Court Allows Retaliation Charge of Health Plan Participant

March 10, 2006 ( - The US District Court for the Eastern District of Tennessee has allowed a health plan participant to proceed with his claim that he was retaliated against by being fired for the increasing costs of his health insurance premiums.

The court denied the employer’s motion for summary judgment, saying genuine issues of material fact existed, BNA reports.   In his opinion, District Judge Harry Mattice, Jr. said the participant presented sufficient evidence for a reasonable fact finder to conclude that the employer’s reasons for firing him were pretextual.

In addition, on a charge that he was discriminated against in violation of the Americans with Disabilities Act (ADA) because of his medical condition, the court decided a reasonable jury could find the participant’s condition qualified as a “disability” under the act.

William Boles was an employee of Polyloom Corp. of America when he was diagnosed with Crohn’s disease, a gastrointestinal disorder.   The series of treatments Boles received for his condition were costly and, as a result, Polyloom’s health insurance premium costs increased.

After his diagnosis, Boles received three disciplinary actions and was terminated.   He sued Polyloom alleging that he was terminated for the purpose of interference of benefits and was discriminated against due to his disease.   He brought a prima facie case of retaliation under the Employee Retirement Income Security Act (ERISA) against the employer.

Polyloom claimed Boles was fired for failure to follow work instructions.   However, evidence of a conversation Boles had with a human resource manager, in which the manager said Polyloom could not afford the rising health premiums, worked against the company for its motion for summary judgment against the retaliation and discrimination claims.

The court said Boles provided evidence of the conversation with the human resource manager, the fact that the same manager participated in the decision to fire him, and the proximity in time between the conversation and his termination.   Though the evidence was circumstantial, the court said, it was still sufficient to allow a jury to decide the case.