Goodwin v. Liberty Life Assurance Co. of Boston et al

Filing 19

///ORDER granting 17 Motion for Judgment; denying 14 Motion for Summary Judgment. Clerk is directed to enter judgment and close the case. So Ordered by Judge Joseph A. DiClerico, Jr.(gla)

UNITED STATES DISTRICT COURT FOR THE
DISTRICT OF NEW HAMPSHIRE

Wendy Goodwin
v.
Liberty Life Assurance Co.
of Boston d/b/a Liberty
Mutual Group, Inc.

Civil No. 12-cv-414-JD
Opinion No. 2014 DNH 047

O R D E R
Wendy Goodwin brought suit under the Employee Retirement
Income Security Act (“ERISA”), 29 U.S.C. § 1001 et seq., seeking
to overturn the decision of Liberty Life Assurance Co. of Boston
(“Liberty”) to terminate her long term disability (“LTD”)
benefits.

The parties have both moved for judgment on the

administrative record.

See L.R. 9.4(c).

Standard of Review
The standard of review in an ERISA case differs from that in
an ordinary civil case, where summary judgment is designed to
screen out cases that raise no trialworthy issues.

See, e.g.,

Orndorf v. Paul Revere Life Ins. Co., 404 F.3d 510, 517 (1st Cir.
2005).

“In the ERISA context, summary judgment is merely a

vehicle for deciding the case,” in lieu of a trial.

Bard v.

Boston Shipping Ass’n, 471 F.3d 229, 235 (1st Cir. 2006).

Rather

than consider affidavits and other evidence submitted by the
parties, the court reviews the denial of ERISA benefits based
“solely on the administrative record,” and neither party is
entitled to factual inferences in its favor.

Id.

Thus, “in a

very real sense, the district court sits more as an appellate
tribunal than as a trial court” in deciding whether to uphold the
administrative decision.

Leahy v. Raytheon Co., 315 F.3d 11, 18

(1st Cir. 2002).

Background1
Wendy Goodwin was employed by The Timberland Company
(“Timberland”) as a customer fulfillment database administrator,
a sedentary job, since 1987.

As a Timberland employee, Goodwin

was eligible for and participated in the company’s long-term
disability insurance plan (“Plan”), offered through Liberty.
To receive benefits under the Plan, an employee must be
certified as disabled by Liberty.

The Plan defines a disabled

employee as one who “as a result of Injury or Sickness, is unable
to perform the Material and Substantial Duties of . . . [the
employee’s] occupation that [she] was performing when [her]
Disability . . . began.”
On January 23, 2006, Goodwin had a CT scan of her abdomen
and pelvis because of stomach pain.

Following the scan, Goodwin

was examined by Dr. Peter Carter on two occasions in early
February of 2006.

On or about February 15, 2006, Dr. Carter

performed surgery on Goodwin to repair a ventral incisional

1

The parties’ joint statement of material facts does not
comply with Local Rule 9.4(b). The court will consider the
parties’ motions in the interest of avoiding unnecessary delay.
2

hernia.2

At a follow-up appointment on March 8, 2006, Dr. Carter

prescribed Ciprofloxacin, an antibiotic, because Goodwin appeared
to have a possible infection at the incision site.

He also

prescribed pain medication.
Goodwin saw Dr. Carter on March 24 and April 7, 2006.
During the March 24 appointment, Dr. Carter noted that the
antibiotic was helping to treat the infection.

During the April

7 appointment, Dr. Carter noted that the incision had healed
adequately, but that Goodwin had a “mild keloid formation” and a
“moderate amount of discomfort.”

Dr. Carter advised Goodwin to

return to work but to remain on “light duty for this next
month.”3
Goodwin saw Dr. Carter again on May 3, 2006.

Dr. Carter

noted that Goodwin continued to have discomfort, mostly while
sitting, in the area of the incision.

He ordered an ultrasound

of Goodwin’s stomach and a pain consultation.
Goodwin saw Dr. Christopher Delorie for the pain
consultation on May 10, 2006.

