Satterwhite v. Metropolitan Life Insurance

803 F. Supp. 2d 803, 2011 U.S. Dist. LEXIS 29610, 2011 WL 1100293
CourtDistrict Court, E.D. Tennessee
DecidedMarch 22, 2011
DocketCase No. 1:06-cv-165
StatusPublished
Cited by2 cases

This text of 803 F. Supp. 2d 803 (Satterwhite v. Metropolitan Life Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Satterwhite v. Metropolitan Life Insurance, 803 F. Supp. 2d 803, 2011 U.S. Dist. LEXIS 29610, 2011 WL 1100293 (E.D. Tenn. 2011).

Opinion

MEMORANDUM AND ORDER

HARRY S. MATTICE, JR., District Judge.

Plaintiff Brenda Satterwhite brought this action against Defendants Metropolitan Life Insurance Company, the Long Term Disability Plan for Employees of the U.S. Enrichment Corporation, and the United States Enrichment Corp. Plaintiffs initial Complaint alleged a cause of action under 29 U.S.C. § 1132(a)(1)(B) and sought judicial review of a termination of long-term disability (“LTD”) insurance benefits, which took effect as of August 31, 2005. [Court Doc. 1, Compl.] Upon review of Defendants’ decision, the Court remanded Plaintiffs claim back to Defendants for a full review of the record. [Court Doc. 20, Mem. and Order.] On remand, Defendants approved Plaintiffs benefits through January 16, 2006 but found that she was not disabled as of January 17, 2006. Plaintiff moved for this case to be reopened for judicial review of Defendants’ new decision. [Court Doc. 35.]

Before the Court is Plaintiffs Second Motion for Judgment on the Pleadings [Court Doc. 44], Pursuant to 28 U.S.C. § 636(b)(1), the Court referred this matter to United States Magistrate Judge William B. Mitchell Carter for a Report and Recommendation (“R & R”) on Plaintiffs motion. Magistrate Judge Carter entered his R & R [Court Doc. 53] on February 19, 2011. Magistrate Judge Carter determined that Defendants did not adequately review the record on remand pursuant to the Court’s prior Order and concluded that [805]*805Defendants’ new decision was arbitrary and capricious. Accordingly, Magistrate Judge Carter recommended that Plaintiffs Motion be granted and disability benefits be awarded. Defendants filed a timely objection [Court Doc. 55] and Plaintiff timely responded [Court Doc. 56].

Based on the timeliness of Defendants’ Objection, the Court DENIES AS MOOT Defendants’ Unopposed Motion for Entry of an Order Extending Time to Respond to Report and Recommendation [Court Doc. 54],

For the reasons explained below, the Court will ACCEPT AND ADOPT Magistrate Judge Carter’s Report and Recommendation [Court Doc. 53] and Plaintiffs Second Motion for Judgment on the Pleadings [Court Doc. 44] will be GRANTED.

I. STANDARD OF REVIEW

The Court must conduct a de novo review of those portions of the R & R to which an objection is made and may accept, reject, or modify, in whole or in part, the Magistrate Judge’s findings or recommendations. 28 U.S.C. § 636(b)(1)(C). For those portions of the R & R to which objections have been filed, the Court will directly review the decision-making process underlying the Defendant’s denial of benefits.

A claim under 29 U.S.C. § 1132(a)(1)(B) for denial of benefits is to be reviewed “under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan.” Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). If the administrator or fiduciary is afforded discretion by the plan, the decision is reviewed under the arbitrary and capricious standard. Evans v. UnumProvident Corp., 434 F.3d 866, 875 (6th Cir.2006). The Plan documents here assert that the Plan Administrator has discretion to interpret Plan terms. (Administrative Record Plan Documents (“Plan”) at 215.) This Court will therefore conduct its review under the arbitrary and capricious standard.

Under 29 U.S.C. § 1132(a)(1)(B), a court’s review is limited to the administrative record as it existed when the plan administrator made its final decision. Moon v. Unum Provident Corp., 405 F.3d 373, 378-79 (6th Cir.2005). Arbitrary and capricious is one of the least demanding forms of review. McDonald v. Western-Southern Life Ins. Co., 347 F.3d 161, 172 (6th Cir.2003). “Nevertheless, merely because our review must be deferential does not mean our review must also be inconsequential.” Id. A court must “review the quantity and quality of the medical evidence and the opinions on both sides of the issues.” Id. at 172. If the administrative record does not show that the administrator offered a “reasoned explanation” based on substantial evidence, the decision is arbitrary or capricious. Moon, 405 F.3d at 379. Substantial evidence means “much more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” McDonald, 347 F.3d at 171.

II. FACTS

The Report and Recommendation briefly outlined the applicable facts of the case prior to remand (which are further outlined in the Court’s prior Order) and outlined in detail the medical evidence presented to Defendants after remand. The parties have not objected to the facts statement contained in Magistrate Judge Carter’s R & R. The Court finds no error in Magistrate Judge Carter’s findings of fact. Accordingly, the Court hereby ADOPTS BY REFERENCE the entire [806]*806background section of the R & R. (Court Doc. 53, R & R at 2-14.)

III. ANALYSIS

Defendants assert three basic objections. First, Defendants argue that Magistrate Judge Carter misapplied the arbitrary and capricious standard when reviewing Defendants’ decision. (Court Doc. 55, Defs.’ Objs. at 2.) Second, Defendants argue that Magistrate Judge Carter overlooked or diminished significant facts in the record. (Id.') Finally, Defendants contend that Magistrate Judge Carter improperly reversed the burden of proof placed on the parties pursuant to the Plan. (Id.) The Court will address the first two objections in concert, as they are closely related, and will then turn to the final objection.

A. Defendants’ Decision to Deny Benefits on Remand

Defendants assert that a decision based on evidence and supported by a reasoned explanation is not arbitrary and capricious, and Defendants’ discretion to determine eligibility for benefits mandates that its decision be upheld if it is the result of a deliberate principled reasoning process and is supported by substantial evidence. (Defs.’ Objs. at 15-16.) Defendants assert that the decision was supported by substantial evidence and Defendants offered a reasoned explanation, but that Magistrate Judge Carter essentially undertook a de novo review of the decision. (Id. at 16.) Defendants further argue that Magistrate Judge Carter relied heavily on the report of Dr. Kilpatrick, which recounted a onetime encounter with Plaintiff, and that Magistrate Judge Carter improperly called Plaintiffs 20-month treatment with Dr. Larson a “short” treatment history. (Id.) Moreover, Defendants claim that Magistrate Judge Carter gave little weight to Dr.

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Bluebook (online)
803 F. Supp. 2d 803, 2011 U.S. Dist. LEXIS 29610, 2011 WL 1100293, Counsel Stack Legal Research, https://law.counselstack.com/opinion/satterwhite-v-metropolitan-life-insurance-tned-2011.