Harley v. International Paper Co. Long Term Disability Plan

586 F. Supp. 2d 428, 2007 U.S. Dist. LEXIS 97945, 2007 WL 5734510
CourtDistrict Court, D. South Carolina
DecidedDecember 27, 2007
DocketC.A. 9:07-623-PMD
StatusPublished
Cited by2 cases

This text of 586 F. Supp. 2d 428 (Harley v. International Paper Co. Long Term Disability Plan) is published on Counsel Stack Legal Research, covering District Court, D. South Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Harley v. International Paper Co. Long Term Disability Plan, 586 F. Supp. 2d 428, 2007 U.S. Dist. LEXIS 97945, 2007 WL 5734510 (D.S.C. 2007).

Opinion

ORDER

PATRICK MICHAEL DUFFY, District Judge.

This matter is before the court upon the parties cross-motions for judgment. Plaintiff Sabrina Harley (“Harley” or “Plaintiff’) asserts entitlement to certain benefits pursuant to the Employee Retirement Income Security Act, and she also seeks an award of attorney’s fees. See 29 U.S.C. § 1132(a)(1)(B); see also 29 U.S.C. § 1132(g). The parties have entered into a Joint Stipulation agreeing to certain relevant facts, and the parties also agreed that the court may dispose of the matter based upon cross-motions for judgment. 1

BACKGROUND

The parties have stipulated that Plaintiff seeks benefits pursuant to ERISA, 29 U.S.C. § 1132(a)(1)(B), and a claim for attorney’s fees pursuant to 29 U.S.C. § 1132(g). The parties also agreed that Plaintiff has exhausted her administrative remedies under the International Paper Company Long Term Disability Plan (the “Plan”) for her long term disability claim. Furthermore, the parties have agreed which documents constitute the administrative record. Plaintiff and Defendant agree that the abuse of discretion standard applies to the case and that the issue before the court is thus whether Defendant’s denial of Plaintiffs claim for long term disability benefits constitutes an abuse of discretion.

Plaintiff was born on August 10, 1958, and she went to work for Westinghouse (which later became International Paper Company) and continued to work there for approximately eight years. (AR 00014, 00884.) Plaintiffs last day of work at International Paper was May 6, 1998, and she held the position of Storeroom Assistant on that date. (AR 00100.) While employed at International Paper, Plaintiff participated in the long-term disability plan and was thus eligible to apply for benefits.

The Plan defines “disability” as follows: To receive LTD [ (long-term disability) ] benefits, you must be totally disabled. For the first year you are disabled, your disability is considered “total” if it keeps you from doing each and every duty of your regular job. After the first year, you are considered totally disabled if you cannot do any gainful work (either in or outside Westinghouse) for which you are suited by education, training or experience.

(AR 01644.)

On May 7, 1998, Plaintiff was injured when the car she was driving was struck by an eighteen-wheel truck. (AR 00883.) On or about June 1, 1998, Plaintiff applied for and received short term disability benefits, and the diagnosis section of the claim form indicates Plaintiff suffered from sinusitis and migraines. (AR 00846^17.) On March 8, 1999, Plaintiff made her initial claim for long term disability benefits, describing her disability as “chronic headaches,” “neck pain,” and “lower back pain.” (AR 00099.) Her claim for long term disability benefits was approved and was paid for approximately seven years. Then, on January 13, 2006, the Plan administrator *431 sent a letter to Plaintiff indicating that it was terminating her benefits effective January 1, 2006, for failure to submit requested records. (AR 00077.) On January 28, 2006, the Plan administrator received a facsimile that noted Plaintiffs treating physicians as “mental health and Dr. Cary Fetcher.” (AR 00085.) The facsimile, which is dated January 7, 2007, indicates that Plaintiff is totally disabled from any job due to migraines, back trouble, and depression. (AR 00085.) However, the Plan administrator did not reinstate Plaintiffs benefits, and Plaintiff appealed the decision to terminate benefits on May 18, 2006. (AR 00076.) Having exhausted her administrative remedies, the matter is before this court for disposition.

STANDARD OF REVIEW

“[A] court reviewing the denial of disability benefits under ERISA initially must decide whether a benefit plan’s language grants the administrator or fiduciary discretion to determine the claimant’s eligibility for benefits.... ” Gallagher v. Reliance Standard Life Ins. Co., 305 F.3d 264, 268 (4th Cir.2002) (citing Feder v. Paul Revere Life Ins. Co., 228 F.3d 518, 522 (4th Cir.2000)). If the plan language grants discretion to the administrator, the court reviews the denial under an abuse of discretion standard. See Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989); Johannssen v. Dist. No. 1-Pac. Coast Dist. MEBA Pension Plan, 292 F.3d 159, 168 (4th Cir.2002). Otherwise, the appropriate standard of review is de novo. See Firestone Tire & Rubber Co., 489 U.S. at 111, 115, 109 S.Ct. 948; Johannssen, 292 F.3d at 168.

Under the abuse of discretion standard, the “ ‘discretionary decision will not be disturbed if reasonable, even if the court itself would have reached a different conclusion.’ ” Smith v. Continental Cas. Co., 369 F.3d 412, 417 (4th Cir.2004) (quoting Booth v. Wal-Mart Stores, Inc. Assocs. Health & Welfare Plan, 201 F.3d 335, 341 (4th Cir.2000)). This means that so long as the denial of benefits is the result of “ ‘a deliberate, principled reasoning process and ... is supported by substantial evidence,’ ” it will not be disturbed. Brogan v. Holland, 105 F.3d 158, 161 (4th Cir. 1997) (quoting Bernstein v. CapitalCare, Inc., 70 F.3d 783, 787 (4th Cir.1995)). 2 *432 “Substantial evidence is more than a scintilla, but less than a preponderance.” Hensley v. Int’l Bus. Machs. Corp., 123 Fed.Appx. 534, 537 (4th Cir.2004) (citing Newport News Shipbuilding & Dry Dock Co. v. Cherry, 326 F.3d 449, 452 (4th Cir. 2003)).

DISCUSSION

Plaintiff makes several arguments to support her assertion that the Plan administrator’s decision to terminate her benefits was an abuse of discretion. However, before addressing the arguments in this ease, the court will further review the decisions made by the administrator and the medical evidence in the record.

A.

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Bluebook (online)
586 F. Supp. 2d 428, 2007 U.S. Dist. LEXIS 97945, 2007 WL 5734510, Counsel Stack Legal Research, https://law.counselstack.com/opinion/harley-v-international-paper-co-long-term-disability-plan-scd-2007.