Dr. Delorie noted that the “area

along the scar seems boggy and inflammed [sic].”
Tramadol for Goodwin’s pain.

He prescribed

Dr. Delorie also noted that the

“next option would be . . . infiltration of the scar and deeper
tissues with local and steroid.”
2

Goodwin also told Dr. Carter that she had surgery in 2004
to repair an umbilical hernia.
3

It is unclear whether Goodwin returned to work at that
point or at any point prior to early October of 2006.
3

Goodwin saw Dr. Carter on May 17, 2006, to discuss the
results of the ultrasound.

According to Dr. Carter, the

ultrasound showed a “collection of fluid” in Goodwin’s abdomen.
Dr. Carter prescribed codeine for Goodwin, and referred her back
to Dr. Delorie for “some injections to soften up the scar
tissue.”

Goodwin saw Dr. Delorie on May 23, 2006, and received a

nerve block injection to ease her pain.
On May 31, 2006, Goodwin saw Dr. William Gilbert of Kittery
Family Practice.

Dr. Goodwin wrote Goodwin prescriptions for two

pain medications: Gabapentin and Darvocet (also known as
propoxyphene napsylate).

Over the next several months, Goodwin

received and filled renewed prescriptions for these medications
from Dr. Gilbert.
Goodwin saw Dr. Carter on July 18, 2006.

Dr. Carter did not

think that Goodwin’s pain was being caused by the collection of
fluid shown on the ultrasound.

He thought Goodwin may be having

a reaction to the suture used to close the incision from her
previous operation.

On August 8, 2006, Goodwin underwent a

“[d]ebridement of scar tissue, excision of Prolene suture,
evacuation of seroma . . . . [and] repair of small incisional
hernia.”
Goodwin saw Dr. Carter on August 24, 2006, to examine her
for a “possible wound infection” after her August 8 procedure.
Dr. Carter thought that Goodwin was having a “superficial
reaction to the suture material” and noted that he was “at a loss

4

as to why [Goodwin] has so much discomfort.”

Dr. Carter

prescribed Darvocet for Goodwin’s pain.
Goodwin saw Dr. Carter again on September 7, 2006.

Dr.

Carter noted that he had never had a “patient with this much
chronic pain for the entire duration of my career, so I am
perplexed regarding what could be contributing to her
discomfort.”

Dr. Carter also expressed concern “about the amount

of Darvocet and Tylenol [Goodwin] has been taking.”

Dr. Carter

wrote Goodwin a prescription for Tramadol.
Goodwin next saw Dr. Carter on September 28, 2006.
Carter encouraged Goodwin to return to work.

Dr.

He directed her to

see him again in one month, at which point “the inflammation
should subside, and she should feel better.”

He also wrote her a

prescription for Hydrocodone, a pain medication.

It does not

appear that Goodwin saw Dr. Carter the following month or at any
point after the September 28 appointment.
Goodwin returned to work in early October 2006.

Around this

time, Dr. Gilbert wrote Goodwin prescriptions for two pain
medications: Cymbalta (also known as Duloxetine) and Lidoderm
patches.

Goodwin also requested, and apparently received, a new

prescription for Darvocet from Dr. Frederick Thaler of Kittery
Family Practice.

Goodwin stopped going to work in late October

or early November 2006.
Shortly after Goodwin stopped going to work, she completed a
Disability Claim Form for LTD benefits.

5

On the form, she

reported “[p]ersistent severe abdominal incisional pain related
to surgeries performed on 2/15/06 and 8/8/06.”

Goodwin’s claim

was approved, and she began receiving LTD benefits on March 6,
2007.4
On February 19, 2007, Goodwin completed an Activities
Questionnaire for Liberty.

On the questionnaire, Goodwin wrote

that she could sit upright for less than an hour, walk for up to
fifteen minutes when necessary, and drive a car for thirty
minutes.
In March of 2007, Dr. Gilbert completed a Restrictions Form
concerning Goodwin for Liberty.

