Gloria Watts v. BellSouth Telecommunications, Inc.

218 F. App'x 854
CourtCourt of Appeals for the Eleventh Circuit
DecidedFebruary 22, 2007
Docket06-15156
StatusUnpublished

This text of 218 F. App'x 854 (Gloria Watts v. BellSouth Telecommunications, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gloria Watts v. BellSouth Telecommunications, Inc., 218 F. App'x 854 (11th Cir. 2007).

Opinion

PER CURIAM:

This is the second time we’ve had occasion to hear this ERISA case. In the first appeal we reversed and remanded the district court’s grant of summary judgment for BellSouth based on Watts’ failure to exhaust her administrative remedies. Watts v. BellSouth Telecomm., Inc., 316 F.3d 1203, 1204 (11th Cir.2003). We concluded that the exhaustion bar does not apply where the failure to exhaust administrative remedies is the result of language in the summary plan description that the claimant reasonably interpreted as meaning that exhaustion was unnecessary. Id.

On remand the district court again granted summary judgment for BellSouth. This time the district court predicated its decision on Watts’ failure to present evidence raising a genuine issue of material fact about whether the decision of Kemper (BellSouth’s designated claims administrator) to deny short and long term disability benefits to Watts was correct. Watts appeals the summary judgment for Bell-South.

Watts first argues that the district court erred in granting summary judgment for BellSouth when it considered the report of Kemper’s peer review physician as evidence that the denial of Watts’ benefits claim was correct. According to Watts, the peer reviewer’s report is not medical evidence that can be considered by the district court because the peer reviewer did not conduct an examination or medical tests of Watts, and was limited in his review to the information Kemper gave him.

The district court did not err in considering the peer review report as evidence that the denial of Watts’ benefits was proper. As the district court explained, “the United States Supreme Court has clarified, in the area of ERISA, opinions of treating physicians are not entitled to any greater deference than those of reviewing physicians.” (R3:78:19) (citing Black & Decker Disability Plan v. Nord, 538 U.S. 822, 831, 123 S.Ct. 1965, 1970, 155 L.Ed.2d 1034 (2003) (noting that nothing in ERISA “suggests that plan administrators must accord special deference to the opinions of treating physicians”)).

Watts also contends that the district court used improper criteria to conduct its de novo review of the denial of benefits. According to her, the district court, like Kemper, considered only objective evidence related to her claimed disability, even though BellSouth’s disability plan did not provide that only objective evidence was relevant to the claim.

There are two problems with Watts’ argument. For one thing, where the plan puts the burden on the claimant to prove that she is disabled, it is implicit in the requirement of proof that the evidence be objective. See, e.g., Brucks v. Coca-Cola Co., 391 F.Supp.2d 1193, 1205 (N.D.Ga. 2005) (“The requirement that a plaintiff submit objective evidence of the impact of a diagnosed disease, illness or other condition is logical and necessary.... The ob *857 jective-evidenee requirement promotes integrity in the application of the law. It assures claimants are treated fairly and with parity by providing that coverage decisions are not based on varying subjective expressions by claimants of a disease, illness or condition with which they have been diagnosed. That is, it requires claimants to establish that the diagnosed disease, illness or condition results in an actual disability, not just a perceived one. The requirement of objective evidence also promotes integrity by assuring there is corroboration for a claimant’s subjective complaints, thus deterring embellished allegations of the effect of the diagnosed malady as well as deterring fraud in the claims process.”); Fick v. Metro. Life Ins. Co., 347 F.Supp.2d 1271, 1286-87 (S.D.Fla. 2004) (“Case law supports the conclusion that it is reasonable for a plan administrator to require objective medical evidence even where the plan does not specifically contain such a requirement. Where a plan requires proof of continued disability, ‘the very concept of proof connotes objectivity.’ ... In the absence of a requirement of objective evidence, the review of claims for long-term disability benefits would be ‘meaningless because a plan administrator would have to accept all subjective claims of the participant without question.’ Furthermore, the fiduciary role of the plan administrator of scrutinizing claims, protecting the assets of a plan, and paying legitimate claims would be seriously compromised.” (citations omitted)); Hufford v. Harris Corp., 322 F.Supp.2d 1345, 1356 (M.D.Fla.2004) (same).

We disagree with Watts’ assertion that our decision in Godfrey v. BellSouth Tele-comm., Inc., 89 F.3d 755 (11th Cir.1996), is to the contrary. Godfrey had nothing to do with the kind of evidence the claimant must proffer to prove that she is disabled. Rather, all the Godfrey Court said was that BellSouth could not limit payment of disability benefits to only those claimants who suffered a loss of functionality. Id. at 758. The reason is that the plan’s definition of disability was not limited to only those disabilities that affected the claimant’s functionality. Id. Disabled “can mean more than physical paralysis or limited limb movement.” Id. In the present case, unlike in Godfrey, the plan explicitly defined disability as the inability to perform any type of work as a result of a physical or mental illness.

Watts’ objective-evidence argument is problematic for a second reason. She does not point to any subjective evidence in the record which indicates that she is disabled. Instead, Watts exclusively relies on the reports of her treating physician and the independent medical examiner to support her contention that there exists a genuine issue of material fact about whether the denial of her benefits claim was wrong. But, as the district court explained, the descriptions by Watts’ physician of Watts’ condition “do not substantiate [her] inability to perform ‘any type of work’ — instead, and to the contrary, they help to bolster the correctness of the decision to deny benefits.” (R3:78:18). Likewise, the independent medical examiner’s report “does not support an acuity of illness which would preclude any workability whatsoever.” Id. at 18-19.

Thus, as the district court concluded, Watts has not pointed to any evidence in the record — subjective or objective — that would create a genuine issue of material fact about the correctness of the denial of benefits. The district court’s summary judgment for BellSouth is due to be affirmed. Because summary judgment is appropriate even on de novo review of the correctness of the denial decision, it necessarily follows that Watts’ contention that the plan administrator acted arbitrarily *858 and capriciously in denying her benefits fails.

Watts also appeals the district court’s order denying her petition for attorneys’ fees.

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Related

Black & Decker Disability Plan v. Nord
538 U.S. 822 (Supreme Court, 2003)
Nachwalter v. Christie
805 F.2d 956 (Eleventh Circuit, 1986)
Gloria Watts v. Bellsouth Telecommunications, Inc.
316 F.3d 1203 (Eleventh Circuit, 2003)
Fick v. Metropolitan Life Insurance
347 F. Supp. 2d 1271 (S.D. Florida, 2004)
Brucks v. Coca-Cola Co.
391 F. Supp. 2d 1193 (N.D. Georgia, 2005)
Hufford v. Harris Corp.
322 F. Supp. 2d 1345 (M.D. Florida, 2004)

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Bluebook (online)
218 F. App'x 854, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gloria-watts-v-bellsouth-telecommunications-inc-ca11-2007.