Berges v. Standard Insurance

704 F. Supp. 2d 1149, 2010 U.S. Dist. LEXIS 44192
CourtDistrict Court, D. Kansas
DecidedMarch 31, 2010
DocketCivil Action 09-2129-DJW
StatusPublished
Cited by45 cases

This text of 704 F. Supp. 2d 1149 (Berges v. Standard Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Berges v. Standard Insurance, 704 F. Supp. 2d 1149, 2010 U.S. Dist. LEXIS 44192 (D. Kan. 2010).

Opinion

MEMORANDUM AND ORDER

DAVID J. WAXSE, United States Magistrate Judge.

Pending before the Court are the following motions: (1) Defendant Standard Insurance Company’s Motion for Judgment on the Administrative Record (doc. 15); and (2) Plaintiff Marcey Berges’ Motion for Summary Judgment (doc. 28). For the reasons set forth below, the Court will construe Defendant’s motion as one for summary judgment, and will grant it. The Court will deny Plaintiffs motion for summary judgment.

I. Nature of the Matter Before the Court and Background Information

This is an action brought pursuant to section 502(a)(1)(B) of the Employment Retirement Income Security Act (“ERISA”) 1 to recover benefits Plaintiff claims are due her under the terms of a long-term disability plan. Plaintiff was a participant in her employer’s long-term disability plan, which was insured and administered by Defendant. Plaintiff filed a claim for long-term disability benefits that Defendant denied. She now seeks judicial review of Defendant’s decision denying her benefits.

Before proceeding further, the Court notes that Defendant’s motion seeks “judgment on the administrative record.” As the Tenth Circuit recognized in an ERISA case similar to this one, “[t]he Federal Rules of Civil Procedure contemplate no such mechanism as ‘judgment on the administrative record.’ ” 2 The Tenth Circuit thus held that “[pjarties should avoid the practice of requesting it, and courts should avoid purporting to grant it.” 3 It did not provide specific guidance, however, as to how the lower court should treat such a motion.

Here, Defendant states that it “files this Memorandum in Support of its Motion pursuant Local Rule ... 56.1,” 4 which addresses motions for summary judgment. The Court will therefore treat Defendant’s motion as one for summary judgment. The Court notes, however, that the distinction between a motion for judgment on the administrative record and a motion for summary judgment is really more a matter of form than substance, because the Court’s review of the facts in an ERISA case such as this is limited to the facts that are in the administrative record

II. Summary Judgment Standard

Summary judgment is appropriate if the moving party demonstrates that there is “no genuine issue as to any material fact” and that it is “entitled to judgment as a matter of law.” 5 In applying this standard, the court views the evidence and all reasonable inferences drawn from the evidence in the light most favorable to the nonmoving party. 6 This legal standard *1155 does not change where, as here, the court is ruling on cross-motions for summary judgment, 7 for each party has the burden to establish its entitlement to judgment as a matter of law. 8

The Court notes that in ERISA cases seeking review of a denial of ERISA benefits, the court’s review is “limited to the administrative record,” i.e., the materials compiled by the ERISA plan’s administrator in the course of making its decision. 9 Thus, any evidence presented to the Court on summary judgment motions in this type of ERISA case is limited to the administrative record. At the same time, however, the Court notes that its review of the facts is not necessarily limited to the facts that the parties set forth in their briefs as the “uncontroverted facts.” As is discussed in more detail below in Part V, the Court must review the administrative record in this case to determine whether Defendant’s decision to deny Plaintiff benefits was arbitrary and capricious. And in doing so, the Court should consider whether “substantial evidence” supported the decision. 10 Whether evidence is “substantial” must be “evaluated against the backdrop of the administrative record as a whole.” 11 Thus, in ruling on the parties’ summary judgment motions in this case, the Court must evaluate the entire administrative record and not just those particular facts the parties have plucked from the administrative record and inserted into their summary judgment briefs.

In ruling on the parties’ motions, the Court must keep in mind that cross-motions for summary judgment “are to be treated separately; the denial of one does not require the grant of another.” 12 To the extent the cross-motions overlap, however, the court may address the legal arguments together. 13 The Court notes that in this case, the legal issues and arguments made with respect to both motions are virtually identical. Thus, the Court will address the legal issues together.

III. Summary of the Parties’ Arguments

As is discussed below in greater detail, to recover on her ERISA claim, Plaintiff must establish that Defendant’s decision to deny her long-term disability benefits was arbitrary and capricious. One way to do that is to show that the decision was not supported by substantial evidence. Plaintiff contends that Defendant’s decision to deny her benefits was arbitrary and capricious and unsupported by substantial evidence. Plaintiff asserts the following seven reasons as grounds for the Court to enter summary judgment in her favor and award her benefits under the long-term disability plan.

' First, the plan provides that the definition of disability applicable to a participant *1156 “will be the definition approved for your Employer by [Defendant]”; however, Plaintiff contends Defendant “has asserted nothing regarding the ‘definition approved for your employer.’ ” 14

Second, Plaintiffs job with her employer KCM Capital, Inc. required her to travel extensively and internationally, and Defendant failed to take this travel into consideration in concluding that Plaintiff was not disabled.

Third, the Dictionary of Occupational Titles (“DOT”) 186.117-054, which Defendant relied upon, defines the occupation of “President, Financial Institution,” and not “Chief Financial Officer.” Plaintiff therefore contends that it was improper for Defendant to refer to and rely upon DOT 186.117-054 in determining that Plaintiff was not disabled. It was also improper for Defendant to ignore Plaintiffs other job title of Chief Compliance Officer.

Fourth, Defendant never provided its two consulting physicians, Dr. Douglas Haselwood and Dr. Shirley Ingram, with Plaintiffs job titles, job descriptions, or statements made by Plaintiff regarding the requirements of her job.

Fifth, Drs.

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Bluebook (online)
704 F. Supp. 2d 1149, 2010 U.S. Dist. LEXIS 44192, Counsel Stack Legal Research, https://law.counselstack.com/opinion/berges-v-standard-insurance-ksd-2010.