Dr. Gilbert indicated that

Goodwin suffered from “constant abdominal incisional pain” and
that they “have exhausted all treatment options.”
On March 26, 2007, Liberty sent a letter to Dr. Gilbert
asking for his opinions on Goodwin’s ailments so that “we may
continue processing [Goodwin’s] disability claim.”
completed the form on or about April 2, 2007.

Dr. Gilbert

Dr. Gilbert again

indicated that he has “exhausted all treatment options.”

He also

wrote that Goodwin was “unable to work.”
On April 23, 2007, the Social Security Administration
(“SSA”) issued a “Notice of Disapproved Claim” concerning
Goodwin’s claims for social security disability benefits.

4

Goodwin’s last day of work for disability purposes was
deemed to be August 7, 2006.
6

On May 4, 2007, Dr. Gilbert completed another Restrictions
Form concerning Goodwin.

Dr. Gilbert indicated that Goodwin was

not capable of performing even sedentary work, and stated that “I
have nothing else to offer her at this point.”
On October 18, 2007, Goodwin saw Dr. Joshua Greenspan at
Paincare Centers.

Dr. Greenspan noted that Goodwin reported that

her pain had become more manageable and she had improved since
starting chronic narcotic therapy.

Goodwin also told Greenspan,

however, that she was in constant pain in her stomach, and that
her pain was aggravated by “activity, driving, lying down,
sitting, standing, walking, bending, lifting, prolonged
positions, sneezing, [and] coughing.”

Dr. Greenspan prescribed

two medications to help Goodwin manage her pain: Namenda and
Opana.

In addition, Goodwin continued to take Hydrocodone and

Darvocet throughout 2007, both of which were prescribed by Dr.
Gilbert.
On December 16, 2007, the SSA issued another “Notice of
Unfavorable Decision” concerning Goodwin’s claim for social
security disability benefits.
On February 5, 2008, Dr. Greenspan completed a Restrictions
Form for Liberty.

Dr. Greenspan indicated that he “cannot

comment on degree of disability,” but stated only that Goodwin
had “no mental or cognitive restriction.”

7

On February 8, 2008, a doctor at Kittery Family Practice
returned an unsigned Restrictions Form to Liberty.5

The form

indicated that Goodwin “can not even do sedentary work” and that
the doctor who filled out the form “do[es] not see [Goodwin]
returning to work until pain issue is resolved.”

The doctor also

indicated that “I have no other treatment.”
On March 8, 2008, a “vocational consultant,” Teresa Marques,
prepared an Occupational Analysis concerning Goodwin.

Marques

indicated that Goodwin’s job “is at the sedentary physical demand
level with primarily sitting, occasional intermittent standing,
and walking and lifting up to 10 pounds.”
On March 10, 2008, Dr. Gilbert completed another
Restrictions Form.

Dr. Gilbert indicated that he had not seen

Goodwin since September 11, 2007, but opined that she was “unable
to work in any capacity at present.”
That same day, a field investigator interviewed Goodwin.
observed that she “walked gingerly and appeared to be in pain.”

He

Goodwin told the investigator that she is unable to walk or
exercise, that she remains inside all day, and that she is only
able to drive when she is not taking any medications, which is
rare.
On or about June 27, 2008, Goodwin completed another
Activities Questionnaire.

She indicated on the questionnaire

5

Although the form was unsigned, Liberty addressed the
letter enclosing the Restrictions Form to Dr. Gilbert.
8

that she could sit upright for ten to fifteen minutes, walk or
stand for fifteen to twenty minutes, was unable to drive a car
and could sit in a car for fifteen to thirty minutes.
Around this time, Liberty hired a company to do a
surveillance investigation on Goodwin.

Surveillance was

conducted on Goodwin on June 30, July 1, and July 2, 2008.

A

report was issued and sent to Liberty on July 14, 2008, along
with a surveillance video.

The report stated that Goodwin rode

as a passenger in a car on July 1 and July 2 while another person
drove the car, and that the car made several stops each day.
On or about July 23, 2008, Dr. Gilbert responded to
Liberty’s request for additional information concerning Goodwin.
Dr. Gilbert indicated that Goodwin was “unable to work in any
capacity” and that she could perform “less than sedentary work.”
Surveillance was again conducted on Goodwin on September 18,
September 19, September 20, and September 23, 2008.

