Schnur v. CTC Communications Corp. Group Disability Plan

413 F. App'x 377
CourtCourt of Appeals for the Second Circuit
DecidedMarch 14, 2011
Docket10-1943-cv
StatusUnpublished
Cited by5 cases

This text of 413 F. App'x 377 (Schnur v. CTC Communications Corp. Group Disability Plan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schnur v. CTC Communications Corp. Group Disability Plan, 413 F. App'x 377 (2d Cir. 2011).

Opinion

SUMMARY ORDER

Plaintiff-Appellant Susan Schnur appeals from a grant of summary judgment in favor of Defendant-Third-Party Plaintiff-Appellee CTC Communications Corp. Group Disability Plan and Third-Party Defendant-Appellee Continental Casualty Company (“CCC”) on plaintiffs claims which are brought pursuant to the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. §§ 1001 et seq., and which stem from the denial of her claim for long-term disability (“LTD”) benefits under the Group Disability Plan (“the Plan”). Specifically, Schnur alleged below that the Plan’s outside claims administrator, non-party CNA Group Life Assurance Company (“CNA”), failed to credit the medical evidence establishing her permanent disability, and, further, that the process by which CNA evaluated her claim was so procedurally flawed as to render it unreliable. The district court (Sullivan, J.) rejected those claims, finding that CNA’s denial of the claim was not “arbitrary and capricious” and thus that Schnur could not establish an entitlement to relief. On appeal, Schnur contends, first, that the district court erred in applying the “arbitrary and capacious” standard when it should have, instead, reviewed her claim de novo, but, second, that even under the “arbitrary and capricious” standard, she was entitled to relief because CNA’s heavily flawed process of reviewing her claim resulted in a decision that is supported by no reliable evidence. We presume the parties’ familiarity with the underlying facts, the procedural history, and the issues on appeal and revisit those issues only as necessary to facilitate this discussion.

“In an ERISA action, we review the district court’s grant of summary judgment based on the administrative record de novo and apply the same legal standard as the district court.” Hobson v. Metro. Life Ins. Co., 574 F.3d 75, 82 (2d Cir.2009). As noted, the district court applied the “arbitrary and capricious” standard in reviewing the administrative record, an issue Schnur challenges on appeal.

“Although generally an administrator’s decision to deny benefits is reviewed de novo, where ... written plan documents confer upon a plan administrator the discretionary authority to determine eligibility, we will not disturb the administrator’s ultimate conclusion unless it is arbitrary and capricious.” Id. (internal quotation marks omitted). Here, there is no serious dispute that the written plan documents confer discretionary authority upon CTC as the plan administrator and on “other *379 Plan fiduciaries.” 1 Schnur simply contends that CNA was not an “other Plan fiduciar[y]” as that term is used in those documents. We reject that argument for substantially the reasons set forth by the district court. In so doing, we emphasize that, as the sole claims administrator for the Plan, CNA was clearly engaged in the sort of activity that gives rise to a fiduciary responsibility and is thus frequently associated with a “Plan fiduciary.” See, e.g., Aetna Health Inc. v. Davila, 542 U.S. 200, 218-19, 124 S.Ct. 2488, 159 L.Ed.2d 312 (2004) (“A benefit determination under ERISA ... is generally a fiduciary act” and is “part and parcel of the ordinary fiduciary responsibilities connected to the administration of a plan”).

Accordingly, like the district court, we review CNA’s denial of Schnur’s claim for benefits under the “arbitrary and capricious” standard, reversing “only if the decision was without reason, unsupported by substantial evidence or erroneous as a matter of law.” Durakovic v. Bldg. Serv. 32BJ Pension Fund, 609 F.3d 133, 141 (2d Cir.2010) (internal quotation marks omitted). “Substantial evidence is such evidence that a reasonable mind might accept as adequate to support the conclusion reached by the administrator and requires more than a scintilla but less than a preponderance.” Id. (internal quotation marks omitted).

Here, “substantial evidence” supports the denial of Schnur’s claim. Specifically, CNA relied on the opinions of not one but two retained physicians, both of whom reviewed Schnur’s medical record and independently determined that there was insufficient evidence to support a finding of permanent disability. Specifically, as both those doctors found — and the record on appeal supports — virtually all of Schnur’s symptoms were “self-reported” and backed by little, if any, physical evidence. Cf. Hobson, 574 F.3d at 88 (“[I]t is not unreasonable for ERISA plan administrators to accord weight to objective evidence that a claimant’s medical ailments are debilitating[,]” or a lack thereof, “in order to guard against fraudulent or unsupported claims.”). Moreover, as those doctors noted, even if fully credited, Schnur’s symptoms did not warrant a finding of total and permanent disability. Moreover, that CNA chose to credit its own, outside doctors over Schnur’s personal physician is not, itself, grounds for reversing the determination because “courts have no warrant to require administrators automatically to accord special weight to the opinions of a claimant’s physician; nor may courts impose on plan administrators a discrete burden of explanation when they credit reliable evidence that conflicts with a treating physician’s evaluation.” Black & Decker Disability Plan v. Nord, 538 U.S. 822, 834, 123 S.Ct. 1965, 155 L.Ed.2d 1034 (2003).

Alternatively, Schnur contends that various “procedural irregularities” in CNA’s handling of her claim warrant discounting the administrator’s findings. Many of these claims were not raised below and are thus deemed waived on appeal. See In re Nortel Networks Corp. Sec. Litig., 539 F.3d 129, 132 (2d Cir.2008). As for those claims that were preserved, *380 Schnur first contends that CNA had a potential conflict of interest caused by its role as both a claims administrator and reinsurer of the Plan, and, second, that CNA’s initial notice of denial did not comport with statutory and regulatory requirements. Neither claim has merit. With respect to the alleged conflict, the record makes clear — and Schnur does not dispute — that CNA took “active steps to reduce potential bias ... by walling off claims administrators from those interested in firm finances” and, as such, the asserted conflict “provefs] less important (perhaps to the vanishing point).” McCauley v. First Unum Life Ins. Co., 551 F.3d 126, 133 (2d Cir.20()8) (quoting Metro. Life Ins. Co. v. Glenn, 554 U.S. 105, 117, 128 S.Ct. 2343, 171 L.Ed.2d 299 (2008)).

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Bluebook (online)
413 F. App'x 377, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schnur-v-ctc-communications-corp-group-disability-plan-ca2-2011.