Opinion
Civ. A. No. 2:94-2181-18
August 23, 1995.
W. Robert Kinard, Charleston, SC, for plaintiff.
Christopher J. McCool, Cola., SC; Richard A. Farrier, Jr., Charleston, SC; Deirdre M. Shelton, Charleston, SC, for defendant.
ORDER
This matter came for hearing before the court on May 17, 1995 on motion of Defendant, State Farm Insurance Companies ("State Farm"), for summary judgment. Plaintiff's lawsuit is one for retirement disability benefits under a plan governed by the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001, et seq. The Plan Administrator denied the claim for retirement disability benefits by Plaintiff, a member of the Plan, because the required credited service had not accrued. Having heard oral argument and reviewed the pleadings and evidence relied on by Plaintiff, this court grants Defendant State Farm's motion for summary judgment.
I. BACKGROUND
On August 15, 1994, Plaintiff filed suit in this court, alleging causes of action for a violation of Section 510 of ERISA and state common law bad faith. Defendant State Farm moved to dismiss the state common law bad faith claim on the ground that Plaintiff's action was a suit for benefits under a Plan governed by ERISA, and that the state claim for bad faith was preempted. On October 20, 1994, this court dismissed the state common law bad faith claim as preempted by ERISA. Thus, all that remains is a claim under Section 510 of ERISA.
II. FINDINGS OF FACT
The material facts that are relevant to Plaintiff's claims as alleged in the Complaint are not in dispute. Plaintiff was employed by State Farm on July 19, 1976, as a Claim Specialist. On August 16, 1979, she became a member of State Farm Insurance Companies Retirement Plan for United States Employees ("the Plan").
Section 4.1(B) of the Plan provides that one of the requirements for becoming a disabled member is that "[t]he sum of the member's attained age and the length of credited service must be at least 55 years prior to the date of disablement." Section 1.32 of the Plan defines "date of disablement" as "the first workday of any period of time during which the active or Canadian member does not report to work for the company because of total disability by reason of accidental bodily injury or sickness." Section 1.33 of the Plan defines "totally disabled" and "total disability" as "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of at least 12 months."
Plaintiff suffers from asthma, which has worsened over time. Even with maximum therapy, one of Plaintiff's physicians noted on September 24, 1993, that Plaintiff remained severely limited by her asthma. In the Fall of 1993, Plaintiff was also diagnosed as having chronic obstructive pulmonary disease.
By December 1993, Plaintiff's condition had worsened, and she could no longer perform her normal duties at State Farm. December 9, 1993 was the last day Plaintiff reported to work. December 13, 1993, was the first workday Plaintiff failed to report to work because of her physical condition. She was still technically an employee of State Farm, at least until August 16, 1994, because she was receiving paid sick leave.
On March 14, 1994, Plaintiff applied for Social Security benefits with the Social Security Administration and ultimately qualified for benefits. The Social Security Administration determined that Plaintiff became disabled under its rules on December 9, 1993.
Sometime in March 1994, Plaintiff informed her supervisor at State Farm that she would not be able to return to work at her current position. Again, on April 11, 1994, Plaintiff wrote State Farm and advised State Farm that following thorough medical treatment and evaluation, she had been advised that she was totally disabled, and that she would be leaving the Company when all of her benefits had been exhausted. In this letter, Plaintiff also asked State Farm what her benefits were under retirement disability.
On May 4, 1994, in response to Plaintiff's letter of April 11, 1994, State Farm wrote Plaintiff and advised her that she would not be entitled to disability benefits because she did not meet the requirements under the Plan that her attained age and the length of credited service must be at least 55 years prior to the date of disablement. State Farm explained that its records showed that her first day of continuous illness was December 13, 1993; that December 13, 1993, was her "date of disablement" as defined under the Plan; and that on this date, when her disability began, the sum of her attained age and length of credited service was 53 years and 238 days through December 12, 1993. State Farm referred to specific sections in the Summary Plan Description when providing this information to Plaintiff.
