John T. Gore v. El Paso Energy Corporation Long Term Disability Plan and El Paso Energy Corporation

477 F.3d 833, 39 Employee Benefits Cas. (BNA) 2852, 2007 U.S. App. LEXIS 3905, 2007 WL 549470
CourtCourt of Appeals for the Sixth Circuit
DecidedFebruary 23, 2007
Docket05-6792
StatusPublished
Cited by68 cases

This text of 477 F.3d 833 (John T. Gore v. El Paso Energy Corporation Long Term Disability Plan and El Paso Energy Corporation) 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
John T. Gore v. El Paso Energy Corporation Long Term Disability Plan and El Paso Energy Corporation, 477 F.3d 833, 39 Employee Benefits Cas. (BNA) 2852, 2007 U.S. App. LEXIS 3905, 2007 WL 549470 (6th Cir. 2007).

Opinion

OPINION

ARTHUR J. TARNOW, District Judge.

Plaintiff, John T. Gore appeals the district court’s grant of summary judgment in which all claims were dismissed in favor of the employer/ERISA plan administrator El Paso Energy Corporation (“El Paso”) and ERISA plan manager/adjudicator Liberty Life Insurance Company of Boston (“Liberty”).

Gore raises the following issues on appeal: (1) whether the district court erred in dismissing Gore’s claim of breach of fiduciary duty against El Paso, pursuant to 29 U.S.C. § 1132(a)(3); and (2) whether the district court erred in disposing of Gore’s claim for civil penalties against El Paso, pursuant to 29 U.S.C. § 1132(c). Gore does not appeal the district court’s affirmance of Liberty’s denial of Gore’s claim for long-term disability benefits.

For the reasons that the follow, we AFFIRM the district court’s dismissal of Gore’s claim for civil penalties but REVERSE the district court’s dismissal of Gore’s claim of breach of fiduciary duty against El Paso and REMAND the case for further proceedings consistent with this ruling.

I. Factual and Procedural History

Plaintiff John T. Gore began working for Tennessee Gas Pipeline Company (“Tennessee Gas”), a subsidiary of Tenneco, Inc. (“Tenneco”) in 1974. As an employee, Gore participated in Tenneco’s long-term disability (“LTD”) plan, which provided for “own occupation” disability benefits for a period of 24 months and “any occupation” disability benefits thereafter until the age of 65.

In 1996, El Paso acquired Tennessee Gas. Shortly thereafter, El Paso’s area manager and HR manager met with El Paso’s new employees from former Tenne-co Gas. The employees were told that their benefits at El Paso would remain the same as they were at Tenneco. According to *835 Gore, at no time during his employment with El Paso did he receive a summary plan description, nor was he informed of any changes to the plan.

Tenneco’s LTD plan was in effect until December 31,1997. On January 1, 1998, a new Group Disability or Income Policy began to cover the company’s employees, including Gore. This new policy, governed by the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. §§ 1001 et seq., is the subject of this dispute.

Under the terms of the new policy, Liberty was required to both manage and adjudicate claims for El Paso. The plan itself was different from the previous plan in that it provided for “own occupation” disability benefits for only 12 months after an elimination period, as opposed to the 24 months of the Tenneco Plan. After 12 months under the new plan, an employee would be required to demonstrate that his injury prevented him from working “any occupation” for which he is qualified.

In late November 2000, Gore was injured in a natural gas explosion at the El Paso facility and has not worked there since. In June of 2001, Gore filed a claim for LTD benefits with Liberty. Liberty retroactively extended disability benefits to him from May 21, 2001 to May 20, 2002 because it was determined that he was unable to perform his “own occupation.”

In October 2001, a vocational case manager conducted a Transferable Skills Analysis to determine whether occupational alternatives were available to Gore, based on his medical/functional and education/vocational capacities. The case manager determined that occupational alternatives were available to Gore within the petroleum industry involving either sedentary work or work light in physical demand. These occupational alternatives were Control Panel Operator, Dispatcher, or Title Clerk.

In December 2001, a physician conducted an Independent Medical Examination of Gore in connection with his Worker’s Compensation claims. The physician recommended that Gore have certain restrictions placed on his work activities. This report was forwarded to another physician who essentially agreed with its evaluation of Gore’s condition.

In February 2002, Liberty informed Gore that in order to remain eligible for benefits after May 21, 2002, Gore would have to meet the “any occupation” standard.

That next month, Liberty ordered a Labor Market Survey to be conducted concerning the three occupational alternatives identified by the vocational case manager. The survey was sent to nine different employers in Texas and Louisiana concerning nine available positions. Eight of the nine employers determined, based on Gore’s restrictions, that Gore was qualified for the specified job.

In April 2002, Gore submitted his own Vocational Evaluation based on his medical records, academic testing, and a clinical interview with Gore. This personal Vocational Evaluation determined that the types of jobs that Gore could perform were not available in Tennessee.

In May 2002, Liberty notified Gore by letter that it had denied his claim for LTD because he did not meet El Paso’s definition of disability. The denial was based on the finding that other occupational alternatives were available to Gore accounting for his restrictions, limitations, and transferable skills in the petroleum industry.

Gore appealed and requested to “review pertinent claim file documents upon which the denial of benefits was based.” After securing an attorney, the attorney requested from Liberty: (1) the administrative record of Gore’s claim; (2) a written explanation of the claims and appeals procedures applicable to Gore’s claim; (3) an *836 additional 90 days to submit proof; and (4) a written explanation of Liberty’s reasons for relying on the Labor Market Survey.

Liberty denied the appeal on July 23, 2002 by letter. The letter also noted that Mr. Gore had already been forwarded a copy of both the administrative file and a copy of El Paso’s LTD Group Contract. As a result, Liberty denied his request for a copy.

In October of 2003, Gore filed a complaint against both Liberty and El Paso in the United States District Court for the Middle District of Tennessee asserting wrongful denial of long-term disability benefits under El Paso’s LTD plan, pursuant to 29 U.S.C. § 1132(a)(1)(B). Gore also asserted a claim for civil penalties due to defendants’ failure or refusal to provide certain documents within 30 days after written request. Gore finally asserted that both Liberty and El Paso breached their fiduciary duties and requested “other appropriate equitable relief to redress violations of the Plan and/or ERISA,” pursuant to 29 U.S.C. § 1132(a)(3). In addition to “benefits” and “civil penalty” damages, Gore requested an injunction, fees and costs.

The parties conferred, drafted, and submitted a proposed Initial Case Management Order that the district court then entered in February 2003. The order structured the case in two stages.

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477 F.3d 833, 39 Employee Benefits Cas. (BNA) 2852, 2007 U.S. App. LEXIS 3905, 2007 WL 549470, Counsel Stack Legal Research, https://law.counselstack.com/opinion/john-t-gore-v-el-paso-energy-corporation-long-term-disability-plan-and-el-ca6-2007.