Mullins v. AT&T Corporation

Filing

UNPUBLISHED PER CURIAM OPINION filed. Originating case number: CA-03-69 Copies to all parties and the district court/agency. [998572244].. [04-2135, 04-2136, 07-1717, 10-2010]

Case: 04-2135

Document: 208

Date Filed: 04/20/2011

Page: 1

UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT

No. 04-2135

MARGARET MULLINS,
Plaintiff - Appellee,
v.
AT&T CORPORATION,
Defendant – Appellant,
and
CONNECTICUT GENERAL LIFE INSURANCE COMPANY; AT&T LONG TERM
DISABILITY PLAN FOR OCCUPATIONAL EMPLOYEES; AT&T MEDICAL
EXPENSE PLAN FOR OCCUPATIONAL EMPLOYEES,
Defendants.

No. 04-2136

MARGARET MULLINS,
Plaintiff - Appellant,
v.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY; AT&T LONG TERM
DISABILITY
PLAN
FOR
OCCUPATIONAL
EMPLOYEES;
AT&T
CORPORATION; AT&T MEDICAL EXPENSE PLAN FOR OCCUPATIONAL
EMPLOYEES,
Defendants - Appellees.

Case: 04-2135

Document: 208

Date Filed: 04/20/2011

Page: 2

No. 07-1717

MARGARET MULLINS,
Plaintiff - Appellant,
v.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY; AT&T LONG TERM
DISABILITY
PLAN
FOR
OCCUPATIONAL
EMPLOYEES;
AT&T
CORPORATION; AT&T MEDICAL EXPENSE PLAN FOR OCCUPATIONAL
EMPLOYEES,
Defendants - Appellees.

No. 10-2010

MARGARET MULLINS,
Plaintiff - Appellant,
v.
AT&T CORPORATION,
Defendant – Appellee,
and
CONNECTICUT GENERAL LIFE INSURANCE COMPANY; AT&T LONG TERM
DISABILITY PLAN FOR OCCUPATIONAL EMPLOYEES; AT&T MEDICAL
EXPENSE PLAN FOR OCCUPATIONAL EMPLOYEES,
Defendants.

Appeals from the United States District Court for the Eastern
District of Virginia, at Alexandria. Gerald Bruce Lee, District
Judge. (CA-03-69; 1:03-cv-00069-GBL-TCB)

2

Case: 04-2135

Argued:

Document: 208

Date Filed: 04/20/2011

January 26, 2011

Before TRAXLER,
Judges.

Chief

Judge,

Decided:

and

NIEMEYER

and

Page: 3

April 20, 2011

AGEE,

Circuit

Affirmed by unpublished per curiam opinion.

ARGUED: Robert Barnes Delano, Jr., SANDS ANDERSON, PC, Richmond,
Virginia,
for
AT&T
Corporation,
Connecticut
General
Life
Insurance
Company,
AT&T
Long
Term
Disability
Plan
for
Occupational Employees, and AT&T Medical Expense Plan for
Occupational Employees.
Patricia Ann Smith, LAW OFFICES OF
PATRICIA A. SMITH, Alexandria, Virginia, for Margaret Mullins.
ON BRIEF: Jeffrey H. Geiger, SANDS ANDERSON, PC, Richmond,
Virginia,
for
AT&T
Corporation,
Connecticut
General
Life
Insurance
Company,
AT&T
Long
Term
Disability
Plan
for
Occupational Employees, and AT&T Medical Expense Plan for
Occupational Employees.

Unpublished opinions are not binding precedent in this circuit.