A report was

issued and sent to Liberty on September 29, 2008, along with a
surveillance video.

The report stated that the investigator

observed Goodwin walking “in what appeared to be a normal
fashion.”

Goodwin traveled in a car to and attended a hearing on

her claim for social security disability benefits at the SSA on
September 18.

Goodwin rode as a passenger in the car for twenty

to thirty minutes to and from the hearing.6

6

She attended the

Liberty states in its motion that the ride to and from the
SSA was approximately ninety minutes. That assertion is contrary
to the times listed in the surveillance report.
9

hearing for approximately two and a half hours.

The investigator

did not observe Goodwin on any day other than September 18.
On or about October 30, 2008, Dr. Gilbert responded to
Liberty’s second request for additional information concerning
Goodwin.

Dr. Gilbert again indicated that Goodwin was “unable to

work [in] any capacity.”
On October 31, 2008, the SSA issued a “Notice of Decision Fully Favorable” concerning Goodwin’s claim for disability
benefits.
Liberty arranged for Goodwin to undergo an independent
medical examination (“IME”).

The IME was conducted on January 6,

2009, by Dr. Stuart Glassman.

Dr. Glassman observed that

Goodwin’s “ongoing pain complaints appear to be more subjective
than objective in nature.”

He opined that Goodwin “is more

functional than what she self-reports” and “would have a full
time light duty work capability, lifting 20 pounds maximally and
10 pounds frequently, 8 hours a day, 5 days a week.”
At the end of January of 2009, Liberty sent the IME to Dr.
Gilbert for comments.
requested time.

Dr. Gilbert did not respond within the

By letter dated February 16, 2009, Liberty

advised Goodwin of its determination that she no longer met the
Plan’s definition of disability and, therefore, that benefits
were not payable beyond February 13, 2009.
On April 3, 2009, Dr. Gilbert responded to Liberty’s request
for comments on the IME.

Dr. Gilbert indicated that he disagreed

10

with Dr. Glassman’s opinion concerning Goodwin’s functionality,
and stated that she was not able to lift up to twenty pounds or
lift ten pounds frequently in an eight hour day.

Dr. Gilbert

also wrote that he “feel[s] at this time [Goodwin] is not
employable in any capacity.”
By letter dated August 13, 2009, Goodwin requested a “review
of the decision to terminate [her] benefits.”

In support of her

appeal, Goodwin submitted the SSA’s October 31, 2008, decision
and records from Kittery Family Practice.
referred to Dr. Milton Klein for review.

The appeal was
Dr. Klein issued his

report on October 26, 2009, opining that Goodwin “does have the
capacity to sustain full-time work (8 hours per day, 5 days per
week) as she does not demonstrate any documented evidence of
neuromuscular impairment that would support restrictions or
limitations.”
By letter dated October 30, 2009, Liberty advised Goodwin
that it was “unable to alter our original decision to deny
benefits beyond February 13, 2009.”

Goodwin filed this action

on October 29, 2012.

Discussion
Goodwin argues that her challenge should be reviewed de novo
because the Plan does not give Liberty discretionary authority to
determine eligibility for benefits.

She further argues that,

under either the de novo standard or the deferential standard,
she is entitled to judgment because Liberty’s termination of her
11

LTD benefits is unsupported by the medical evidence in the
administrative record and is arbitrary and capricious.

Liberty

argues that the Plan grants it discretionary authority to
determine eligibility for benefits so its decision must be upheld
unless it was arbitrary and capricious, which it was not.

It

further argues that even if the court uses the de novo standard
on review, the termination of Goodwin’s benefits is supported by
the administrative record in any event.

A.

Deferential or De Novo Review
A case challenging the denial or termination of benefits

under ERISA is reviewed de novo “unless the benefit plan gives
the administrator or fiduciary discretionary authority to
determine eligibility for benefits or to construe the terms of
the plan.”

Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101,

115 (1989); see also Matias-Correa v. Pfizer, Inc., 345 F.3d 7,
11 (1st Cir. 2003); Brigham v. Sun Life of Canada, 317 F.3d 72,
80 (1st Cir. 2003).

If the benefit plan gives the administrator

discretionary authority, “the administrator’s decision must be
upheld unless it is arbitrary, capricious, or an abuse of
discretion.”

Wright v. R.R. Donnelley & Sons Co. Group Benefits

Plan, 402 F.3d 67, 74 (1st Cir. 2005).

To trigger the arbitrary

and capricious standard, “the grant of discretionary authority
must be clear.”

Terry v. Bayer Corp., 145 F.3d 28, 37 (1st Cir.

1998); see also Rodriguez-Abreu v. Chase Manhattan Bank, N.A.,
986 F.2d 580, 583 (1st Cir. 1993).
12

Goodwin argues that Liberty’s decision should be reviewed de
novo because the Plan’s terms are “unclear, conflicting and
ambiguous.”

In support, she points to the following clause in

the Plan: “When Liberty receives proof that a Covered Person is
Disabled due to Injury or Sickness and requires the regular
Attendance of a Physician, Liberty will pay the Covered Person a
Monthly Benefit after the end of the Elimination Period . . . .”
Although Goodwin acknowledges that other clauses in the Plan
appear to grant Liberty discretionary authority, she argues that
this clause does not give Liberty the right to determine whether
proof of disability is sufficient and, therefore, the Plan is
ambiguous and should be construed against the drafter, Liberty.
Liberty argues that the Plan clearly grants it discretionary
authority.

It points to three clauses to support its argument.

The first provides that “Liberty shall possess the authority in
its sole discretion, to construe the terms of this policy and to
determine benefit eligibility hereunder.”

The second provides

that “[p]roof [of disability] must be submitted in a form or
format satisfactory to Liberty.”

The third provides that

“Liberty reserves the right to determine if the Covered Person’s
Proof of loss is satisfactory.”
The First Circuit has held that language in a benefits plan
giving an insurer “sole discretion” to determine eligibility was
sufficient to convey discretionary authority.

See Leahy, 315

F.3d at 15 (“discretionary grant hardly could be clearer” where
the plan documents gave the insurer “‘the exclusive right, in
13

[its] sole discretion, to interpret the Plan and decide all
matters arising thereunder’”); see also McCabe v. Liberty Life
Assur. Co. of Boston, 2011 WL 4499998, at *1 (D.N.H. Sept. 27,
2011).

In addition, language that suggests that proof must be

satisfactory to the insurer is sufficient to vest discretionary
authority in the insurer.

See Brigham, 317 F.3d at 81 (adopting

the view that language such as “‘to us’ after ‘satisfactory’ [is]
an indicator of subjective, discretionary authority on the part
of the administrator, distinguishing such phrasing from policies
that simply require ‘satisfactory proof’ of disability, without
specifying who must be satisfied”); see also Figueiredo v. Life
Ins. Co. of N. Am., 709 F. Supp. 2d 137, 144 (D.R.I. 2010).
Goodwin cites no authority to support her theory that
despite a clear grant of discretionary authority in a plan, a
potential lack of clarity in other plan terms can support
application of the de novo standard.

Accordingly, the court will

apply the deferential standard of review.7

7

Because Liberty, as the plan administrator and insurer,
both makes eligibility determinations and pays benefits, a
structural conflict of interest exists. See Met. Life Ins. Co.
v. Glenn, 554 U.S. 105, 111 (2008). Goodwin, however, did not
raise the issue, much less show that the conflict influenced
Liberty’s decision. See Cusson v. Liberty Life Assurance Co. of
Boston, 592 F.3d 215, 225 (1st Cir. 2010). Therefore, the court
applies the deferential standard without considering the effect,
if any, of the structural conflict.
14

B.