On May 27, 1994, Plaintiff wrote State Farm and explained that she thought she should be entitled to retirement disability benefits because she was currently out on sick leave of absence, and was continuing to accrue credited service for eligibility for benefits. Plaintiff based this position on her interpretation of the Summary Plan Description. On July 28, 1994, State Farm responded to Plaintiff's letter of May 27, 1994. In this letter, State Farm did the following: explained that the Plan provides that a member shall become a disabled member if, among other things, the sum of the member's attained age and the length of credited service is at least 55 years prior to the date of disablement; provided the definitions of "date of disablement" and "totally disabled" under the Plan; explained that December 13, 1993 was her date of disablement because it was the first workday of the last period of time she did not report to work because of a medically determinable physical condition, her condition had lasted for more than eight months, and there was nothing to indicate that her condition would not last another four months; provided two different examples to explain the terms "totally disabled" and "date of disablement" — one in which an employee is absent due to illness on a specific date but returns to work, and one in which an employee is absent due to illness on a specific date but never returns to work because of the nature of the illness; and advised her that she was not eligible for retirement disability benefits under the plan and explained how it arrived at this decision. State Farm also enclosed a copy of the entire Plan with this letter.
On August 16, 1994, Plaintiff's leave benefits expired, and she was terminated. Prior to this date, Plaintiff had received and reviewed the applicable portions of the Summary Plan Description and the Plan.
III. SUMMARY JUDGMENT STANDARD
Summary judgment is appropriate in those cases in which there is no genuine dispute as to material fact, and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c). All evidence should be viewed in the light most favorable to the non-moving party. Perini Corp. v. Perini Construction, Inc., 915 F.2d 121, 123-24 (4th Cir. 1990). The judge is not to weigh the evidence, but rather to determine if there is a genuine issue for trial. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249, 106 S.Ct. 2505, 2510-11, 91 L.Ed.2d 202 (1986). Where the record taken as a whole could not lead a rational trier of fact to find for the non-moving party, disposition by summary judgment is appropriate. Teamsters Joint Council No. 83 v. CenTra, Inc., 947 F.2d 115, 119 (4th Cir. 1991).
IV. ANALYSIS
It is undisputed that the standard of review for the Plan Administrator's decision in this case is abuse of discretion. The Plan vests ample discretion in its administrator to avoid a de novo review under Firestone Tire Rubber Co. v. Bruch, 489 U.S. 101, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989).
The Fourth Circuit, in a case that involved the same issue, the same defendant, the same Plan language, and the same Plan language interpretations as in the present case, held that the administrator's denial of retirement disability was not an abuse of discretion. See DeWitt v. State Farm Insurance Companies Retirement Plan, 905 F.2d 798 (4th Cir. 1990). In DeWitt, the first workday missed by the plaintiff because of his physical condition was June 18, 1984. On that date, the sum of his age and credited service was 54 years, 326 days; thus, he failed to qualify for retirement disability by 39 days. The Plan Administrator conceded that had the plaintiff worked a single day after July 9, 1984, and had then been unable to continue, he would have qualified. The Fourth Circuit noted that this result is harsh, "but faithful to the language of the plan, and plainly not an abuse of the Plan Administrator's discretion." Id. at 801.
Like Plaintiff here, the plaintiff in DeWitt argued that he continued to earn credited service while on sick leave. State Farm agreed that the plaintiff remained a member of the plan and continued to earn credited service after his injury; but contended that "date of disablement" is not defined as an employee's last day of credited service, but rather as the last day he worked. State Farm's interpretation of the Plan language was that the credited service must have accrued prior to the "date of disablement" for the member to be eligible for retirement disability benefits. The court found this interpretation by State Farm withheld "abuse of discretion" review. Id. at 801-802.
