Durakovic v. Bldg. Serv. 32 BJ Pension Fund

CourtCourt of Appeals for the Second Circuit
DecidedJune 24, 2010
Docket09-3651
StatusPublished

This text of Durakovic v. Bldg. Serv. 32 BJ Pension Fund (Durakovic v. Bldg. Serv. 32 BJ Pension Fund) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Durakovic v. Bldg. Serv. 32 BJ Pension Fund, (2d Cir. 2010).

Opinion

09-3651-cv Durakovic v. Bldg. Serv. 32 BJ Pension Fund

1 UNITED STATES COURT OF APPEALS 2 3 FOR THE SECOND CIRCUIT 4 5 August Term, 2009 6 7 8 (Argued: April 5, 2010 Decided: June 24, 2010) 9 10 Docket No. 09-3651-cv 11 12 - - - - - - - - - - - - - - - - - - - - -x 13 14 BEJAZE DURAKOVIC, 15 16 Plaintiff-Appellant, 17 18 - v.- 19 20 BUILDING SERVICE 32 BJ PENSION FUND, BUILDING SERVICE 32BJ 21 HEALTH FUND, BUILDING SERVICE 32BJ BENEFITS FUND, 22 23 Defendants-Appellees. 24 25 - - - - - - - - - - - - - - - - - - - -x 26

27 Before: JACOBS, Chief Judge, WINTER and WALKER, 28 Circuit Judges. 29 30 Plaintiff, Bejaze Durakovic, appeals from an August 4,

31 2009 judgment of the United States District Court for the

32 Eastern District of New York (Block, J.), dismissing her

33 ERISA challenge to a union disability-benefits denial.

34 Durakovic, an office cleaner, suffered chronic pain and

35 weakness in the years following a 1999 automobile accident,

36 and applied for disability benefits from the relevant union 1 funds. When her claim was denied, she filed suit in federal

2 court pursuant to 29 U.S.C. § 1132(a)(1)(B). On cross

3 motions for summary judgment, the district court dismissed

4 the suit. REVERSED.

5 IRA H. ZUCKERMAN (Max D. Leifer, 6 of counsel), New York, NY, for 7 Plaintiff-Appellant. 8 9 Ira A. Sturm, Raab, Sturm & 10 Ganchrow, LLP, New York, NY, for 11 Defendants-Appellees.* 12 13 DENNIS JACOBS, Chief Judge: 14 15 Plaintiff, Bejaze Durakovic, appeals from an August 4,

16 2009 judgment of the United States District Court for the

17 Eastern District of New York (Block, J.), dismissing her

18 ERISA challenge to a union disability-benefits denial.

19 Durakovic, an office cleaner, suffered chronic pain and

20 weakness in the years following a 1999 automobile accident,

21 and applied for disability benefits from the relevant union

22 funds. When her claim was denied, she filed suit in federal

23 court pursuant to 29 U.S.C. § 1132(a)(1)(B). 1 On cross

* Appellees’ counsel failed to appear for oral argument. 1 29 U.S.C. § 1132(a)(1)(B) affords a right of action to a “participant or beneficiary . . . to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights 2 1 motions for summary judgment, the district court dismissed

2 the suit. We reverse, holding that a fund organized

3 pursuant to 29 U.S.C. § 186(c)(5) is conflicted within the

4 meaning of Metropolitan Life Insurance Company v. Glenn, 128

5 S. Ct. 2343 (2008); that the district court should have

6 accorded the conflict in this case more weight; and that no

7 rational trier of fact could have failed to conclude that

8 the benefits denial was arbitrary and capricious.

10 BACKGROUND

11 Bejaze Durakovic emigrated to this country from

12 Yugoslavia in 1971, when she was twenty-four; she never

13 attained more than a sixth-grade education. For thirty-two

14 years, she was an office cleaner at 55 Water Street, in New

15 York City, and a member of the Service Employees

16 International Union, Local 32B-J. In 1999, Durakovic was

17 involved in an automobile accident, but continued to work,

18 reporting chronic pain and weakness. This continued until

19 2003, when the pain and weakness caused her to cease work.