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PER CURIAM:
Margaret
granting

Mullins

summary

appeals

judgment

the

district

against

her

court’s

on

her

decision

claim

for

disability benefits under a long-term disability plan (the “LTD
Plan” or “Plan”) self-funded by her employer, AT&T Corporation
(“AT&T”),
Company

administered

Income

(“CGLIC”),
Security

§ 1132(a)(1)(B).

by

and

Act

Connecticut

governed
of

AT&T

1974

by

General
the

Employee

(“ERISA”).

cross-appeals

Life

the

See

Insurance
Retirement
29

district

U.S.C.
court’s

decision imposing a penalty under 29 U.S.C. § 1132(c)(1) for
AT&T’s failure to produce a copy of the Summary Plan Description
(“SPD”) upon Mullins’ request.

We affirm.

I.
Mullins was employed by AT&T as a communications assistant.
In this capacity, she handled “relay” calls for disabled persons
that required her to type telephone conversations as quickly as
possible.
Under

the

While at AT&T, Mullins was covered by the LTD Plan.
Plan,

an

employee

is

considered

disabled,

therefore entitled to LTD benefits, when:
in the sole opinion of [CGLIC], [the employee] is
determined
to
be
incapable
of
performing
the
requirements of any job for any employer (including
non-AT&T employment), (as a management or occupational
employee), for which the individual is qualified or
may reasonably become qualified by training, education

4

and

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or experience, other than a job that pays less than 50
percent of [the employee’s] annual Base Pay.
J.A. 365.
In April 1998, Mullins was diagnosed with bilateral carpal
tunnel

syndrome

(“CTS”)

which

caused

sensitivity and pain in her hands.

her

to

experience

Mullins also had diabetes,

which was thought to aggravate her CTS condition.

In late 1998

and early 1999, Dr. Stephen Schroering, an orthopedic surgeon,
performed carpal tunnel surgery on both of her hands.

Mullins

returned to work at AT&T on April 8, 1999, but her physician
determined that she was unable to perform the continuous and
repetitive keyboarding duties required by her position.

She

stopped working at AT&T effective April 16, 1999.
On

April

condition
forceful
maximum
work

23,

1999,

prohibited
grasping

grip

with

her

with

Schroering

from

“work

either

strength,”

either

Dr.

and

hand,

requiring

hand,

other

including

stated

greater

that

Mullins’

repetitive

than

“work

requiring

keyboard

work.”

50%

of

or
her

repetitive
J.A.

548.

However, Dr. Schroering noted that Mullins “does well as long as
she is not doing” such repetitive work throughout the day.
548.
and

J.A.

He felt that Mullins was unable “to return to her usual
customary

work

as

an

AT&T

vocational rehabilitation.”
Mullins

a

10%

permanent

operator,

J.A. 548.

disability

5

and

w[ould]

require

Dr. Schroering assigned

for

mild

residual

carpal

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tunnel symptoms in the right hand and a 10% permanent disability
for mild residual carpal tunnel symptoms in the left hand, which
equated

to

a

12%

whole

person

permanent

disability.

Dr.

Schroering left his practice in mid-1999.
In September 1999, Mullins applied for benefits under the
LTD

Plan,

claiming

that

the

pain

and

weakness

in

her

hands

rendered her “incapable of performing the requirements of any
job for any employer” under the terms of the Plan.
Mullins,

a

high

education,

was

evaluation

of

medical

school

35

application.

years

Mullins’

records

graduate

from

old

LTD
the

with

at

the

claim

by

two

years

time.

of

CGLIC

obtaining

physicians

J.A. 365.

began

copies

identified

college

of
in

its
the
her

In addition to Dr. Schroering, Mullins listed Dr.

Leopoldo Bendigo, Dr. Robert Strang, Dr. Douglas Williams, and
Dr. N.C. Ratliffe as her treating physicians.
Dr.

Bendigo,

an

orthopedic

surgeon,

performed

independent medical examination of Mullins on May 14, 1999.

an
He

stated that Mullins was unable to return to her duties at AT&T
“at this point in time.”

J.A. 545.

However, he felt that she

had not reached maximum medical improvement and prescribed three
to six months of physical therapy.
Dr. Strang, an orthopedic surgeon, began seeing Mullins in
early August 1999, after Dr. Schroering left his practice.