Termination of LTD Benefits
Under the arbitrary and capricious standard, the court can

overturn a defendant’s termination decision only if it finds
“that the insurer’s eligibility determination was unreasonable in
light of the information available to it.”

Cooke v. Liberty Life

Assur. Co. of Boston, 320 F.3d 11, 19 (1st Cir. 2003); see also
Wright, 402 F.3d at 74 (the court must decide “whether the
aggregate evidence . . . could support a rational determination
that the plan administrator acted arbitrarily in denying the
claim for benefits”).

The standard is “generous” to the

administrator, but “is not a rubber stamp.”
Johnson, 585 F.3d 11, 15 (1st Cir. 2005).

Wallace v. Johnson &
A decision to deny or

terminate benefits will be upheld so long as it was “reasoned and
supported by substantial evidence.”

Medina v. Metro. Life Ins.

Co., 588 F.3d 41, 45 (1st Cir. 2009).

“Evidence is substantial

if it is reasonably sufficient to support a conclusion.”

Stamp

v. Metro. Life Ins. Co., 531 F.3d 84, 87 (1st Cir. 2008).
“Evidence contrary to an administrator’s decision does not make
the decision unreasonable, provided substantial evidence supports
the decision.”

Wright, 402 F.3d at 74.

Goodwin faults Liberty for giving minimal weight to the
opinion of her treating physician, Dr. Gilbert, and relying
heavily on the opinions of Dr. Glassman and Dr. Klein.

She

argues that Dr. Glassman’s opinion was not entitled to great
weight because it did not consider any medical evidence prior to
October 21, 2008, and because his opinion was refuted by Dr.
15

Gilbert’s April 3, 2009, letter.

She also contends that Dr.

Klein’s opinion was flawed in that he only appears to have
reviewed Dr. Gilbert’s Restrictions Form dated May 4, 2007, and
in that he does not explain why Goodwin had improved since
Liberty found that she was disabled prior to February 13, 2009.
Liberty argues that it properly relied on Dr. Glassman’s and Dr.
Klein’s opinions, as well as the surveillance investigation
reports, and that its decision is supported by substantial
evidence.
1.

Dr. Gilbert

Goodwin argues that Liberty’s decision cannot stand because
it “gives minimal weight, if any, to the medical opinions of her
regularly attending physician,” Dr. Gilbert, who repeatedly
stated that Goodwin was unable to work in any capacity.

“[T]he

opinion of the claimant’s treating physician, [however], . . . is
not entitled to special deference.”

Orndorf, 404 F.3d at 526

(citing Black & Decker Disability Plan v. Nord, 538 U.S. 822, 831
(2003)).

Thus, “‘[a] plan administrator is not obligated to

accept or even to give particular weight to the opinion of a
claimant’s treating physician.’”

Medina, 588 F.3d at 46 (quoting

Morales-Alejandro v. Med. Card Sys., Inc., 486 F.3d 693, 700 (1st
Cir. 2007)).

Therefore, Liberty was not required to defer to Dr.

Gilbert’s opinions, and the fact that Liberty gave the opinions
little weight does not demonstrate that its decision was
arbitrary and capricious.

16

2.

Other Evidence

Goodwin also argues that Dr. Glassman’s and Dr. Klein’s
opinions are flawed in that they fail to explain why Goodwin
improved on or about February 13, 2009, because Liberty had
determined that she was disabled prior to that point.

She

argues, therefore, that Liberty improperly relied on Dr.
Glassman’s and Dr. Klein’s opinions, and that Liberty’s decision
to terminate her benefits was not supported by substantial
evidence.
The First Circuit has held “that substantial evidence must
support a plan fiduciary’s decision to terminate benefits in
light of its initial finding of disability.”

Fifield v. HM Life

Ins. Co., 900 F. Supp. 2d 110, 118 (D.N.H. 2012) (discussing the
holding of Cook, 320 F.3d at 119); see also Keough v. Liberty
Life Assur. Co. of Boston, 2005 WL 428581, at *13 (D.N.H. Feb.
24, 2005).

Thus, in order to find a claimant no longer disabled

after granting benefits, an insurer must cite “contradictory
medical evidence in the record to support its decision to reject
[existing] evidence.”

