United States District Court, D. Arizona
Dominic U. Lanza United States District Judge.
before the Court is Plaintiff Nathan Culver's
(“Culver”) motion to supplement the
administrative record or remand (Doc. 59), which Defendants
oppose (Doc. 62). Neither party has requested oral argument.
As explained below, the motion will be granted to the extent
it seeks a remand.
is a former employee of Defendant NXP USA, Inc.
(“NXP”) who, after becoming disabled in October
2014, sought benefits under NXP's Long Term Disability
Insurance Plan. NXP self-funded this plan and hired a pair of
third-party companies-first Aetna and then Prudential-to
serve as plan administrators.
April 2015, Aetna denied Culver's initial application for
long-term disability (“LTD”) benefits. (Doc. 62-2
September 2015, Culver appealed this decision. (Doc. 62-2 at
August 16, 2016, Aetna reversed its previous decision and
granted Culver's application for LTD benefits. (Doc.
59-1.) However, Aetna also sent a separate letter to Culver
on that date in which it explained that its definition of
disability would be changing in November 2016 and thus asked
Culver to submit an array of additional medical information.
(Doc. 59-3 at 3.)
August 22, 2016, Aetna sent another letter to Culver
encouraging him to apply for Social Security disability
benefits. (Doc. 59-2.) This letter explained that,
“[a]lthough your [LTD] benefit would be reduced by any
Social Security disability benefits you may receive, you and
your family still stand to gain some very significant
financial advantages by obtaining a Social Security award . .
. .” (Id.) In response, Culver faxed a letter
to Aetna confirming that he'd already submitted such an
application. (Doc. 62-2 at 9.)
September and October 2016, Aetna made repeated requests to
Culver's attorney to supply additional medical
information, but these requests were either ignored or
inadequately addressed. (Doc. 59-3 at 3; Doc. 62-2 at 42-45.)
October 15, 2016, Culver executed a consent form that
authorized Aetna to obtain his “entire Social Security
file including all medical records, Financial records,
consultations, reviews, exams, etc.” from the Social
Security Administration (“SSA”). (Doc. 59-5.)
November 1, 2016, Aetna terminated Culver's LTD benefits
and sent Culver a letter explaining that this decision was
based on his failure to provide requested medical
information. (Doc. 59-3.)
April 2017, Culver appealed this decision and submitted some
additional medical records in support of his appeal. (Doc.
62-2 at 2-3.)
August 2017, Prudential (which had now replaced Aetna as the
claims administrator) upheld the November 2016 termination of
LTD benefits. (Doc. 62-2 at 63-68.)
February 2018, Culver appealed this decision. (Doc. 62-2 at
21.) In support of this appeal, Culver informed Prudential
that “he has now been determined to qualify for Social
Security Disability Insurance. Although he has not yet
received the final written decision, we have included a
letter from Mr. Culver's Social Security Disability
attorney outlining the current status of his ...