Rodriguez v. McGraw-Hill Cos. Long Term Disability Plan

Rodriguez v. McGraw-Hill Cos. Long Term Disability Plan

Opinion

 [*677] OPINION AND ORDER

With the gruesome example of AIDS so salient in our collective consciousness, it should come as no surprise that "new" diseases are first recognized by their symptoms and only much later by their etiology. At what point, therefore, an ailment becomes "medically determinable" is a complex question, not easily reducible to a single test or formula. The issue here presented is whether the malady known as "fibromyalgia" is medically determinable, notwithstanding the absence of a definitive objective test for its diagnosis. The issue arises in the context of the parties' renewed cross-motions for summary judgment. ¹ 

 [**2]  The facts pertinent to the instant motions are as follows. Plaintiff Yvonne Rodriguez began working for defendant McGraw-Hill Companies ("McGraw-Hill") as a secretary in July 1979 and, over the course of the next twenty years, rose to become Director of Editorial Operations for Business Week Magazine, in which capacity she was responsible for, inter alia, the production, printing, and timely closing of each edition of the magazine. See Affidavit of Daniel G. Heyman, sworn to July 26, 2002 ("Heyman Affidavit"), Ex. U (Deposition of Yvonne Rodriguez, June 6, 2002, hereinafter "Rodriguez Deposition") at 10-11, 38-39. Between December 1998 and February 1999, however, plaintiff was diagnosed as suffering from costochondritis, fibromyalgia, and chronic fatigue syndrome -- ailments that, she alleges, caused her severe pain, headaches, and fatigue. Rodriguez Deposition at 43, 66, 68.

According to Rodriguez, by June 1999 her symptoms had become so severe that she was unable to perform her normal duties. See Rodriguez Employment File D00725-726. Beginning June 28, 1999, she went on leave and, under the terms of McGraw-Hill's Short Term Disability Plan, received 100% weekly compensation [**3]  for a period of 26 weeks. When this was exhausted, she applied for the first tranche of the longer-term disability benefits available under McGraw-Hill's Long Term Disability Plan, which, if granted, would have provided her with certain benefits for an additional 24-month period commencing December 28, 1999. However, the Plan Administrator, co-defendant Prudential Insurance Company of America, denied the request. After exhausting her administrative appeals, Rodriguez commenced the instant lawsuit, seeking the 24-month additional benefits and other relief. ²

The operative provision of the Long Term Disability Plan, Section VI,  [**4]  states in subsection (1) that:

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