Buha v. United Food & Commercial Workers International Union-Industry Pension Fund

77 F. App'x 347
CourtCourt of Appeals for the Sixth Circuit
DecidedOctober 3, 2003
DocketNo. 02-1389
StatusPublished

This text of 77 F. App'x 347 (Buha v. United Food & Commercial Workers International Union-Industry Pension Fund) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Buha v. United Food & Commercial Workers International Union-Industry Pension Fund, 77 F. App'x 347 (6th Cir. 2003).

Opinion

ROGERS, Circuit Judge.

Cheryl Buha developed debilitating hand and wrist problems after working for the same company for almost three decades. Although she eventually received social security disability benefits, the United Food and Commercial Workers International Union-Industry Pension Fund (“Fund”) denied her application for disability benefits under their pension plan because the Fund determined that she was not disabled at the time she left employment. Buha sued to obtain review of the Fund’s denial, and the district court granted summary judgment in Buha’s favor. The Fund appeals this decision. Because the Fund’s determination was not arbitrary or capricious, we reverse the judgment of the district court.

Facts

Buha worked at Kroger Supermarkets for 29 years, operating the cash register, packing grocery bags, and stocking shelves. In 1986 Buha began complaining of pain in her wrists and hands. By March 6, 1995, her hand problems had deteriorated such that she was no longer able to work.

On September 19, 1995, Buha filed a claim for disability benefits with the Social Security Administration (“SSA”), but she was denied after the initial review because the SSA found that she could be employed [348]*348in a job that did not involve lifting. Buha asked the SSA to reconsider its decision, but she was again denied. After the second denial, Buha requested a hearing, in which she unsuccessfully argued that she became disabled as of June 28, 1994. At the SSA hearing, the administrative law judge (“ALJ”) considered evidence from her treating physician Dr. Albert Pierce and a vocational expert. The ALJ determined that Buha was able to perform other jobs in Michigan and therefore was not disabled. Buha did not appeal the SSA decision any further.

Less than two years later, Buha applied for SSA benefits again, and after a February 10, 1999, hearing on her disability, another ALJ concluded that Buha had been disabled since the date she asserted she was unable to work—July 8,1997—the day after the earlier SSA decision that she was not disabled.

After that decision by the SSA, Buha applied, in May 1999, for disability pension benefits from the Fund, asserting that she was disabled in March 1995. In 1990, the Fund merged with the Michigan United Food and Commercial Workers Unions and Food Employers Joint Pension Fund (“Michigan Fund”), of which Buha was a member. The Fund is a “pension plan” as defined by 29 U.S.C. § 1002(2); it provides pension benefits to eligible participants, and is administered by a plan administrator (“Board of Trustees” or “Trustees”). Buha qualifies as a “participant” under 29 U.S.C. § 1002(7).1 Both the Michigan Fund and the Fund “require that a participant demonstrate that he or she was totally and permanently ‘disabled’ ... at the time the participant terminated Covered Employment.”2 To establish total and permanent disability, the participant must demonstrate that “he is unable to engage in any substantial gainful activity by reason of any medically determinable, physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months[.]”3 J.A. at 75.

On November 22, 1999, the Fund’s Board of Trustees denied Buha’s application for disability benefits because she did not “become Totally and Permanently Disabled while working in Covered Employment.” J.A. at 86. In the letter the Fund sent Buha explaining its decision, the Fund cited only the SSA determination of a 1997 disability date as the reason for the denial of benefits; Buha was deemed to have been disabled for SSA purposes only from July 8, 1997. Buha ceased working in March 1995, and Kroger stopped contributing payments to the Fund on her behalf at that time. According to the Fund standard, Buha needed to have been disabled in March 1995—the time she left covered [349]*349employment—to recover from the Fund. The Trustees concluded that since she had tried and failed under SSA to be declared disabled since 1995, the subsequent SSA disability ruling and onset date of July 1997 kept her from recovering from the Fund.

In the Fund’s administrative record, there was other evidence to support the Trustee’s decision. First, the Fund provided Buha with a required Medical Statement for her physician to complete to assist the Trustees in their determination of her eligibility for disability benefits. Dr. Pierce simply responded “don’t know” to three questions asking the time when the present injury occurred, the “[d]ate the patient became unable to work,” and previous history of this illness. J.A. at 97. Further, Dr. Pierce stated he had “no objective findings” under the section entitled present condition, and he did not complete the section to certify that he “find[s] the patient to be totally disabled.” J.A at 97-99. Second, there was a report by Dr. Buckingham, the Trustees’ medical consultant. After reviewing the administrative record, Dr. Buckingham concluded that there was no reason to establish a disability date before July 8,1997.

Buha appealed this decision within the Fund on the ground that the SSA determination was insufficient both legally and factually for the Trustees to decide that she was not disabled. She submitted additional evidence in support of her claim. This evidence included a 2000 letter from Dr. Pierce stating that he believed “Buha has been disabled from significant employment since 1994.” J.A. at 195. In addition, she submitted the notes Dr. Pierce kept concerning her visits.4 The Fund also received the SSA decisions. In addition, Dr. Buckingham’s successor. Dr. Weiss, based on the administrative record, concluded that she was not totally and permanently disabled from Covered Employment in 1995. Buha was notified of her unsuccessful appeal by the Fund on September 11, 2000. This letter did not mention the earlier SSA determination of a disability onset date as a reason for the denial, and according to Buha, mentioned for the first time that the denial was because she could have performed some work between March 1995 and July 1997.

After this denial, Buha filed a suit in the district court on March 2, 2001, seeking disability benefits from the Fund under § 502(a)(1)(B) of the Employee Retire[350]*350ment Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1132(a)(1)(B). She alleged that the Fund’s denial of her disability benefits was arbitrary and capricious. The parties both filed motions for summary judgment, and the district court conducted a hearing. On February 19, 2002, the district court denied the Fund’s motion and granted Buha’s Motion for Disability Pension Benefits retroactive to March 7,1995, ruling that the Fund’s denial of Buha’s “benefits reflected an ‘arbitrary and capricious’ evaluation of the medical evidence.” The district court also held that the Fund was not entitled to use offensive collateral estoppel to argue an onset date of 1997. The Fund filed this timely appeal.

Discussion

We review a district court’s grant of summary judgment de novo. See Smith v. Ameritech,

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