Dr.

Strang suggested physical therapy and referred Mullins to Dr.
6

Case: 04-2135

Williams,

a

Document: 208

neurologist,

for

Date Filed: 04/20/2011

his

opinion

and

Page: 7

recommendations

regarding the continued pain and sensitivity in her hands.

Dr.

Williams had previously performed nerve conduction studies on
Mullins in May 1998, prior to her CTS surgeries, but felt that
she did not have CTS at that time.

On September 23, 1999, Dr.

Williams noted that Mullins had “pretty good grip strength,” but
was continuing to experience bilateral hand pain.

J.A. 488.

It

was his impression that she had a “small fiber neuropathy . . .
related to her diabetes.”
that

her

problems

were

J.A. 553.
unrelated

He continued to believe
to

CTS.

He

prescribed

medication and asked Mullins to follow-up with him in two weeks.
On

September

28,

1999,

Dr.

Strang

advised

that

Mullins

had

“neuropathy of both hands due to the carpal tunnel syndrome and
the diabetic neuropathy,” and was unable to return to work “[a]t
this time.”

J.A. 443.

Dr. Ratliff was Mullins’ family doctor.

In October 1999,

he completed a statement of disability, stating that Mullins had
a

“[s]evere

limitation

of

functional

capacity”

“incapable of minimal (sedentary) activity.”

and

J.A. 492.

was

It was

his opinion that Mullins was totally disabled from her position
at AT&T and from “any other work.”

J.A. 492.

However, he noted

that Mullins’ prognosis was “[g]uarded,” and offered no opinion
as to whether a fundamental or marked change was expected.

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In October 1999, Dr. Strang and Dr. Williams each completed
a physical assessment at the request of CGLIC, based on their
evaluation of Mullins.

Dr. Strang stated that Mullins could

sit, stand and walk for eight hours a day, and occasionally
reach above and below her shoulders, but was unable to lift,
carry, push or pull, perform simple or firm grasping, or perform
fingering/keyboarding

or

other

fine

manipulation.

J.A.

444.

Dr. Williams stated that Mullins could sit for 8 hours a day,
stand and walk for 7 hours a day, lift and carry up to 20 pounds
frequently, lift and carry up to 50 pounds occasionally, push
and

pull

occasionally,

frequently,

and

occasionally

Mullins.

perform

perform

manipulation.

reach

above

simple

and

below

grasping

fingering/keyboarding

her

shoulders

frequently,
and

other

and
fine

On January 17, 2000, Dr. Williams reevaluated

He

stated

that

Mullins’

predominant

deficits

were

sensory and assigned Mullins a 4% functional impairment in each
upper extremity, which equated to a 4% overall impairment.
Due
physical
Strang

to

the

conflicting

abilities,

and

Dr.

medical

particularly

Williams,

CIGNA

evidence

from

her

referred

as

to

specialists,

Mullins’

physician advisor, Dr. Thomas Franz, for his review.
advised

that

the

current

information

Mullins’

failed

to

case

Dr.
to

a

Dr. Franz

allow

for

a

definitive diagnosis and failed to support a finding of physical
inability to work at a light or sedentary level.
8

Case: 04-2135

On

January

Document: 208

27,

2000,

Date Filed: 04/20/2011

CGLIC

denied

Page: 9

Mullins’

claim

for

benefits as submitted, advising her that there was insufficient
evidence

to

support

her

claim

that

she

was

“incapable

of

performing the requirements of any job for any employer” under
the terms of the Plan.

J.A. 365.

In support of the decision,

CGLIC noted the differing views of Dr. Strang and Dr. Williams,
as well as the review by Dr. Franz.
Upon Mullins’ request for review of CGLIC’s denial, CGLIC
obtained updated medical records from her treating physicians.
In addition, CGLIC consulted a physician advisor, Dr. Edward
Kern, for an opinion as to whether Mullins had a psychological
condition that would impact her ability to work.

