Wade v. Hewlett-Packard Development Co. LP Short Term Disability Plan

493 F.3d 533, 2007 WL 2068102
CourtCourt of Appeals for the Fifth Circuit
DecidedJuly 26, 2007
Docket05-21068
StatusPublished
Cited by68 cases

This text of 493 F.3d 533 (Wade v. Hewlett-Packard Development Co. LP Short Term Disability Plan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wade v. Hewlett-Packard Development Co. LP Short Term Disability Plan, 493 F.3d 533, 2007 WL 2068102 (5th Cir. 2007).

Opinion

DENNIS, Circuit Judge:

Alfred Wade appeals a summary judgment in favor of the defendant-appellee, administrator of his employer’s Shorb-Term Disability Plan, on his claim for benefits under the Plan. We affirm.

I.

Claimant-appellant Alfred Wade began his employment with Compaq Computer Corporation (“Compaq”) in 1988 as a Line Operator; at the time he left his employment, he was employed as an internal consultant in sales and services at one of Compaq’s retail stores. On August 24, 2000, Wade consulted a psychiatrist, Dr. Mary Ann Ty, who diagnosed Wade with major depression and attention deficit-hyperactivity disorder. Dr. Ty based her diagnosis on Wade’s symptoms including: feelings of being “out of control” and “overwhelmed,” hypersomnia, decrease in energy, difficulty with concentration and attention, disorganization, and inability to complete tasks. However, she found that Wade’s ability to make decisions regarding daily living, relationships, and life was rated as “good.” She advised him not to go to work.

Upon this diagnosis, Wade, on August 24, 2000, filed a claim for short-term disability benefits. The Plan defined “disability” as:

... a medical condition (or having such a condition, as the case may be) determined by the Plan Administrator to be one which is continuous and prevents the Employee from performing each of the material duties of his or her regular occupation. The Employee (1) must also be under the regular care of Physician appropriate to the medical condition and (2) cannot be working at any job for wage or profit in order to be Disabled or considered to have a Disability, except when such a job is for his Employer or within the terms of Rehabilitative Employment pursuant to Section 3.9.

Compaq, his employer, was the Plan Administrator and retained final authority over benefits decisions; however, it outsourced preliminary short-term disability benefits review to ValueOptions, a disability care management service company. Upon receiving Wade’s claim, ValueOp-tions opened a disability case file for him on or around August 29, 2000.

*536 The Plan’s benefits review process consisted of three levels. ValueOptions conducted the first two levels, while Compaq conducted the third and final level. At the first level, ValueOptions solicited a neuro-physiologist, Dr. Barbara Uzzell, to conduct a psychiatric and functional assessment of Wade on September 25, 2000. 1 Based upon this assessment, she diagnosed him with Dysthymic Disorder and Avoi-dant Personality Disorder. Her assessment of ten categories revealed Wade’s moderate impairment in three of the categories, whereas there was mild to no impairment in the other seven. She recommended that Wade continue treatment with Dr. Ty and referred him to Suzi Phelps, a psychologist and therapist. However, because Dr. Uzzell found that Wade’s condition did not constitute a disability, she recommended denying benefits. A ValueOptions psychiatrist, Dr. Frank Webster, reviewed Wade’s file, agreed with Dr. Uzzell that Wade was not disabled, and upheld Dr. Uzzell’s recommendation. On September 26, 2000, ValueOp-tions contacted Wade via telephone and communicated its decision to deny benefits; it did not share Dr. Uzzell’s report with him or send him a denial letter. In this conversation, Wade immediately advised ValueOptions of his desire to appeal and to submit information from his treating physician.

At the second level of the claims process, the ValueOptions Appeals Committee (on which Dr. Webster was a member) reviewed Wade’s claim and the initial denial of benefits. They invited Wade’s treating physicians to submit a letter and a copy of treatment notes for consideration; on October 4, 2000, Dr. Ty and Dr. Phelps submitted information to the Committee. Nevertheless, the ValueOptions Appeals Committee, on October 6, 2000, affirmed the denial of short-term disability benefits. As it explained in a letter to Wade, “the clinical information provided does not meet ValueOptions’ Short-term Disability criteria.” Additionally, the letter explained to Wade that he had the right to appeal to Compaq and provided an address and phone number. The letter did not, however, reference the Plan criteria, explain why his information failed to meet the criteria, advise him of the appeal time-line, or detail the information Wade should submit to perfect his appeal.

Wade’s attorney wrote to Compaq on December 5, 2000, requesting various Plan documentation and requesting an appeal. Compaq responded, inviting Wade’s attorney to provide any additional information for Compaq to assess in its review of Wade’s claim. At this third and final level, the Compaq Welfare Benefits Administrative Committee (“WBAC”), comprised only of Elaine Boddome (a Compaq employee), reviewed Wade’s claim in May 2001. 2 Kathy Collier, a Compaq benefits representative responsible for preparing Wade’s file to present to WBAC, noticed several errors in ValueOptions’ processing of Wade’s *537 claim. Therefore, she requested that Va-lueOptions re-review Wade’s case and provide WBAC with additional information. Additionally, WBAC enlisted another psychiatrist, Dr. Conway McDanald, to conduct an additional review of all of the documentation in Wade’s file. Subsequently, on August 24, 2001, WBAC issued a final denial of short-term disability benefits via a letter to Wade. This letter explained that short-term disability benefits were being denied, because the documentation did not substantiate a claim for short-term disability.

Wade sued in the United States District Court for the Southern District of Texas under 29 U.S.C. § 1132(a)(1)(B). 3 Upon assessing the parties’ cross-motions for summary judgment, the district court denied Wade’s motion, granted defendant’s motion. The court also summarily and sua sponte awarded costs in favor of the defendant.

Wade timely appealed, wherein he argues that the district court erred by: (1) applying the abuse of discretion standard of review to Wade’s case, despite an asserted conflict of interest; (2) disregarding the impact of significant procedural errors, which allegedly should have reduced the district court’s level of deference to the Plan Administrator; (3) refusing to conclude that the Plan Administrator abused its discretion; and (4) awarding costs to the defendant.

II.

We review a district court’s grant of summary judgment in ERISA cases de novo, applying the same standard as the district court. Baker v. Metropolitan Life Ins., 364 F.3d 624, 627 (5th Cir.2004) (citing Performance Autoplex II Ltd. v. Mid-Continent Casualty Co., 322 F.3d 847, 853 (5th Cir.2003)). A grant of summary judgment is proper if there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Id. (citing Performance Autoplex, 322 F.3d at 853; Fed.R.Civ.P.

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Cite This Page — Counsel Stack

Bluebook (online)
493 F.3d 533, 2007 WL 2068102, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wade-v-hewlett-packard-development-co-lp-short-term-disability-plan-ca5-2007.