Brumm v. Bert Bell NFL Retirement Plan

995 F.2d 1433, 16 Employee Benefits Cas. (BNA) 2361, 1993 U.S. App. LEXIS 14208, 1993 WL 205030
CourtCourt of Appeals for the Eighth Circuit
DecidedJune 16, 1993
DocketNo. 92-3346
StatusPublished
Cited by23 cases

This text of 995 F.2d 1433 (Brumm v. Bert Bell NFL Retirement Plan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brumm v. Bert Bell NFL Retirement Plan, 995 F.2d 1433, 16 Employee Benefits Cas. (BNA) 2361, 1993 U.S. App. LEXIS 14208, 1993 WL 205030 (8th Cir. 1993).

Opinion

■ MORRIS SHEPPARD ARNOLD, Circuit Judge.

Donald Brumm, a vested participant in the Bert Bell NFL Retirement Plan (Plan), applied for disability benefits under the Plan, which is governed by ERISA, 29 U.S.C. § 1001 et seq. Throughout a number of proceedings between 1984 and 1987, the Plan’s retirement board (Board) denied Brumm the full disability benefits that he sought. Brumm then sued the Plan and Board members under 29 U.S.C. § 1132(a)(1). This appeal arises from the district court’s grant of the Plan’s summary judgment motion, 802 F.Supp. 258. We reverse. ■

I.

Brumm played football for two different NFL teams between 1963 and 1972. He sustained a number of injuries to his back and knees during his NFL career, and he suffers from traumatic spondylolisthesis (forward displacement of one vertebrae over another) between the second and third vertebrae of his back.

After his football career, Brumm worked as a truck driver until October, 1977, when he was involved in a truck accident and suffered a back injury. A physician’s notes, recorded at the time of the post-accident examination, indicate that Brumm was suffering a “pre-existing spondylolisthesis between L2 and L3” with “some degenerative changes between this area indicating that this spondylolisthesis was old.” The doctor noted that the “injury occurred during [Brumm’s] occupation as a professional athlete.” Following the accident, Brumm worked as a dispatcher for the trucking company, then as a surveyor, and finally as owner/manager of a fast-food restaurant. Brumm has been unemployed since December, 1984, and says he is unable to work because he suffers constant back pain.

Brumm applied for Plan benefits in November, 1984. Under Section 5.2 of the Plan, a participant is “totally and permanently disabled” if he “has become totally disabled to the extent that he is prevented from or unable- to engage in any occupation or employment for remuneration or profit_” Section 5.1 of the Plan provides for two levels of total and permanent disability payments: a player is eligible for “Level 1 T & P” benefits if “totally and permanently disabled” due to “a football injury incurred while an Active Player”; he receives “Level 2 T & P” benefits if his “total and permanent disability results from other than a football injury.” The phrase “a football injury incurred while an Active Player” is not defined.

Pursuant to his application for benefits, Brumm was examined by a Dr. Darnell, a Plan-selected physician. Although there is some confusion as to Dr. Darnell’s assessment of Brumm’s disability, he indicated on a Plan document that Brumm was neither “totally disabled” nor “unable to engage in any occupation for any remuneration or profit.” In April, 1985, the Board considered Brumm’s application for disability benefits and, looking only at Dr. Darnell’s report, denied Brumm’s disability claim because it determined that he was not “totally and permanently disabled” under Section 5.2. A notice-of-denial letter sent’ to Brumm in May, 1985 confirmed that the Board’s decision was based on Section 5.2, ie., that Brumm was not totally and permanently disabled.