Dr. Pierce

Nelson had previously diagnosed Mullins with major depression in
November 1999, and raised questions as to Mullins’ ability to
function

as

a

result.

However,

Dr.

Nelson

also

noted

that

Mullins was able to drive to her examination and manage her
financial

affairs.

Dr.

Kern,

who

is

board-certified

in

psychiatry and neurology, reviewed Mullins’ records, including
those of Dr. Nelson, and reported that the information did not
address functionality and that malingering was a concern.
The

updated

physicians
demonstrate

for

her

medical
hand

conflicting

and her ability to work.

records
pain

and

opinions

from

Mullins’

sensitivity

regarding

both

treating

continued
her

to

diagnosis

On April 18, 2000, Dr. Strang advised
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that Mullins “has a confusing case of neuropathy of the hands.”
J.A. 528.

He also noted that there was an additional dispute

between two neurologists, Dr. Williams and Dr. Dew, as to the
cause of her pain.

Dr. Strang concluded that “[a]t any rate, it

would appear that [Mullins] does have significant pain in her
hands, and it would appear that she is still unable to do her
work.”

J.A. 528.

On June 13, 2000, Dr. Erdogan Atasoy, a specialist in hand
surgery, evaluated Mullins.

Dr. Atasoy diagnosed Mullins with

“thoracic outlet compression and associating myofascitis.”
581.

J.A.

Dr. Atasoy stated that Mullins could perform “[l]ight work

lifting

20

lbs

maximum

with

frequent

restricted to 10 lbs or less.”

lifting

J.A. 582-83.

or

carrying

She was to avoid

work requiring “constant repetitive/static use of both hands –
pushing/pulling,

pinching/gripping,

flexion/extension

of

wrist/elbow, pronation/supination (palm down/palm up),” the “use
of vibratory tools,” overhead work, climbing poles or ladders,
and unprotected heights.

J.A. 583.

He suggested a “[s]lower

pace work” and limited her to a “[w]ork day not to exceed more
that 6 hours per day/5 days per week.”
In

light

physicians,

of

CGLIC

the
next

continuing
referred

capacity examination (“FCE”).

J.A. 583.

conflict
Mullins

between
for

a

Mullins’
functional

The evaluation took place for

several hours over 2 days, and identified a number of physical
10

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strengths and limitations.

Date Filed: 04/20/2011

Page: 11

Because Mullins was unable to lift

10 pounds occasionally and right-hand carry, the FCE indicated
that Mullins capabilities could not be classified as “sedentary”
under the Dictionary of Occupational Titles.

However, the FCE

recommendation was that Mullins should be able to return to a
job within the specific capabilities and restrictions set forth
in

the

activity

report

of

the

FCE.

No

additional

physical

rehabilitation was recommended.
CGLIC forwarded the results of the FCE to Drs. Ratliffe,
Strang, Williams, and Atasoy for their review and comment.
Ratliffe did not respond.
still unable to work.

Dr.

Dr. Strang stated that Mullins was

Dr. Williams and Dr. Atasoy, however,

both agreed that Mullins was capable of performing full-time
sedentary work in accordance with the limitations listed in the
FCE.
In

October

2000,

CGLIC

referred

Mullins’

file

for

a

Transferable Skills Analysis (“TSA”) to determine whether there
were

jobs

that

Mullins

identified in the FCE.

could

perform

within

the

limitations

The TSA revealed three jobs that Mullins

could perform based upon her skills, education, and abilities,
and

which

claim.

met

the

salary

Specifically,

restrictions

Mullins

was

able

for
to

resolution
work

scheduler, insurance clerk, or call-out operator.

as

of
a

her

space

In November

2000, CGLIC also referred Mullins’ file for a Labor Market Study
11

Case: 04-2135

(“LMS”),
within

in

Document: 208

order

Mullins’

accommodate

to

Date Filed: 04/20/2011

determine

geographical

her

limitations

whether
area

and

there

the

were

employers

would

that

meet

Page: 12

actually

wage

replacement

requirements of the Plan.

