Garg v. Employee Benefits Administrative Committee

52 F. App'x 852
CourtCourt of Appeals for the Seventh Circuit
DecidedDecember 5, 2002
DocketNo. 01-1484
StatusPublished
Cited by1 cases

This text of 52 F. App'x 852 (Garg v. Employee Benefits Administrative Committee) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garg v. Employee Benefits Administrative Committee, 52 F. App'x 852 (7th Cir. 2002).

Opinion

ORDER

Plaintiff-Appellant Ramesh Garg (“Garg”) sued Defendant-Appellee Employee Benefits Administrative Committee (the “Committee”), in its capacity as Plan Administrator of Square D Company’s Disability Plan (the “Plan”), for denying his claims for short-term and long-term disability benefits. The district court granted the Committee’s motion for sum[853]*853mary judgment, and Garg appeals. We affirm.

I. FACTUAL BACKGROUND

At approximately 9:20am on Monday, November 30, 1998, Garg left Square D’s facility in Schiller Park, Illinois for the last time as an employee. Hired as an electrical engineer in July 1997, Garg had repeatedly been warned by Square D that his poor job performance could lead to termination. In October 1998, one month before he was discharged, Garg received one of several performance memoranda stating that he was releasing orders at an average rate well below (i.e., 50% less) than the rate required of Square D employees, and warning that if his performance did not improve he would be fired.

The morning of November 30, Garg sent a memo to his supervisor blaming his poor work performance on Square D’s computer software program. That memo made no mention of any alleged disability, illness, or sickness. Indeed, it is undisputed that during his entire employment at Square D, Garg (1) never claimed that he had a disability, illness, or sickness that impacted his ability to do his job prior to being terminated by Square D; (2) never submitted any documentation from any of his physicians establishing his alleged disability during his term of employment at Square D, or (3) never requested any time off due to his alleged disability while an employee of Square D.

About five hours after Garg left Square D’s facility, Garg’s wife telephoned the Human Resources Manager of Square D’s Schiller Park facility and requested an application for short-term disability (“STD”) benefits. Square D initially denied the request, but some time thereafter sent Garg an STD claim form. Garg returned his STD application to Square D on February 1, 1999. Several months later, Garg also applied for long-term disability (“LTD”) benefits under the Plan.

Under the terms of the Plan, which by its terms is governed by the Employee Retirement Income Security Act of 1974 (“ERISA”), a claimant seeking STD benefits must be (1) “unable to perform [his] job responsibilities because of an aceident/sickness as determined by the disability claims administrator”; and (2) “under the regular care of a doctor.” The Plan states that STD benefits end upon the termination of the recipient’s employment. A claimant seeking LTD benefits on the basis he is “totally disabled” must establish that he is (1) “unable to perform each task required by [his] job”; and (2) “under the regular care of a doctor.” In addition, those who are “gainfully employed” cannot be considered “totally disabled” unless they “are working under an approved rehabilitation program designed by Square D.”

Pursuant to its claim procedures, Square D forwarded both of Garg’s applications to its disability plan’s claims administrator, the Hartford Insurance Company (“Hartford”). Hartford denied both of Garg’s claims, noting essentially that as he had worked full-time until his termination, he was neither eligible for Plan benefits nor “disabled” under the terms of the Plan. In accord with the Plan’s appeal rights, Garg appealed Hartford’s denial of his claims to the Committee.

The Committee upheld the denial of Garg’s STD claim on two grounds: (1) Garg was not covered by the Plan, as the Plan provided that coverage ended when the employee “end[ed] employment with Square D”; and (2) Garg did not meet the definition of “disabled” under the Plan while employed, as he had worked full-time until his termination, never missing work or even claiming he was disabled. The Committee also upheld the denial of [854]*854Garg’s LTD claim, noting that Garg (1) was not eligible for benefits under the terms of the Plan as he “only had disability coverage through the last date of his employment”; (2) had been “gainfully employed” up until his termination (and thus able “to perform his job responsibilities”); and (3) had not been under a Square D-approved rehabilitation program.

On September 14, 2000, Garg filed a complaint in the district court for the Northern District of Illinois seeking review of the denial of benefits by the Committee. On November 14, 2001, the district judge filed a Memorandum Opinion and Order granting the Defendant’s motion for summary judgment and denying Garg’s counter motion for summary judgment. Garg timely filed this appeal, and this Court has jurisdiction over this matter pursuant to 28 U.S.C. § 1291.

II. DISCUSSION

A. Standard of Review

A summary judgment motion should be granted if there is “no genuine issue as to any material fact.” Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). “Only disputes over facts that might affect the outcome of the suit under the governing law will properly preclude the entry of summary judgment. Factual disputes that are irrelevant or unnecessary will not be counted.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). We review a grant of summary judgment de novo, viewing all the facts and drawing all reasonable inferences therefrom in favor of the nonmoving party. See Butera v. Cottey, 285 F.3d 601, 605 (7th Cir.2002).

B. The Administrator’s Decision

Where, as here, the Plan gives the Committee, as Plan Administrator, the discretion and authority to grant or deny claims and to construe the Plan’s provisions, we review the administrator’s decision under the arbitrary and capricious standard. See Firestone Tire & Rubber v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989); Herzberger v. Standard Ins. Co., 205 F.3d 327, 331 (7th Cir.2000). Accordingly, this Court may reverse the administrator’s decision only if it was clearly unreasonable. See Hightshue v. AIG Life Ins. Co., 135 F.3d 1144, 1147 (7th Cir.1998). If the plan administrator’s interpretation of the Plan “ “was made rationally and in good faith,’ we will not second-guess whether the decision is right.” Id. (quoting Brown v. Retirement Comm. of Briggs & Stratton, 797 F.2d 521, 529 (7th Cir.1986)).

Garg does not dispute on this appeal that his coverage under the Plan terminated along with his employment. (Appellant’s Br.

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