In the present case, Defendant determined that December 13, 1993, was Planitiff's "date of disablement" because that is the first workday of the last period of time she did not report to work because of a medically deter-minable physical condition. Plaintiff presented no evidence that her date of disability, as defined by the Plan, was not December 13, 1993. The Plan Administrator, interpreting the Plan language, determined that on this date, the sum of Plaintiff's attained age and the length of credited service was less than 55 years, and thus Plaintiff was not entitled to disability retirement benefits. This interpretation withstands the "abuse of discretion" standard. See DeWitt, 905 F.2d at 801-802.
Plaintiff argues that the passage of the Americans with Disability Act of 1990, 42 U.S.C. § 12101, since DeWitt was decided, makes it possible that DeWitt would have been decided differently. Specifically, Plaintiff, argues that the Plan, as interpreted, discriminates against disabled persons in violation of the ADA. Plaintiff did not plead an ADA claim against State Farm. Thus, the issue of whether or not State Farm violated the ADA is not before the court.
Plaintiff's discrimination claim under ERISA fails because there is no right to recover under ERISA if the Plan is discriminatory on its face. ERISA does not require employers to provide any particular benefits nor does it forbid discrimination in the provision of employee benefits. Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 91, 103 S.Ct. 2890, 2897, 77 L.Ed.2d 490 (1983); McGann v. H H Music Co., 946 F.2d 401, 408 (5th Cir. 1991) (evidence of intentional discrimination in the creation, alteration or termination of employee benefit plans cannot alone sustain a claim under Section 510). Section 510 of ERISA relates to discriminatory conduct directed against individuals; it does not forbid general. See Owens v. Storehouse, Inc., 984 F.2d 394, 400 (11th Cir. 1993); Deeming v. American Standard, Inc., 905 F.2d 1124, 1127 (7th Cir. 1990); Aronson v. Servus Rubber Div. of Chromalloy, 730 F.2d 12, 16 (1st Cir. 1990), cert. denied, 469 U.S. 1017. 105 S.Ct. 431, 83 L.Ed.2d 357 (1984).
Plaintiff claims that the Plan treats all employees who are absent from work for disabling reasons differently than employees absent for other reasons. Because Plaintiff is not claiming that she was treated differently than other disabled members, she does not have a valid claim under Section 510 of ERISA. See Foote v. Folks, Inc., 864 F. Supp. 1327 (N.D.Ga. 1994) (remedy under ERISA does not exist since plaintiff is alleging merely that the plan disallows AIDS-related coverage to all plan participants or beneficiaries).
Plaintiff also argues that State Farm induced her not to return to work. Plaintiff's only basis for this contention is that she was told that she would be terminated when her leave benefits expired and that she was repeatedly told she would not be entitled to retirement disability benefits. Viewing the evidence in the light most favorable to Plaintiff, this is not evidence that State Farm induced her not to return to work.
It was Plaintiff who informed State Farm that she was totally disabled and that she would be leaving State Farm when all of her benefits had been exhausted. Based on this, upon being questioned by Plaintiff regarding benefits to which she would be entitled, State Farm told Plaintiff that she would not be entitled to retirement disability benefits because on the date of her disablement, which is not disputed, her attained age and the length of credited service did not equal or exceed 55 years.
Last, Plaintiff argues that the Summary Plan Description is vague, confusing and contradictory, primarily because the accrual of credited service during sick leave or periods of disability is handled in three different ways. Two sections of the Summary Plan description cited by Plaintiff in support of this argument deal with options available or what happens after the Plan member becomes a disabled member and is eligible for disability benefits. The other section to which Plaintiff refers is the subject Plan language, which addresses credited service when determining eligibility for disability benefits. Thus, the sections cited by Plaintiff involve completely separate and distinct subject matters, two of which address matters after one becomes a disabled member, and only one which addresses how one becomes a disabled member.
As held by the Fourth Circuit in DeWitt, the effect of the Plan Administrator's interpretation is unfortunate, but the result is consistent with the language of the Plan. This court is bound by the Fourth Circuit's decision in DeWitt.