The LMS identified six employers with

existing

that

job

openings

would

accommodate

Mullins’

limitations.
On November 27, 2000, CGLIC sent Mullins a letter upholding
the initial denial of LTD benefits, based upon its determination
that

Mullins

limitations

was
and,

able

to

perform

therefore,

that

sedentary
she

was

work

not

within

her

“incapable

of

performing the requirements of any job for any employer” under
the terms of the Plan.
reconsideration

of

the

J.A. 365.
decision.

Mullins again requested

On

January

9,

2003,

after

review by an appeals team, CGLIC issued its final denial of
Mullins’ claim for LTD benefits.

II.
Mullins brought this lawsuit in district court under 29
U.S.C. § 1132(a)(1)(B), claiming that the defendants improperly
denied her benefits under the LTD Plan.
her

complaint

to

seek

statutory

Mullins later amended

penalties

under

29

U.S.C.

§

1132(c)(1)(B) for AT&T’s failure to produce to her a copy of the
SPD upon her request for the LTD Plan documents.

On cross-

motions for summary judgment, the district court granted summary
12

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judgment for the defendants on Mullins’ claim for LTD benefits.
However, the district court granted summary judgment to Mullins
on her claim for statutory penalties and ordered AT&T to pay
Mullins

penalties

totaling

$18,400.

Mullins

appealed

the

district court’s decision on her claim for LTD benefits and AT&T
appealed the district court’s imposition of the penalty.
This is the third appeal from the district court’s grant of
summary judgment to the defendants on Mullins’ claim for LTD
benefits.
discretion

Mullins
by

argued

denying

her

below

that

claim

in

CGLIC

part

had

because

abused

its

CGLIC

had

violated its internal procedures during its consideration of her
claim.

However, until recently, Mullins’ attempts to obtain the

production of the claims manuals, protocols, and other internal
guidelines relating to the processing of LTD claims and appeals
from claims denials had been unsuccessful.

Without addressing

the merits of the issues, we twice remanded this matter to the
district court with instructions that it ascertain the existence
of any such claims-processing documents and produce the relevant
documents to Mullins.

See Mullins v. AT&T Corp., 290 Fed. Appx.

642 (4th Cir. 2008) (unpublished).
were

produced

to

Mullins,

the

After the relevant documents

district

summary judgment to the defendants.

court

again

granted

The district court found

that CGLIC had substantially complied with its claims-processing
documents and that Mullins had failed to prove that CGLIC abused
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its discretion in considering and denying her claim under the
LTD Plan.

Accordingly, the parties’ cross-appeals are now back

before us and ready for disposition.

III.
We

begin

decision

with

awarding

Mullins’

summary

appeal

judgment

of
to

the
the

district

court’s

defendants

on

her

claim for LTD benefits.
A.
We review the district court’s grant of summary judgment de
novo, applying the same legal standards that the district court
employed.

See Evans v. Eaton Corp. Long Term Disability Plan,

514 F.3d 315, 321 (4th Cir. 2008).

Where, as here, an ERISA-

covered plan confers discretion on the plan’s administrator to
interpret its provisions and issue a determination, we review
the administrator’s determination under an abuse-of-discretion
standard.

See Metropolitan Life Ins. Co. v. Glenn, 554 U.S.

105, 111 (2008); Evans, 514 F.3d at 321.
discretion

standard,

we

will

not

set

Under the abuse-ofaside

the

plan

administrator’s decision if it is reasonable, even if we would
have reached a different conclusion independently.

See Booth v.

Wal-Mart Stores, Inc. Associates Health & Welfare Plan, 201 F.3d
335,

341

reasonable

(4th
“if

Cir.
it

is

2000).
the

The
result
14

administrator’s
of

a

decision

deliberate,

is

principled

Case: 04-2135

reasoning

process

evidence.”