Keough, 2005 WL 428581, at *13; see also

McOsker v. Paul Revere Life Ins. Co., 279 F.3d 586, 589 (8th Cir.
2002) (“We are not suggesting that paying benefits operates
forever as an estoppel so that an insurer can never change its
mind; but unless information available to an insurer alters in
some significant way, the previous payment of benefits is a
circumstance that must weigh against the propriety of an
insurer’s decision to discontinue those payments.”); Walker v.
17

Grp. Long Term Disability Ins., 256 F.3d 835, 840 (8th Cir. 2001)
(“Nothing in the claims record justified [the administrator’s]
decision that a change of circumstances warranted termination of
the benefits it initially granted.”).
Liberty points to several pieces of information which
justified its decision to terminate benefits.

Liberty relied in

part on the surveillance videos and accompanying reports it
obtained in July and September of 2008, which suggested that
Goodwin’s limitations are less severe than she and Dr. Gilbert
had stated.

See Gross v. Sun Life Assur. Co. of Canada, 734 F.3d

1, 25 (1st Cir. 2013) (“We have long recognized that even limited
surveillance is a useful way to check the credibility of
individuals who claim disability based on symptoms that are
difficult to evaluate through objective tests.”); Cusson, 529
F.3d at 229; Tsoulas v. Liberty Life Assur. Co., 454 F.3d 69, 80
(1st Cir. 2006).
Liberty also relied on the opinions of Dr. Glassman and Dr.
Klein, both of whom stated that Goodwin had at least full-time,
sedentary work capacity.

Although Goodwin argues that both

doctors were required to explain how her condition improved as of
February 13, 2009, that argument is without merit.

The burden is

on Liberty to point to evidence in the record to justify a
decision to terminate benefits after granting them.

18

That burden

does not fall on Dr. Glassman or Dr. Klein, physicians who had
never before offered an opinion as to Goodwin’s disability.8
In short, in reaching the decision to terminate Goodwin’s
benefits in February of 2009, Liberty relied on evidence that
contradicted the evidence it had relied upon in initially
granting Goodwin LTD benefits under the Plan.9

Therefore,

Liberty’s decision to terminate Goodwin’s LTD benefits was not
arbitrary or capricious.

See Gannon v. Metro. Life Ins. Co., 360

F.3d 211, 216 (1st Cir. 2004) (“[I]n the presence of conflicting
evidence, it is entirely appropriate for a reviewing court to
uphold the decision of the entity entitled to exercise its
discretion.”).

Conclusion
For the foregoing reasons, the defendant’s motion for
judgment on the administrative record (document no. 17) is

8

Indeed, Dr. Klein was specifically tasked with determining
Goodwin’s limitations from February 14, 2009, onward. Dr.
Glassman based his opinion largely on his examination of Goodwin
in January of 2009 and her recent medical record.
9

Goodwin also points to the SSA’s determination of
disability on October 31, 2008. Although the SSA’s determination
may weigh in favor of a finding of disability under the Plan,
“‘benefits eligibility determinations by the Social Security
Administration are not binding on disability insurers.’”
Morales-Alejandro, 486 F.3d at 699 (quoting Pari-Fasano v. ITT
Hartford Life & Accident Ins. Co., 230 F.3d 415, 420 (1st Cir.
2000)). Thus, Liberty permissibly provided Goodwin with benefits
throughout 2007 and 2008 despite the SSA’s denial of benefits to
Goodwin on April 23, 2007, and December 16, 2007, and terminated
benefits in February of 2009 despite the SSA decision that
Goodwin was disabled in October of 2008.
19

granted.

The plaintiff’s motion for judgment on the

administrative record (document no. 14) is denied.

The clerk of

court is directed to enter judgment accordingly and to close the
case.
SO ORDERED.

____________________________
Joseph A. DiClerico, Jr.
United States District Judge
March 4, 2014
cc:

William D. Pandolph, Esq.
Shawn J. Sullivan, Esq.

20