Meyer v. Duluth Building Trades Welfare Fund

149 F. Supp. 2d 1093, 2001 U.S. Dist. LEXIS 9462, 2001 WL 754439
CourtDistrict Court, D. Minnesota
DecidedJune 21, 2001
DocketCIV 00-1176 RLE
StatusPublished

This text of 149 F. Supp. 2d 1093 (Meyer v. Duluth Building Trades Welfare Fund) is published on Counsel Stack Legal Research, covering District Court, D. Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Meyer v. Duluth Building Trades Welfare Fund, 149 F. Supp. 2d 1093, 2001 U.S. Dist. LEXIS 9462, 2001 WL 754439 (mnd 2001).

Opinion

ORDER

ERICKSON, United States Magistrate Judge.

I. Introduction

This matter came before the undersigned United States Magistrate Judge pursuant to the consent of the parties, made in accordance with the provisions of Title 28 U.S.C. § 636(c), upon the parties’ Cross-Motions for Summary Judgment. A Hearing on the Motions was conducted on January 25, 2001, at which time, the Defendant Duluth Building Trades Welfare Fund (“Fund”) appeared by John H. Bray, Esq., and the Plaintiff Jerald Meyer (“Meyer”) appeared by Thomas F. Andrew, Esq. For reasons which follow, we grant the Fund’s Motion for Summary Judgment.

*1096 II. Factual and Procedural Background

This is an action which arises under the Employee Retirement Income Security Act, Title 29 U.S.C. § 1132(a)(1)(B) (“ERISA”), which was commenced by Meyer, who is a participant in the Fund. Meyer seeks disability and medical benefits, from the Fund, for injuries he sustained when he fell while working at his wife’s place of business, on September 23, 1999. By this action, Meyer seeks to set aside the Fund’s decision to deny him benefits.

The parties have filed a Stipulation of Facts for the purposes of their Cross-Motions for Summary Judgment. As stipulated by the parties, Meyer’s injury occurred while he was working at Bill’s Café, which was purchased by his wife in July of 1999. Meyer’s wife is the sole owner of Bill’s Café and, as a result, Meyer had no ownership interest, rights, or obligations towards Bill’s Café. 1

Immediately prior to Meyer’s accident, Meyer’s wife asked him to measure the back wall of the Café so that she could determine the price of having that wall of the Café resided. While Meyer was measuring the back wall, he fell from a scaffold and was knocked unconscious. As a result of the fall, Meyer suffered a variety of injuries, including a serious brain injury, broken ribs, a broken wrist, and an injured vertebra. The parties concede that these injuries will prevent Meyer from returning to his trade as a plumber and pipefitter. 2

After sustaining his injuries, on September 30, 1999, Meyer submitted a “Statement of Claim for Disability Benefits” to the Fund. On November 24, 1999, the Fund denied this claim, stating as follows:

The basis for this denial can be found in your Summary Plan Description on page 41, #2(c). Based on the information received, it appears that this should have been covered under the restaurant’s workmen’s compensation.

Stipulation of Facts, Ex. B., at 2.

The Fund’s denial of Meyer’s claim for benefits was based upon the following exclusion, which is contained within the Fund’s Summary Plan Description:

EXCLUSIONS AND LIMITATIONS
Payment will not be made under any health benefit or Weekly Income Benefit of the Plan for the following:
2. Charges incurred in connection with:
c. Any Accidental Injury or Sickness which would be covered under Workers’ Compensation, or similar law, regardless of whether or not such insurance was in force and effect at the time of injury.

Id., Ex. C., at 41.

In response to this denial, Meyer wrote to the Trustees of the Fund and advised that, at the time of his accident, he was between jobs, and had an unemployment insurance claim. Id., Ex. B., at 3. In addition, Meyer wrote:

I do not own any part of, or have any claim in the restaurant whatsoever. So I was not working for wages, profit or gain of any kind. I was not working at all. I was getting some measurements so that my wife could get an estimate *1097 from the lumber yard on redoing the back of the building.

Id. 3

On February 11, 2000, Shirley Hanson, who is the Fund’s Administrator, wrote the following to Meyer, in order to inform him of the Fund’s reconsideration of his request for benefits:

As stated in our letter of November 24, 1999, the claim was denied based on the information submitted regarding your injury. Please refer to page 41, #2(c) in your Summary Plan Description Booklet. Even though this was denied by the restaurant’s workers’ comp carrier, it appears that the main reason for denial was that you, personally, are not covered by the work comp insurance. It does appear, however, that you could have been covered if you had so elected.

Id. at 5.

Meyer has exhausted all administrative remedies, which are available to him, in administratively appealing the Fund’s denial of his claim for benefits. In this action, Meyer seeks to overturn the Fund’s decision to deny his benefit claim.

III. Discussion

A. Standard of Review. Summary Judgment is not an acceptable means of resolving triable issues, nor is it a disfavored procedural shortcut when there are no issues which require the unique proficiencies of a Jury in weighing the evidence, and in rendering credibility determinations. Celotex Corp. v. Catrett, 477 U.S. 317, 327, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). Summary Judgment is appropriate when we have viewed the facts, and the inferences drawn from those facts, in a light most favorable to the nonmoving party, and we have found no triable issue. Krentz v. Robertson, 228 F.3d 897, 901 (8th Cir.2000); Curry v. Crist, 226 F.3d 974, 977 (8th Cir.2000); Carter v. St. Louis Univ., 167 F.3d 398, 400 (8th Cir.1999). For these purposes, a disputed fact is “material” if it must inevitably be resolved and the resolution will determine the outcome of the case, while a dispute is “genuine” if the evidence is such that a reasonable Jury could return a Verdict for the nonmoving party. See, Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986); Herring v. Canada Life Assurance, 207 F.3d 1026 (8th Cir.2000); Liebe v. Norton, 157 F.3d 574, 578 (8th Cir.1998); Dodd v. Runyon, 114 F.3d 726, 729 (8th Cir.1997).

As Rule 56(e) makes clear, once the moving party files a properly supported Motion, the burden shifts to the nonmov-ing party to demonstrate the existence of a genuine dispute. In sustaining that burden, “an adverse party may not rest upon the mere allegations or denials of the ad *1098

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149 F. Supp. 2d 1093, 2001 U.S. Dist. LEXIS 9462, 2001 WL 754439, Counsel Stack Legal Research, https://law.counselstack.com/opinion/meyer-v-duluth-building-trades-welfare-fund-mnd-2001.