Document: 208

and

if

Date Filed: 04/20/2011

it

is

supported

Page: 15

by

substantial

Bernstein v. CapitalCare, Inc., 70 F.3d 783, 788

(4th Cir. 1995) (internal quotation marks omitted).
In Booth, we set forth eight nonexclusive factors to be
considered

by

courts

in

reviewing

the

plan

administrator’s

decision:
(1) the language of the plan; (2) the purposes and
goals of the plan; (3) the adequacy of the materials
considered to make the decision and the degree to
which they support it; (4) whether the fiduciary’s
interpretation was consistent with other provisions in
the plan and with earlier interpretations of the plan;
(5) whether the decisionmaking process was reasoned
and
principled;
(6)
whether
the
decision
was
consistent
with
the
procedural
and
substantive
requirements of ERISA; (7) any external standard
relevant to the exercise of discretion; and (8) the
fiduciary’s motives and any conflict of interest it
may have.
Booth, 201 F.3d at 342-43; see also Williams v. Metropolitan
Life Ins. Co., 609 F.3d 622, 630 (4th Cir. 2010). 1
B.
Mullins

contends

that

the

district

court

erred

in

concluding that CGLIC’s decisionmaking process was reasoned and
1

In Metropolitan Life Insurance Co. v. Glenn, 554 U.S. 105
(2008), the Supreme Court clarified that an administrator’s
conflict of interest does not alter or modify the abuse-ofdiscretion standard of review.
See id. at 115-16; see also
Williams v. Metropolitan Life Ins. Co., 609 F.3d 622, 630-31
(4th Cir. 2010).
Instead, the conflict of interest is to be
weighed along with other applicable factors.
See Glenn, 554
U.S. at 117; Williams, 609 F.3d at 631. In this case, however,
the parties agree that there was no conflict of interest.

15

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Date Filed: 04/20/2011

Page: 16

principled, and erred in concluding that substantial evidence
supported the denial of benefits.

We disagree.

When Mullins first sought LTD benefits under the Plan, she
had been seen by two surgeons and a neurologist for the pain and
sensitivity in her hands.

The medical opinions of Mullins’ own

treating physicians conflicted, however, both as to her specific
diagnosis as well as to her functional capacity to perform work.
Resolving such conflicts in the opinions of Mullins’ treating
physicians

was

CGLIC’s

responsibility

and

well

within

the

discretion conferred to it under the terms of the LTD Plan.

See

Booth, 201 F.3d at 345; Brogan v. Holland, 105 F.3d 158, 162-63
(4th Cir. 1997).

In determining that Mullins had failed to

prove, as was her burden, that she was “incapable of performing
the requirements of any job for any employer,” J.A. 365, CGLIC
reasonably

considered

and

relied

upon

the

opinions

of

Dr.

Williams and Dr. Atasoy, as well as the results of the FCE,
which indicated that she was capable of performing sedentary
work within her limitations.

CGLIC also took the additional

step of obtaining both the TSA and LMS, and determined that
there were actual jobs available in the market which Mullins
could

perform

minimum

wage

within

her

requirement

limitations
necessary

and
for

which
a

finding

disability under the definition in the LTD Plan.

16

exceeded

the

against

Thus, CGLIC’s

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Page: 17

determination was clearly supported by substantial evidence in
the administrative record.
Mullins

acknowledges

that

the

medical

conflicting on the issue of her disability.

evidence

was

However, she argues

that we should find that CGLIC abused its discretion because it
did

not

strictly

adhere

to

its

internal

claims

processing

procedures when considering her claim and, consequently, denied
her

claim

based

upon

evidence

solicited nor relied upon.
CGLIC

was

limited

under

that

it

should

have

neither

Most notably, Mullins contends that
its

claims

processing

procedures

to

considering the opinion of Mullins’ “attending physician,” and
asserts that while Drs. Ratliff, Strang, and Schroering might be
considered

“attending

physicians,”

Drs.

