Susan Lee Horner

Background Education:  Bachelor of Science, Masters of Education specializing in Cardiac Rehabilitation;  15 years experience in Cardiac Rehabilitation and noninvasive special procedures technology;  Authored medical textbook, "Ambulatory Electrocardiography, Applications and Techniques," 1983, J.B. Lippincott, Co. (369-page medical textbook on Ambulatory Electrocardiography/"Holter Monitoring" -- EKG interpretation. 

Juris Doctor (JD), University of San Diego School of Law, 1989.  Medical background applied to wide-variety of medical issues confronted in ERISA employee benefits claims, whether through disability insurance, life insurance or accidental death and dismemberment insurance.   I am a Partner of Miller Monson Peshel Polacek & Hoshaw, downtown San Diego, CA. 

My client experience in this area is widespread, inclusive of issues involving occupational assessment (job vs. occupation), mental disabilities, physical disabilities, mental vs. physical disabilities, pain and disability, disabling medication side effects, benefits calculations including offsets of other income, pre-or post-disability income issues, preexisting condition.  Litigation issues have included but are not limited to ERISA preemption, ERISA standard of review, ERISA scope of review; ERISA discovery and the fiduciary exception, exhaustion of 'administrative' remedies, including "deemed exhaustion."  I have counseled and assisted attorneys --both ERISA attorneys and non-ERISA attorneys--  nationwide.

I have handled claims and cases involving Aetna Life Ins. Co., Canada Life Assurance Co., Cigna Group Insurance / Life Ins. Co. of North America (LINA), The Hartford Life & Accid. Ins. Co.,  Lincoln National Life Ins. Co., Metroplitan Life Ins. Co.,  Prudential Ins. Co. of America, ReliaStar Life Ins. Co./ING,  Reliance Standard Life Ins. Co., Standard Ins. Co., Sun Life Assurance Co. of Canada, Union Central Life Ins. Co., Unum Ins. Co. (and related entities, such as Provident, Paul Revere),  as well as self-funded plans. 

A number of the case decisions, either published or LEXIS/Westlaw available, I have handled include:

Rivkin v. Union Central Life Ins. Co., 2013 U.S. App. LEXIS 12377, 55 Employee Benefits Cas. (BNA) 2376 (9th Cir. June 18, 2013)

Withrow V. Bache Halsey Stuart Shield, Inc., Salary Protection Plan (LTD), 655 F.3d 1032, 2011 U.S. App. LEXIS 17526, 2011 WL 3672778 (9th Cir. 2011) (Aug. 23, 2011) (insurer: Reliance Standard Life Ins. Co.) (Statute of limitations decision); case history, 2008 WL 1836696, 2008 U.S. Dist. LEXIS 35900 (S.D. Cal. April 22, 2008) (ruling on motions in limine); 2007 U.S. Dist. LEXIS 48533 (S.D. Cal. July 5, 2007)

Nash v. Life Insurance Co. of North America, 2011 U.S. Dist. LEXIS 67430 (S.D. Cal. June, 22, 2011); CASE HISTORY includes, 2010 U.S. Dist. LEXIS 134024 (S.D. Cal. Dec. 9, 2010); 2010 WL 2044935 (S.D. Cal. May 18, 2010); 2009 U.S. Dist. LEXIS 36285, *9 (N.D. Ill. Apr. 29, 2009) (granting in part Plaintiff’s request for production of documents from third party surveillance company Photofax Inc.)

Micha v. Sun Life Assurance Co., 789 F. Supp. 2d 1248 (S.D. Cal. May 2, 2011)

Kochenderfer v. Reliance Std. Life Ins. Co., 2009 WL 4722831, 2009 U.S. Dist. LEXIS 112954 (S.D. Cal. Dec. 4, 2009) (decision on the merits); subsequent fee decision at 2010 WL 1912867, 2010 U.S. Dist. LEXIS 41330 (S.D. Cal. April 21, 2010)

Neathery v. Chevron Texaco Corp. Group Accident Policy, 2009 WL 3199173, 2009 U.S. Dist. LEXIS 96031 (S.D. Cal. Aug. 11, 2009) (Bench trial decision, for Plaintiff, reversing denial of accidental death benefits by Life Insurance Co. of North America); CASE HISTORY, 303 Fed. Appx. 485, 2008 WL 5233207, 2008 U.S. App. LEXIS 26106 (9th Cir. , 2008) (unpub) (reversing and remanding, but affirming ‘administrative-remedies’ "deemed exhaustion" decision at 2006 U.S. Dist. LEXIS 96585 (S.D. Cal. Feb. 13, 2006), aff’d 303 Fed. Appx. 485, 2008 WL 5233207, 2008 U.S. App. LEXIS 26106 (9th Cir. 12/15/08); CASE History also includes 2006 U.S. Dist. LEXIS 96586 (S.D. Cal. July 7, 2006) (granting in part Plaintiff’s motion to compel production of "privileged" documents)

Perez v. Cozen & O'Connor etc, 2006 U.S. Dist. LEXIS 90356 (S.D. Cal. Dec. 13, 2006) (findings of fact/conclusions of law; entry of judgment for Plaintiff). Subsequent decisions included, (Perez II), 2008 U.S. Dist. LEXIS 109878 (S.D. Cal Aug 19, 2008) (awarding 10% interest on LTD benefits under the equities of the case); (Perez I) 2007 U.S. Dist. LEXIS 53996 (S.D. Cal. Mar. 27, 2007) (fee decision). CASE HISTORY includes, Perez v. Cozen & O'Connor etc, 459 F. Supp. 2d 1018 (S.D. Cal. 2006) and 2005 U.S. Dist. Lexis 29370 (S.D. Cal. 11/3/2005).

Hemenway v. Unum Life Ins. Co. of Am., 89 Fed. Appx. 630, 2004 U.S. App. LEXIS 4011 (9th Cir. Mar. 1, 2004) (unpub.) (ERISA policy contract interpretation issue on calculation of benefits, for appellant Hemenway)

Rodolff v. Provident Life & Accid. Ins. Co., 256 F.Supp. 2d 1137 (S.D. Cal. 2003)

Mogck v. Unum Life Ins. Co. of America, 292 F.3d 1025 (9th Cir. 2002) (statute of limitations issue, Reversing dismissal of action under contractual suit limitations time bar); subsequent decision in case, Mogck v. Unum, 289 F. 1181 (S.D. Cal. 2003) (fee decision).

Russo v. Hartford Life & Accid. Ins. Co., 2002 U.S. Dist. LEXIS 26566 (S.D. Cal. 2/5/2002)

Meoli v. American Medical Services of San Diego, 35 F.Supp. 2d 761 (S.D. Cal. 1999)

Enslow ex rel. Enslow v. United States, 42 F.3d 1399, 1994 U.S. App. LEXIS 39444 (9th Cir. Cal. 1994) Reported in full at, 1994 U.S. App. LEXIS 32765 (9th Cir. Nov. 15, 1994) (unpub)