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Foster v. Sedgwick Claims Management Services, Inc.

United States District Court, District of Columbia

December 1, 2015

KELLY FOSTER, Plaintiff,
v.
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., et al., Defendants.

MEMORANDUM OPINION

JAMES E. BOASBERG UNITED STATES DISTRICT JUDGE

On August 28, 2015, this Court issued a Memorandum Opinion and separate Order granting summary judgment in favor of Defendants Sedgwick Claims Management Services, Inc., and Sun Trust Bank’s Short-Term and Long-Term Disability Plans. See ECF Nos. 28-29. Plaintiff Kelly Foster now moves under Federal Rule of Civil Procedure 59(e) to alter or amend that judgment and under Rule 15(a) to amend her Complaint. As the arguments and legal theories she offers are based neither on new or previously unavailable evidence nor on any intervening change in the law, the Court will deny the Motion.

I.Background

The background of this case is set forth in greater detail in the Court’s Opinion, see Foster v. Sedgwick Claims Mgmt. Servs., Inc., 2015 WL 5118360 (D.D.C. Aug. 28, 2015), but a truncated summary of the dispute will suffice here. Plaintiff, a former employee of Sun Trust Bank, asserts that she suffers from a host of physical conditions - including dry eyes, anxiety, fatigue, and fibromyalgia - that rendered her “totally disabled” and unable to work. Id. at *1. She applied for but was denied benefits under the Bank’s Short-Term Disability (STD) Plan, as well as its Long-Term Disability (LTD) Plan - the latter of which requires sustained eligibility for the former, or for Workers’ Compensation, as a precondition of receiving benefits. Id. at *2. After Sedgwick, the claims administrator for both plans, upheld these denials, Foster filed the present lawsuit to clarify and enforce her rights under the plans, as permitted by the Employee Retirement Income Security Act (ERISA). Id.; see also 29 U.S.C. § 1132(a); Compl., ¶¶ 1-4.

Defendants thereafter moved for summary judgment, contending, first, that the STD Plan was not covered by ERISA, and, second, that Foster was not eligible for benefits under the LTD Plan. See ECF No. 22 (Def. MSJ) at 1-2. Concurring with both contentions, the Court granted the Motion.

In its Opinion, the Court began by noting that Foster had unambiguously conceded that the STD Plan is not governed by ERISA, and that such concession seemed wise given that the Plan resembled a payroll-practices plan rather than an employee-benefit plan that would be covered by the statute. See Foster, 2015 WL 5118360, at *3. Her remedy, therefore, would lie, if at all, in state contract law. Id.

The Court next turned to the LTD Plan, which all parties agreed was governed by ERISA. Id. at *4. As a threshold matter, Plaintiff had argued that the Court should review her denial of benefits de novo, but Sedgwick had insisted that a more deferential standard of review was required. Id. at *4-5. The Court concluded that when a benefits plan such as this one vests its administrator with the authority to assess a claimant’s eligibility for benefits, such authority is discretionary and therefore may only be reviewed for abuse of discretion. Id. The Court thus employed that standard. Id. at *5-7.

In considering the merits, the Court first noted that the LTD Plan requires that claimants be disabled for a 180-day “waiting period, ” during which they (1) may not return to work for more than 30 days and (2) must maintain eligibility for STD benefits or Workers’ Compensation. See ECF No. 22, Exh. 3 (LTD Plan) at 4-5. Sedgwick informed Foster that it denied her request for LTD benefits because she had failed to satisfy either of the two waiting-period requirements. See ECF No. 22, Exh. 17 (LTD Denial Letter). Relying on the evidence in the record, the Court concluded that Sedgwick did not abuse its discretion in deciding that Foster had not proven that she was entitled to STD benefits throughout the waiting period. See Foster, 2015 WL 5118360, at *6-7. The Court further concluded, inter alia, that Foster had not presented evidence that a conflict of interest altered or in any way motivated Sedgwick’s eligibility determination in her case. Id. at *8.

On September 25, 2015, Plaintiff timely filed the instant Motion for Reconsideration and for Leave to File an Amended Complaint. See ECF No. 30.

II. Legal Standard

Federal Rule of Civil Procedure 59(e) permits the filing of a motion to alter or amend a judgment when such motion is filed within 28 days after the judgment’s entry. The Court must apply a “stringent” standard when evaluating Rule 59(e) motions. See Ciralsky v. CIA, 355 F.3d 661, 673 (D.C. Cir. 2004). “A Rule 59(e) motion is discretionary and need not be granted unless the district court finds that there is an intervening change of controlling law, the availability of new evidence, or the need to correct a clear error or prevent manifest injustice.” Firestone v. Firestone, 76 F.3d 1205, 1208 (D.C. Cir. 1996) (internal quotation marks and citation omitted); see also 11 C. Wright & A. Miller, Fed. Prac. & Proc. Civ. § 2810.1 at 158-62 (3d ed. 2012) (stating that the “four basic grounds” for Rule 59(e) motion are “manifest errors of law or fact, ” “newly discovered or previously unavailable evidence, ” “prevent[ion of] manifest injustice, ” and “intervening change in controlling law”). Critically, Rule 59(e) “is not a vehicle to present a new legal theory that was available prior to judgment.” Patton Boggs LLP v. Chevron Corp., 683 F.3d 397, 403 (D.C. Cir. 2012).

III. Analysis

In her Motion for Reconsideration, Foster advances two new theories about the STD Plan: Abjuring her prior concession that the Plan was not covered by ERISA, she now contends that it is covered by the statute. Alternatively, she asserts that the STD Plan is so “related” to the ERISA-covered LTD Plan that ERISA preempts any state-law remedies; as a result, she believes, her claim lies only under ERISA. She also repeats two previously argued theories about the LTD Plan - namely, that the Court should have reviewed Sedgwick’s decision to deny her LTD benefits under a de novo standard, and that Sedgwick improperly labored under a conflict of interest as the claims administrator for both Plans. Last, Plaintiff asks that the Court permit her to amend her ...


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