20 Durakovic filed a claim for disability benefits with

21 her union pension, health, and benefits funds (the “Funds”)

to future benefits under the terms of the plan.” 3 1 in December 2003. The union disability plan provides

2 benefits to those deemed “totally and permanently unable, as

3 a result of bodily injury or disease, to engage in any

4 further employment or gainful pursuit.” In support of her

5 claim, she submitted reports by two physicians, Dr. Leonard

6 Langman, a neurologist, and Dr. Alan Dayan; and a notice of

7 benefits award from the Social Security Administration,

8 which had found her disabled. On receipt of her benefits

9 application, the Funds sent her to an independent physician,

10 Dr. Ludmilla Bronfin, who also submitted a report.

11 • Report of Dr. Langman. Dr. Langman concluded that 12 Durakovic was “totally disabled” “for any 13 occupation.” He diagnosed her with cervical and 14 lumbar radiculopathy. And he noted that she 15 complained of pain in her neck and lower back, and 16 that she was experiencing spasms in the cervical 17 and lumbar regions of her spine. His diagnosis 18 was supported by a nerve conduction report, and 19 MRIs of her back and right knee. The nerve 20 conduction report also evidenced mild carpal 21 tunnel syndrome, and the MRI indicated some 22 tearing in the menisci of her right knee.

23 • Report of Dr. Dayan. Dr. Dayan conducted an 24 initial consultation and concluded that Durakovic 25 suffered from “[r]ight knee internal derangement 26 that has been long lasting in nature and continues 27 to cause significant disability.”

28 • Report of Dr. Bronfin. Dr. Bronfin concluded that 29 Durakovic “should not be deemed totally disabled 30 and could attempt to work in a sedentary 31 capacity.” She based her conclusion on a physical 32 examination and on Durakovic’s medical records.

4 1 She accepted the diagnoses of Durakovic’s doctors.

2 The Funds denied Durakovic’s claim by letter dated

3 March 5, 2004. They determined that Durakovic was not

4 disabled “based on the following medical information: Dr.

5 Ludmilla Bronfin, [the Funds’] panel neurologist, found that

6 [she was] not totally and completely unable to work in any

7 capacity for any occupation.” The letter did not mention

8 any of the evidence submitted by Durakovic.

9 Durakovic timely appealed the denial. The appeals

10 board sent her to another independent physician, Dr. Ira

11 Rashbaum, who submitted a report that echoed the relevant

12 findings of Dr. Bronfin: Durakovic was “not totally

13 disabled and could attempt to work in a sedentary capacity.”

14 Dr. Rashbaum premised his conclusion on, inter alia, a

15 range-of-motion test of her spine and extremities, and a

16 review of her medical records.

17 The appeals board denied Durakovic’s appeal by letter

18 dated December 13, 2004, based additionally on Dr.

19 Rashbaum’s report. Shortly thereafter, Durakovic commenced

20 this action pursuant to 29 U.S.C. § 1132(a)(1)(B),

21 challenging the Funds’ decision to deny her disability

22 benefits.

5 1 On March 20, 2007, the Funds reopened Durakovic’s

2 application in light of our decision in Demirovic v.

3 Building Service 32 B-J Pension Fund, 467 F.3d 208 (2d Cir.

4 2006), which arose from a denial of benefits under the same

5 disability plan. In Demirovic, we held that the Funds

6 cannot deem a person able to work (and therefore not

7 “totally disabled”) simply because she is physically capable

8 of performing some job, of whatever type; to be deemed able

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Durakovic v. Bldg. Serv. 32 BJ Pension Fund, Counsel Stack Legal Research, https://law.counselstack.com/opinion/durakovic-v-bldg-serv-32-bj-pension-fund-ca2-2010.