United States District Court, D. Oregon
E. Glor John C. Shaw Megan E. Glor, Attorneys at Law, PC
Attorneys for Plaintiff
Russell S. Buhite Ogletree, Deakins, Nash, Smoak &
Stewart, P.C. Attorney for Defendant
OPINION & ORDER
A. HERNÁNDEZ, UNITED STATES DISTRICT JUDGE
the Court is Plaintiff David Black's Motion to Compel
Production . Plaintiff brought this action against
Defendant Hartford Life & Accident Insurance Company
(“Hartford”), alleging that it wrongfully
terminated his long term disability (“LTD”)
benefits claim in violation of the Employee Retirement Income
Security Act (“ERISA”), 29 U.S.C. § 1001
et seq. Plaintiff seeks a Court order compelling
Defendant to produce three categories of documents by
responding to Requests for Production 1-3, 6-9, and 12-16.
See Mot. to Compel 2, ECF 15.
Motion is GRANTED in part.
was employed by DMX Music as a Lead Customer Service
Representative. Compl. ¶¶ 4-8, ECF 1. Plaintiff was
diagnosed with Atypical Parkinson's Disease and obtained
LTD benefits beginning in December of 2005. Id. at
¶¶ 9-11. Plaintiff's LTD policy is insured by
Hartford, which is responsible for determining
Plaintiff's eligibility for benefits and for paying
benefit awards. Id. at ¶¶ 1, 8; Glor Decl.
Ex. B, at 1, ECF 16. Plaintiff was granted an initial
twenty-four months of LTD benefits based on his inability to
perform material duties of his “own occupation.”
Compl. ¶ 12; Glor Decl. Ex. B, at 69. After the
twenty-four month period ended, Plaintiff continued to
receive benefits under the more stringent “any
occupation” standard. Compl. at ¶ 13; Glor Decl.
Ex. B, at 69. Plaintiff received LTD benefits for
approximately nine years under the “any
occupation” standard. Glor Decl. Ex. B, at 66-72.
the outset of Plaintiff's LTD claim, Defendant directed
Plaintiff to apply for Social Security Disability Income
(“SSDI”) benefits. Id. at 75-76.
Plaintiff applied for SSDI benefits. In 2009, the Social
Security Administration (“SSA”) determined that
he was “unable to perform any work existing in
significant numbers in the national economy.”
Id. at 78. SSA determined that Plaintiff was
disabled as of February 1, 2006, and it awarded him benefits
he should have received since that date. Id.
Plaintiff's retroactive SSDI benefits award offset
Defendant's prior LTD benefit payments to Plaintiff.
Id. at 81. As a result, Plaintiff's monthly LTD
payments were roughly cut in half and Plaintiff paid
Defendant $24, 780 out of the SSDI award to cover
Defendant's overpayment. Id. In the seven years
following SSA's determination, the nature of
Plaintiff's disabling condition was regularly confirmed
by physicians and Defendant. Id. at 82- 97.
November 20, 2015, Defendant's Special Investigation Unit
(“SIU”) proactively began investigation
Plaintiff's LTD claim based on online information that
Plaintiff had started a business. Id. at 98.
Defendant hired a third-party vendor to conduct surveillance
of Plaintiff. Id. at 101-105. The video surveillance
showed Plaintiff walking with a cane, using public
transportation, going to the bank, getting his hair cut,
shopping, and carrying groceries. Id. Defendant also
found an online YouTube video of Plaintiff playing in a band
in May of 2014. SIU scheduled an interview with Plaintiff
which was conducted on March 17, 2016. Id. at 123.
Regarding his purported business, Plaintiff explained that he
had registered a business but that he never derived any
income from it and continued paying to maintain the corporate
license to keep alive his hope of someday working again.
Id. at 142-43. Moreover, Defendant hired neurologist
Dr. Robert Egan, who examined Plaintiff on June 14, 2016.
Based on Dr. Egan's examination and review of
Defendant's surveillance footage, he concluded that
Plaintiff did not have Atypical Parkinson's disease.
Id. at 156.
August 31, 2016, Defendant wrote a letter to Plaintiff
informing him that his LTD benefits claim had been
terminated. Id. at 157-69. Plaintiff appealed the
decision, proffering additional medical reports and
explaining that in the YouTube video, he could clearly be
seen sitting the back playing drums, not out front playing
guitar. Id. at 173-76. Defendant denied
Plaintiff's appeal. Plaintiff then filed this lawsuit
alleging that Defendant abused its discretion under ERISA
when it decided to terminate his LTD benefits claim.
Plaintiff filed a Motion to Compel Production, seeking three
categories of documents responsive to Plaintiff's first
requests for production. Defendant opposes the motion.
Rule 26 of the Federal Rules of Civil Procedure, parties
“may obtain discovery regarding any nonprivileged
matter that is relevant to any party's claim or defense
and proportional to the needs of the case . . . .”
Fed.R.Civ.P. 26(b)(1). In ERISA cases, discovery may be
limited because the statute's primary goal is to provide
inexpensive and expeditious resolution to employee benefits
claims. Boyd v. Bert Bell/Pete Rozelle NFL Players
Retirement Plan, 410 F.3d 1173, 1178 (9th Cir. 2005)
(citing Taft v. Equitable Life Assurance Soc'y,
9 F.3d 1469, 1472 (9th Cir. 1993). District courts are
generally limited to the administrative record unless a
so-called structural conflict of interest exists. Montour
v. Hartford Life & Acc. Ins. Co., 588 F.3d 623, 630
(9th Cir. 2009). A conflict of interest exists where the
“the entity that administers the plan, such as an
employer or an insurance company, both determines whether an
employee is eligible for benefits and pays benefits out of
its own pocket.” Metro. Life Ins. Co. v.
Glenn, 554 U.S. 105, 108 (2008). Where this conflict of
interest exists, the plaintiff may be entitled to discovery
outside of the administrative record to determine the
“nature, extent, and effect” the conflict may
have had on the decision-making process. Burke v. Pitney
Bowes Inc. Long-Term Disability Plan, 544 F.3d 1016,
1028 (9th Cir. 2008) (quoting Abatie v. Alta Health &
Life Ins. Co., 458 F.3d 955, 970 (9th Cir. 2006)).
seeks production of three categories of documents, the first
two he refers to ...