Brumm’s attorney subsequently filed a timely request for reconsideration of the Board’s decision, providing supplemental medical and psychiatric evidence tending to prove Brumm’s disability. The Board denied Brumm’s request in June, 1985. Almost a year passed without further activity on the claim. In May, 1986, Brumm’s attorney provided the Plan with still more evidence to support Brumm’s claim, including evidence of a December, 1985, grant of Social Security benefits based on Brumm’s inability “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.” After tabling Brumm’s appeal several times, the Board finally sent Brumm to a neutral psychiatrist. After several examinations, the psychiatrist signed a Plan form indicating that Brumm [1436]*1436was disabled from engaging “in any occupation for remuneration or profit.” He concluded that Brumm was permanently disabled from a combination of depressive disorder and back pain and that his disability resulted from an injury caused by “a football-related activity.” Board trustees finally voted on Brumm’s claim by mail ballot in early January, 1987, and Brumm was notified on January 21, 1987, that he was being granted Level 2 benefits for four months with continuation dependent on consideration of.his claim at the March meeting. The letter did not state the basis of the decision, but the Board evidently considered Brumm to be totally and permanently disabled within the meaning of Section 5.2, and the issue became the proper level of benefits to which Brumm was entitled under Section 5.1.

On January 28, 1987, the Plan received an arbitrator’s opinions and decisions on a separate matter involving seven players whose claims for Level 1 benefits had been submitted to arbitration. The arbitrator, Sam Ka-gel, concluded that a player would be eligible for Level 1 T & P (“football”) benefits (1) if the player incurred his disability from one identifiable football injury and (2) if he became totally and permanently disabled within a reasonable time after leaving football. Other totally and permanently disabled participants would receive Level 2 (“non-football”) benefits. Brumm was not a party to this arbitration.

In March, 1987, the Board voted to continue Brumm’s Level 2 benefits, but it tabled his request for Level 1 benefits and an earlier onset date. At a May, 1987, meeting the Board summarily denied Brumm’s request for Level 1 and an earlier onset date. On June 24, 1987, a Plan administrator sent Brumm a letter informing him that the Board had denied his request for reclassification. The letter referred to Section 5.1 as the basis for the denial. Although no other reason was stated for the denial, an internal Plan document indicates that the Board relied on the standards established in the Ka-gel arbitration.1 In upholding the Board’s decision, the district court opined that the Board denied Brumm Level 1 benefits because his disability did not “stem from ‘a’ football injury” under Section 5.1. Brumm continues to receive Level 2 disability benefits.

Brumm raises several issues on appeal. In our discussion of the proper standard of review and in the context of our assessment of the Board’s decision under that standard, we discuss several of Brumm’s arguments. We- reverse based on our finding that the Board’s presumed interpretation of Section 5.1 was unreasonable and constituted an arbitrary and capricious denial of benefits.

II.

We note at the outset that our analysis is somewhat complicated by the Board’s failure to provide Brumm with adequate notice regarding its denial of Level 1 benefits. The June, 1987, notice letter stated that he was denied Level 1 benefits “because [Brumm] did not meet the requirements of Section 5.1 of the Plan ..., the disability results from a football injury incurred while an Active Player’.” This notice is inadequate under the ERISA statutory scheme which requires that every Plan shall provide “adequate notice in writing to any participant or beneficiary that his claim for benefits under the Plan has been denied, setting forth the specific reasons for such denial, written in a manner calculated to be understood by any participant.” 29 U.S.C.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Witcher v. TeamCare
E.D. Arkansas, 2019
Garcia-Moreno v. Great-West Life & Annuity Insurance
402 F. Supp. 2d 1031 (N.D. Iowa, 2005)
Alane King v. Hartford Life
Eighth Circuit, 2005
Allison v. Wellmark, Inc.
153 F. Supp. 2d 1023 (N.D. Iowa, 2001)
Marolt v. Alliant Techsystems, Inc.
146 F.3d 617 (Eighth Circuit, 1998)
Siemers v. Severance Pay Plan of Conoco, Inc.
940 F. Supp. 235 (D. Nebraska, 1996)
Kracht v. Aalfs Associates H.C.P.
905 F. Supp. 604 (N.D. Iowa, 1995)
Clark v. Metropolitan Life Ins. Co.
67 F.3d 299 (Sixth Circuit, 1995)
Lickteig v. Business Men's Assurance Co. of America
61 F.3d 579 (Eighth Circuit, 1995)

Cite This Page — Counsel Stack

Bluebook (online)
995 F.2d 1433, 16 Employee Benefits Cas. (BNA) 2361, 1993 U.S. App. LEXIS 14208, 1993 WL 205030, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brumm-v-bert-bell-nfl-retirement-plan-ca8-1993.