Medina v. Metropolitan Life Insurance

Filing 920091125

Opinion

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var WPFootnote1 = 'Specifically, the notice stated:\
\
                   We reviewed the medical progress notes of your\
physician, Dr. Hector Stella Estevez, dated from June 4,\
2006 to August 16, 2006. They indicate that you continue\
to have high blood pressure. However, the readings\
documented in the medical reports are within a normal\
range. Your physician indicated a weight-loss plan but\
he has not documented what the recommended plan is, what\
your weight was at the start of the plan and what\
progress, if any, has been made to date. Your physician\
gave a diagnosis of congestive heart failure, but he has\
not furnished any electrocardiogram, medical examination\
findings, laboratory tests or X-rays to support that\
diagnosis. Your physician reports problems with the\
C-pap machine but he does not make any other\
recommendation. Although we have treatment notes since\
July, no information is contained in them with respect to\
physical and/or functional limitations or restrictions\
that prevent you from returning to your own job as a\
maintenance technician at Abbott.\
'

var WPFootnote2 = 'The Plan states in relevant part:\
\
              In carrying out their respective responsibilities under\
the Plan, the Plan administrator and other Plan\
fiduciaries shall have discretionary authority to\
interpret the terms of the Plan and to determine\
eligibility for and entitlement to Plan benefits in\
accordance with the terms of the Plan. Any\
interpretation or determination made pursuant to such\
discretionary authority shall be given full force and\
effect, unless it can be shown that the interpretation or\
determination was arbitrary and capricious.\
'

var WPFootnote3 = 'Medina argues that a less deferential standard of review\
should apply, notwithstanding the Plan\'s grant of discretionary\
authority to MetLife, because a "serious procedural irregularity\
existed" that "caused a serious breach of the plan administrator\'s\
fiduciary duty." Woo v. Deluxe Corp., 144 F.3d 1157, 1160 (8th\
Cir. 1998). Even if we were to subscribe to such a rule, we find\
no such irregularity here.\
'

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