Williams

and

Atasoy

should not have been.
Although the term ”attending physician” is used in CGLIC’s
claims-processing

materials,

it

is

not

defined

therein

and

common medical definitions of that term vary depending upon the
context

in

“attending
different
setting.

which

it

is

physician”
from

the

in

used.
a

meaning

For

example,

the

hospital

setting

might

of

term

that

in

a

meaning
be

of

quite

non-hospital

The district court rejected Mullins’ narrow definition

of the term “attending physician” and found that its use was not
intended to distinguish a claimant’s primary physician from all
other treating physicians, but rather to delineate physicians
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who have actually seen and treated the claimant from those who
have not. 2

At the time that Mullins filed her claim for LTD

benefits, she had been seen on three occasions by Dr. Strang,
the orthopedic surgeon who assumed her care after Dr. Schroering
left his practice, and on one or two occasions by Dr. Williams,
the neurologist who had seen her previously and to whom she was
referred for additional evaluation and treatment by Dr. Strang.
Under these circumstances, we agree with the district court’s
determination

that

the

term

“attending

physician”

did

not

exclude CGLIC’s initial consideration of Dr. Williams’ opinion
or

its

later

consideration

solicited from Dr. Atasoy.
consider

the

term

“attending

of

the

second

surgical

opinion

Furthermore, even if we were to
physician”

to

be

limited

to

a

single physician in other settings or circumstances, we cannot
say

that

CGLIC

abused

its

discretion

or

otherwise

acted

unreasonably in considering Drs. Williams and Atasoy to be an
attending

or

treating

physicians

here,

or

in

requesting

and

considering their medical records and opinions on the issue of
Mullins’ functional capacities and ability to work.

2

We also note that the LTD Agreement between CGLIC and AT&T
similarly defines an “Attending Physician” as “a duly licensed
physician, psychiatrist, or psychologist treating the Claimant
or Covered Person.” J.A. 70.

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Building upon this “attending physician” argument, Mullins
also

claims

that

CGLIC

abused

its

discretion

by

failing

to

strictly follow certain preferred procedures set forth in its
claims-processing
information.
an

documents

for

resolving

conflicting

medical

The district court found that although CGLIC had

obligation

to

some

degree

to

process

Mullins’

claim

in

accordance with these procedures, and that such compliance is
always a consideration on the question of reasonableness of a
decision, strict compliance is not a prerequisite to a finding
that the plan administrator’s overall decision was principled
and reasonable.
We

agree.

It

is

well

settled

that

the

decisionmaking

process by a claims administrator, including external standards
relevant to the exercise of the administrator’s discretion, is a
factor to be considered in the overall determination of whether
the administrator abused its discretion in denying LTD benefits.
See Booth, 201 F.3d at 342-43.

However, it is but one factor to

weigh alongside the other factors and the administrative record.
Cf. Glenn, 554 U.S. at 117; Williams, 609 F.3d at 631.

Indeed,

as noted by the district court, a contrary ruling would rob the
plan

administrator

documents.

of

the

discretion

granted

in

the

same

Having reviewed the administrative record and the

claims processing documents, we agree with the district court’s
determination

that

CGLIC

substantially
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complied

with

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procedures and, to the extent it varied therefrom, did not abuse
its discretion in doing so.
As noted above, CGLIC was presented from the outset with
conflicting medical opinions among Mullins’ treating physicians
regarding both her diagnosis and her ability to work.
the

most

direct

recently

assumed

referred

her

conflict

considered

for

her

the

care

was

further

and

between
the

surgeon

neurologist

evaluation

conflicting

the

opinions

to

and

treatment.

of

Mullins’

Indeed,
who

had

whom

he

CGLIC
treating

physicians, solicited the opinion of a physician consultant, and
obtained an FCE to independently evaluate her physical strengths
and limitations for employment. 3

CGLIC then made a reasonable,

principled determination that Mullins, who was in her mid-30s
with some college education at the time, had failed to prove
that she was “incapable of performing the requirements of any
job

for

any

employer”

reasonably qualified.

for

which

she

was

or

could

become

J.A. 365.

