on August 26, 2014. For the reasons explained below, the Court grants Defendants' Motion for Summary Judgment (Doc. 50) and denies Plaintiff's two motions (Docs. 47-48).

I. BACKGROUND[1]

Odyssey Healthcare Management ("Odyssey") hired Plaintiff as a registered nurse on April 22, 2003. (Pl. Statement of Facts ("PSOF"), Doc. 49 ¶ 1). As a new employee, Plaintiff elected to enroll in a long-term disability coverage plan offered by Odyssey. (Admin. Record, Doc. 49-1 at 54-57). In October 2004, Plaintiff communicated with Odyssey's human resources representatives concerning Plaintiff's intention to take a medical leave of absence and to potentially apply for short-term disability benefits. ( Id. at 63-64). In November 2004, Plaintiff completed paperwork related to her request for medical leave and short-term disability benefits. ( Id. at 58-62). Later that month, during Odyssey's open enrollment for benefits period, Plaintiff elected not to change her current benefits, including long-term disability coverage. ( Id. at 51).

According to Plaintiff's unverified Complaint (Doc. 1 at Ex. A), Plaintiff was employed by Odyssey until approximately January 2005 ( id. ¶ 8). Plaintiff's unverified Complaint further alleges that, at some point, Plaintiff timely submitted a long-term disability claim to Defendants, but that Defendants refused to process the claim. ( Id. at ¶¶ 10-11).

On December 17, 2010, Plaintiff filed suit in Maricopa County Superior Court asserting a claim under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §§ 1001 et seq., based on Defendants' alleged denial of Plaintiff's claim for long-term disability benefits under the Plan. (Doc. 1 at Ex. A). On January 21, 2011, Defendants removed this action to this Court based on federal-question jurisdiction. (Doc. 1).

Eventually, the Parties filed a Joint Proposed Case Management Plan (Doc. 32) in which Plaintiff elaborated on the factual basis for her Complaint ( id. at 2). During the pendency of discovery, Defendant disclosed the administrative record currently before the Court (Doc. 49-1 at Ex. A). Because the administrative record is so scant, Defendant attempted to investigate the factual basis for Plaintiff's claim that Defendants denied Plaintiff's application. Plaintiff, however, fought Defendants' attempts at discovery, arguing that supplementing the administrative record through discovery was both unnecessary and forbidden by Ninth Circuit Court of Appeals case law. (Mems. Re: Disc. Dispute, Docs. 44-45). Consequently, throughout this litigation, Plaintiff has steadfastly refused to comply with any discovery request, including answering interrogatories, allowing Plaintiff to be deposed, or submitting an affidavit.

After the close of discovery, Plaintiff filed the instant Motion for Remand (Doc. 47) and Motion for Partial Summary Judgment (Doc. 48). In support of Plaintiff's Motion for Partial Summary Judgment, Plaintiff submitted the PSOF. (Doc. 49). Plaintiff's PSOF relies, in large part, on Plaintiff's Affidavit (Doc. 49-1 at Ex. B), which purports to supplement the administrative record and provide evidence proving Plaintiff's various factual allegations. Later, Defendants filed their own Motion for Summary Judgment (Doc. 50) and objections to, among other things, Plaintiff's submission of her Affidavit to supplement the administrative record.

II. LEGAL STANDARD FOR SUMMARY JUDGMENT

Summary judgment is appropriate when "the movant shows that there is no genuine issue as to any material fact and that the moving party is entitled to summary judgment as a matter of law." Fed.R.Civ.P. 56(a). A party asserting that a fact cannot be or is genuinely disputed must support that assertion by "citing to particular parts of materials in the record, " including depositions, affidavits, interrogatory answers or other materials, or by "showing that materials cited do not establish the absence or presence of a genuine dispute, or that an adverse party cannot produce admissible evidence to support the fact." Id. at 56(c)(1). Thus, summary judgment is mandated "against a party who fails to make a 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 Corp. v. Catrett, 477 U.S. 317, 322 (1986).

Initially, the movant bears the burden of pointing out to the Court the basis for the motion and the elements of the causes of action upon which the non-movant will be unable to establish a genuine issue of material fact. Id. at 323. The burden then shifts to the non-movant to establish the existence of material fact. Id. The non-movant "must do more than simply show that there is some metaphysical doubt as to the material facts" by "com[ing] forward with specific facts showing that there is a genuine issue for trial.'" Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586B87 (1986) (quoting Fed.R.Civ.P. 56(e) (1963) (amended 2010)). A dispute about a fact is "genuine" if the evidence is such that a reasonable jury could return a verdict for the nonmoving party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). The non-movant's bare assertions, standing alone, are insufficient to create a material issue of fact and defeat a motion for summary judgment. Id. at 247B48. Further, because "[c]redibility determinations, the weighing of the evidence, and the drawing of legitimate inferences from the facts are jury functions, not those of a judge, ... [t]he evidence of the non-movant is to be believed, and all justifiable inferences are to be drawn in his favor" at the summary judgment stage. Id. at 255 (citing Adickes v. S.H. Kress & Co., 398 U.S. 144, 158-59 (1970)); Harris v. Itzhaki, 183 F.3d 1043, 1051 (9th Cir. 1999) ("Issues of credibility, including questions of intent, should be left to the jury.") (internal citations omitted).

