Opinion
IP 00-C-983-B/S
March 18, 2002
ENTRY AFTER BENCH TRIAL
This ERISA case was tried to the court on March 18, 2002. After hearing the parties and reviewing the evidence, we find in favor of the defendant.
The facts, set forth in detail in Blickenstaff v. R.R. Donnelley Sons Co. Short Term Disability Plan, 2002 WL 169320 (S.D.Ind. January 28, 2002), are briefly summarized here. Katherine Blickenstaff worked as a materials handler for defendant R.R. Donnelley Sons and was a beneficiary of its employee benefits plan. The Plan's claims evaluator is a subsidiary of Hartford Life Accident Insurance Company, which we refer to here as Hartford or the Plan. Ms. Blickenstaff applied for, and received, short term disability (STD) benefits. In February 1999, she applied for long term disability (LTD) benefits. The Plan denied her the requested benefits in a letter of March 18, 1999 and, after Ms. Blickenstaff appealed the decision, affirmed its denial on April 21, 1999.
The issue before us a trial was whether the Plan's denial of benefits was arbitrary and capricious. Firestone Tire Rubber Co. v. Bruch, 489 U.S. 101, 110-11 (1989); Brehmer v. Inland Steel Indus. Pension Plan, 114 F.3d 656, 660 (7th Cir. 1997). This deferential standard of review essentially requires us to determine whether the Plan's benefits decision was "downright unreasonable." Donato v. Metropolitan Life Ins. Co., 19 F.3d 375, 380 (7th Cir. 1994), quoting Fuller v. CBT Corp., 905 F.2d 1055, 1058 (7th Cir. 1990). "The standard . . . requires this Court to defer to the Plan's decision unless the decision was unreasonable." Schaub v. Consolidated Freightways, Inc. Extended Sick Pay Plan, 895 F. Supp. 1136, 1140 (S.D.Ind. 1995). The plaintiff, of course, bore the burden of persuasion as to that issue.
On summary judgment we found the existence of a genuine issue of material fact as to whether the Plan's decision was arbitrary and capricious because it was unclear on the record which of two conflicting job descriptions provided the basis for the Plan's denial of benefits. There is, however, such a gaping chasm between the mere existence of a genuine issue of material fact (the summary judgment standard) and a fact proven by a preponderance of the evidence (the standard at trial) that, on weighing the evidence, we have no difficulty in determining that the Plan's denial of benefits was lawful.
Although we stray from the limited issue before us, we note that the Plan here (and similarly-situated defendants in the future) may wish to counsel benefits decision makers to state clearly and unambiguously in their letters of denial the precise grounds, including the documents, on which their decisions rest. Ms. Rud's denial letter of March 18, 1999 bases its decision on "all documents contained in your employment record, viewed as a whole. . . ." Pl. Ex. 7, Record pp. 0054-56 (at p. 0055). Where, as here, "all documents" includes two conflicting job descriptions, a court may (as we did here) have difficulty arriving at the conclusion that the decision was not arbitrary and capricious as a matter of law.
The parties stipulated to the evidence at trial. With the exception of Ms. Blickenstaff's limited testimony, the evidence consisted of the documentary record from the administrative proceeding. Ms. Blickenstaff argued at trial that, instead of relying on the "accommodated job description" — a job description which meliorated the strenuousness of the tasks Ms. Blickenstaff was required to perform — Ms. Rud based her denial of benefits on a "generic" or "generalized" description of a "Material Handler," without regard to Ms. Blickenstaff's modified physical requirements. Plaintiff's evidence was insufficient to persuade us of this point. Even if it had convinced us, however, that showing is a far from a showing that the decision to deny benefits was "arbitrary and capricious."
By contrast, the Plan presented a reasonable view of the evidence which showed that the denial of benefits was based on the accommodated job; that is, on Ms. Blickenstaff's actual work restrictions as conveyed to the Plan by the employer. Pl. Ex. 4 (Record p. 0101). It further showed that the Plan ordered a functional equivalency exam, the results of which it forwarded to Ms. Blickenstaff's physician, Dr. Mark Williams, with a request that Dr. Williams respond with any inaccuracies. Record, p. 201. Dr. Williams did not dispute the results; he found that Ms. Blickenstaff "is capable of light work for eight hours a day." Record, p. 0061. In other words, he agreed that Ms. Blickenstaff could perform the functions of the accommodated job. Finally, the Plan presented a plausible showing that Ms. Blickenstaff herself understood that the decision was made on the basis of the accommodated job description and presented no objection to that standard in her appeal. Record, p. 0050. In other words, at the time Ms. Rud made the decision, Ms. Blickenstaff had offered insufficient evidence to show that she was unable to perform the accommodated job or (the same thing) that she was entitled to benefits.
Since we find that defendant has offered persuasive evidence that it acted reasonably in denying benefits to Ms. Blickenstaff, we cannot find that it acted arbitrarily and capriciously. Accordingly, we find in favor of the Plan and have entered judgment in its favor in a separate Judgment.