Hine v. Hewlett-Packard Co.

The casenote of the month is from the Disability E-News Alert! a monthly newsletter describing new disability insurance developments.  For subscription information, e-mail Mark DeBofsky or visit www.disabilityenewsalert.com .

Hine v. Hewlett-Packard Co., 2006 U.S.Dist.LEXIS 68716 (N.D.N.Y. 9/25/2006)(Issue: Multiple Chemical Sensitivity, Mental versus Physical Disability).  The plaintiff in this case became disabled in 1989 due to multiple chemical sensitivity, chronic fatigue and severe allergies caused by exposure to chemicals at work.  The plan paid benefits throughout the 1990’s; however, in 2000, a medical record review performed by Prudential found no basis for the MCS diagnosis and suggested a somatoform disorder.  Consequently, the plan terminated benefits stating that there was no physiologic basis for Hine’s disorder and he had long since exhausted the plan’s 24 month limit for payment of benefits due to mental disorders.

When Hine appealed, the file was reviewed by a psychiatrist, Dr. Stephen Gerson, who concluded that Hine suffered from a somatoform disorder, depression and anxiety.   When Prudential upheld the determination, Hine filed suit.  Applying a de novo standard of review, the court found that questions of fact precluded the entry of summary judgment.

Although the court held that neither the doctrines of waiver nor estoppel prevented Prudential from challenging the diagnosis, the court also rejected Prudential’s contention that it was undisputed Hine’s disability was caused at least in part by a psychiatric disorder.  The court concluded,

The record presents material questions of fact on the issue of whether plaintiff's total disability "is caused at least in part by a mental, psychoneurotic or personality disorder." There is competent medical evidence from which a fact-finder could conclude that plaintiff's total disability was and continues to be caused completely by a physiological condition and that any psychological problems he has are the result of -- not a cause of -- his disability. Compare Reid v. Aetna Life Ins. Co., 393 F.Supp.2d 256, 265 (S.D.N.Y. 2005) (granting summary judgment to defendant where "the only physicians to certify Plaintiff as disabled ... cite to psychological factors for his disability."); O'Sullivan v. The Prudential Ins. Co. of Am., 2002 WL 484847, *10 (S.D.N.Y.) (granting summary judgment to defendant because "no rational jury could find that [plaintiff] established how her medical condition rendered her totally disabled"). *11-*12.

Thus, both parties’ motions for summary judgment were rejected.

This note appeared in the Disability E-News Alert! For subscription information, please go to www.disabilityenewsalert.com .