U.S. District Court, Western District of New York Case Summaries:

Daily Record (Rochester, NY), Sep 29, 2008

U.S. District Court, Western District of New York

Social Security

Muschawek v. Astrue

07-CV-558

Judge Skretny

Background: The plaintiff's claim for disability benefits was denied and he seeks judicial review of the denial. The disabilities alleged include hearing loss, Attention Deficit Hyperactivity Disorder and bipolar disorder. The ALJ found the plaintiff was not under a disability, as defined by the regulations, at any point during the relevant period. It was found that he retains the residual functional capacity to perform a wide range of unskilled work at the medium level of exertion and, at 21 years old, can find work available in the national economy. Both parties moved for judgment on the pleadings.

Ruling: The plaintiff's ability to drive, do household chores and work on the computer for five hours per day was consistent with a finding that the plaintiff could maintain adequate attention and concentration to perform a wide range of simple work activities. The defendant's motion for judgment is granted.

Joseph D. Clark, of the Law Offices of Kenneth Hiller for the plaintiff, and Jane B. Wolfe, U.S. Attorney's Office, for the defendant

ERISA

Wasmund v. Meritain Health Inc.

08-CV-498

Judge Scott

Background: Plaintiffs Mark Wasmund, his wife, Shaunette, and their son, Jacob, sued the defendant for breach of insurance contract, negligence in denying benefits, breach of fiduciary duty, arbitrary and capricious denial of medical care, and wanton and reckless denial of medical care, and also claim the defendant made improper medical decisions based on improper and insufficient medical facts. Jacob was injured in 2007 causing C-6 quadriplegia and coverage was denied. The defendant removed the action to federal court on the basis of federal subject matter jurisdiction under the Employee Retirement Income Security Act of 1974. The defendant moved for summary judgment, arguing that because it is the plan administrator, not a fiduciary, it is not subject to a damage action for claim denials. The plaintiffs "have sued the wrong party."

Ruling: The plaintiffs' claims are preempted by ERISA because they seek relief available under ERISA's civil enforcement provisions. The defendant did not possess the discretion that the plaintiffs allege, therefore the defendant's motion for summary judgment is granted.

John P. Feroleto for the plaintiff, and Richard A. Grimm III of Magavern, Magavern & Grimm for the defendant