Wegner v. Standard Insurance

129 F.3d 814, 1997 U.S. App. LEXIS 34412, 1997 WL 721777
CourtCourt of Appeals for the Fifth Circuit
DecidedDecember 9, 1997
Docket97-20062
StatusPublished
Cited by142 cases

This text of 129 F.3d 814 (Wegner v. Standard Insurance) 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
Wegner v. Standard Insurance, 129 F.3d 814, 1997 U.S. App. LEXIS 34412, 1997 WL 721777 (5th Cir. 1997).

Opinion

STEWART, Circuit Judge:

This case, which calls for us to construe the phrase “overtime pay and any other extra compensation” as it appears in a group disability insurance policy, arises from an injury suffered by Robert P. Wegner shortly after he accepted a higher-compensating, out-of-town job assignment from his employer. Standard Insurance Company, the issuer of the policy, contends that Wegner’s higher earnings at the time he was injured constitute excluded “overtime” or “any other extra compensation” under the policy, and therefore the proper basis for calculating his disability benefit is ;his lower pre-assignment rate of compensation. In response to cross-mptions for summary judgment, the district court held in favor of Wegner, finding that his higher compensation was not overtime or extra compensation and therefore serves as the proper basis for calculating the disability benefit. In. a separate order, the district court also awarded Wegner attorneys’ fees. Standard appeals both rulings, and we affirm.

BACKGROUND

On June 29, 1990, Robert P. Wegner (“Wegner”) began work as a service technician/fabricator with CRC-Evans Pipeline, Inc. (“CRC-Evans”) in Houston at the rate of $10.25 per hour. He received a pay increase to $10.75 per hour soon thereafter. On July 22, 1991, Wegner accepted an assignment to, CRC-Evan’s “Kern River Project” in Las Vegas. The Employee Assignment Agreement provided that he was being assigned to the project as a senior operator/teehnician; he would be paid a salary of $300 per day for working approximately 12 *817 hours per day, 7 days a week; and his assignment would end upon either the successful completion of the project or termination of the project by CRC-Evans or the contractor. A Change Authorization/Employment Authorization form implementing Wegner’s change in status from an hourly to a salaried employee qualified the compensation change as being effective for the duration of the assignment only. 1

On September 4, 1991, while working on a construction site, Wegner fell from a truck and suffered shoulder and elbow injuries. On September 21, 1991, CRC-Evans executed another authorization form, terminating Wegner’s assignment to the Kern River project and returning' his status to that of an hourly employee paid at the rate of $10.75 per hour. At the time of his injury, Wegner was covered by a long-term disability insurance policy (the “policy”) provided by CRC-Evans, as part of an employee welfare benefit plan within the purview of the Employee Retirement Income Security Act of 1974 (“ERISA”). 2 Accordingly, Wegner applied for disability benefits pursuant to the policy. 3 Standard Insurance Company (“Standard”), the issuer of the policy, accepted Wegner’s disability claim, but the present dispute as to the proper calculation of the benefit amount soon arose.

In the event of a disability, the policy provides coverage for 60% of an employee’s “pre-disability earnings,” subject to “maximum amount” limits not applicable here. The policy defines “predisability earnings” as follows:

PREDISABILITY EARNINGS means your monthly rate of earnings from your EMPLOYER including commissions and deferred compensation, but excluding bonuses, overtime pay and any other extra compensation.

(emphasis added). The predisability earnings used to compute the disability benefit is determined as follows:

If you become DISABLED, the ... PRE-DISABILITY EARNINGS used to compute your LTD BENEFIT will be based oh your monthly rate of earnings in effect on your last full day of ACTIVE WORK before you become DISABLED. Any change in the amount of your monthly rate of earnings which is approved or becomes effective after that last full day of ACTIVE WORK will have no effect on the amount of your ... PREDISABILITY EARNINGS used to compute your LTD BENEFIT for that period of DISABILITY.

In determining the amount of disability benefits to be paid to Wegner, Standard based its calculation of Wegner’s predisability earnings on the $10.75 per hour rate he was earning prior to his assignment to the Kern River project.

On or about March 14, 1995, Wegner filed suit in Texas state court, asserting that his predisability earnings should be calculated on the basis of his higher $300 per day rate of compensation at Kern River. Standard removed the case to the United States District Court for the Southern District of Texas, Houston Division, and subsequently filed a motion , for summary judgment arguing that the $300 per day rate of compensation constituted “overtime” or “any other extra compensation” that was excluded from coverage under the policy. Wegner then filed a counter-motion for summary judgment, arguing that the increased pay did not constitute “overtime” or “any other extra compensation” and .therefore was the proper basis on which to calculate predisability earnings. The parties stipulated that if Wegner’s interpretation of the policy was adopted, the amount of back benefits payable to him through July 19, 1996 would be $221,846.40; *818 should the court expand the benefits period beyond July 19,-1996, the appropriate rate would be $5,459.58 per month.

On October 31, 1996, the district court ruled in favor of Wegner on the Cross-motions for summary judgment; in addition, the district court requested further briefing and production of evidence on whether Wegner was entitled to attorneys’ fees. On December 18,1996, the district court awarded Weg-ner substantially all the relief he sought regarding attorneys’ fees, and entered the final judgment in this case. Standard timely appeals, and this court has jurisdiction of this case pursuant to 28 U.S.C. § 1291.

DISCUSSION

Construction of Policy

We review a district court’s grant of summary judgment de novo. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587, 106 S.Ct. 1348, 1356, 89 L.Ed.2d 538 (1986); Todd v. AIG Life Ins. Co., 47 F.3d 1448, 1451 (5th Cir.1995). Summary judgment is appropriate if the record discloses “that there is no genuine issue as to any material fact and the moving party is entitled to a judgment as a matter of law.” Fed. R.Civ.P. 56(c). In making this determination, we' must evaluate the facts in the light most favorable to the non-moving party. Matsushita, 475 U.S. at 587, 106 S.Ct. at 1356; Todd, 47 F.3d at 1451.

Moreover, when we are called to interpret an ERISA-covered policy in cases involving the denial of benefits challenged under 29 U.S.C. § 1132(a)(1)(B), we construe the terms of the plan de novo

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Bluebook (online)
129 F.3d 814, 1997 U.S. App. LEXIS 34412, 1997 WL 721777, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wegner-v-standard-insurance-ca5-1997.