Finally, when multiple parties submit cross-motions for summary judgment, the Court considers each motion on its own merits but must consider all of the evidence presented in determining whether a genuine issue of material fact exists. Fair Hous. Council of Riverside Cnty., Inc. v. Riverside Two, 249 F.3d 1132, 1136 (9th Cir. 2001).

III. EVIDENCE AT SUMMARY JUDGMENT

In support of Plaintiff's Motion for Summary Judgment, Plaintiff submitted a Statement of Facts ("PSOF") supported by both the administrative record in this case (PSOF, Doc. 49-1 at Ex. A, 1-74) and Plaintiff's affidavit (PSOF, Doc. 49-1 at Ex. B, 75-80). Defendants, however, have filed an Objection (Doc. 59) to the admissibility of a majority of the PSOF. Defendants specifically object to numerous paragraphs on various hearsay and foundational grounds. ( Id. at 2-5 (objecting to PSOF ¶¶ 8, 18-21, 24, 28-33, 35-36, 39, 42-43)). Additionally, Defendants generally object to the admissibility of Plaintiff's Affidavit and, therefore, to the portions of the PSOF that rely on Plaintiff's Affidavit for support.[2] ( Id. at 1-2 (objecting to PSOF ¶¶ 2-8, 10-22, 24-28, 33-42); Defs.' Resp. to Pl.'s Mot. for Partial Summ. J., Doc. 60 at 7-9).

A. Legal Standard for Evidentiary Objections

The Ninth Circuit Court of Appeals ("Ninth Circuit") applies a double standard to the admissibility requirement for evidence at the summary judgment stage. See 10B Charles Alan Wright, Arthur R. Miller & Mary Kay Kane, Federal Practice and Procedure § 2738 (3d. ed. 1998).

With respect to the non-movant's evidence offered in opposition to a motion for summary judgment, the Ninth Circuit has stated that the proper inquiry is not "the admissibility of the evidence's form" but rather whether the contents of the evidence are admissible. Fraser v. Goodale, 342 F.3d 1032, 1036 (9th Cir. 2003); see also Fed.R.Civ.P. 56(c)(2) ("A party may object that the material cited to support or dispute a fact cannot be presented in a form that would be admissible in evidence."); Celotex, 477 U.S. at 324 ("We do not mean that the nonmoving party must produce evidence in a form that would be admissible at trial in order to avoid summary judgment." (emphasis added)). Accordingly, the Ninth Circuit has held, albeit sometimes implicitly, that a non-movant's hearsay evidence may establish a genuine issue of material fact precluding a grant of summary judgment. See Fraser, 342 F.3d at 1036-37; Carmen v. S.F. Unified Sch. Dist., 237 F.3d 1026, 1028-29 (9th Cir. 2001); Beyene v. Coleman Sec. Servs., Inc., 854 F.2d 1179, 1182 (9th Cir. 1988). But see Orr v. Bank of Am., NT & SA, 285 F.3d 764, 779 (9th Cir. 2002). Thus, "[m]aterial in a form not admissible in evidence may be used to avoid, but not to obtain summary judgment, except where an opponent bearing a burden of proof has failed to satisfy it when challenged after completion of relevant discovery." Tetra Techs., Inc. v. Harter, 823 F.Supp. 1116, 1120 (S.D.N.Y. 1993).

The Ninth Circuit has required, however, that evidence offered in support of a motion for summary judgment be admissible both in form and in content. See Canada v. Blain's Helicopters, Inc., 831 F.2d 920, 925 (9th Cir. 1987); Hamilton v. Keystone Tankship Corp., 539 F.2d 684, 686 (9th Cir. 1976). Accordingly, unauthenticated documents cannot be considered in ruling on a motion for summary judgment because authentication is a "condition precedent to admissibility." Orr, 285 F.3d at 773; see also Canada, 831 F.2d at 925 ("[D]ocuments which have not had a proper foundation laid to authenticate them cannot support a motion for summary judgment."). A document authenticated through personal knowledge must be supported with an affidavit "[setting] out facts that would be admissible in evidence" and "show[ing] that the affiant or declarant is competent to testify on the matters stated."[3] Fed.R.Civ.P. 56(c)(4).

Similarly, evidence containing hearsay statements is admissible only if offered in opposition to the motion. "Because [v]erdicts cannot rest on inadmissible evidence' and a grant of summary judgment is a determination on the merits of the case, it follows that the moving party's affidavits must be free from hearsay." Burch v. Regents of the Univ. of Cal., 433 F.Supp.2d 1110, 1121 (E.D. Cal. ...


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