3

As correctly noted by the district court, Mullins’
challenge to CGLIC’s FCE referral under its internal procedures
also fails to demonstrate an abuse of discretion. The procedure
relied upon by Mullins does not, by its terms, apply to the FCE
obtained.

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IV.
We turn now to AT&T’s cross-appeal of the district court’s
decision to impose a statutory penalty upon AT&T under 29 U.S.C.
§ 1132(c)(1).

We review the district court’s decision for an
See Davis v. Featherstone, 97 F.3d 734,

abuse of discretion.
735-36 (4th Cir. 1996).

In February 2001, Mullins’ former counsel requested copies
of the “AT&T [LTD] policy . . . and a copy of all other plan
documents concerning that [LTD] policy.”
later,

AT&T

produced

copies

of

the

LTD

J.A. 63.
plan

Two months

and

AT&T/CGLIC

Agreement, but did not include a copy of the SPD.

In March

2003, after litigation was initiated by Mullins’ new counsel,
AT&T produced a copy of the SPD to Mullins.
Under 29 U.S.C. § 1132(c)(1), the district court may, in
its discretion, impose penalties of up to $100 per day against
plan

administrators

who

fail

to

furnish

certain

requested by plan participants under ERISA.

documents

See Faircloth v.

Lundy Packing Co., 91 F.3d 648, 659 (4th Cir. 1996).
factors

generally

guide

[the]

district

court’s

“Two

discretion:

prejudice to the plaintiff and the nature of the administrator’s
conduct

in

documents.”

responding

to

the

participant’s

request

for

plan

Davis, 97 F.3d at 738; see also Faircloth, 91 F.3d

at 659 (noting that the court may consider prejudice and bad
faith in exercising its discretion).
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The district court found that Mullins’ written request for
“a

copy

of

all

other

plan

documents

concerning

[the

LTD]

policy,” was sufficient to notify AT&T that the response should
include the SPD.

With regard to prejudice, the district court

noted that while the SPD did contain some additional information
not otherwise provided in the documents produced, Mullins was
not

ultimately

information.

prejudiced

by

the

delay

in

obtaining

the

With regard to the conduct of AT&T, the district

court found that AT&T did not act in bad faith, but nevertheless
had failed to produce complete information in violation of the
statute.

Under the circumstances, the district court concluded

that the maximum penalty of $100 per day was unwarranted but
that a penalty of $25 per day would be appropriate.
We

cannot

say

court’s discretion.

that

this

was

an

abuse

of

the

district

“Although prejudice is a pertinent factor

for the district court to consider, it is not a prerequisite to
imposing a penalty.”
necessary

that

the

level of bad faith.

Davis, 97 F.3d at 738.
plan
Id.

administrator’s

It is also not

conduct

rise

to

Rather,

[t]he purpose of the penalty provision is to provide
plan administrators with an incentive to meet requests
for information in a timely fashion.
When there is
some doubt about whether a claimant is entitled to the
information requested, the Supreme Court has suggested
that an administrator should err on the side of
caution.

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Id. (citation omitted); see also Faircloth, 91 F.3d at 659 (“The
purpose of [§ 1132(c)(1)] is not to compensate participants for
injuries,

but

to

punish

noncompliance

with

ERISA.”).

Accordingly, we affirm the grant of summary judgment to Mullins
on her claim for statutory penalties under § 1132(c)(1).

V.
For the foregoing reasons, we affirm the district court’s
grant of summary judgment to the defendants on Mullins’ claim
for LTD benefits under 29 U.S.C. § 1132(a)(1)(B), and we affirm
the district court’s grant of summary judgment to Mullins on her
claim for penalties under § 29 U.S.C. § 1132(c)(1).
AFFIRMED

23