Holly Odd v. Delta Air Lines, Inc. et al
Filing
73
FINDINGS OF FACT AND CONCLUSIONS OF LAW by Judge William D. Keller. Judgment is entered in favor of Defendants. IT IS SO ORDER FOR FURTHER DETAILS). (SEE ORDER F(Made JS-6. Case Terminated.) (yl)
JS-6
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UNITED STATES DISTRICT COURT
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CENTRAL DISTRICT OF CALIFORNIA
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HOLLY ODD,
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Plaintiff,
13
v.
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DELTA AIR LINES, INC., a
corporation; DELTA FAMILY-CARE
DISABILITY AND SURVIVORSHIP
PLAN, an ERISA plan; DOES 1
through 10, inclusive,
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A.
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1.
that is administered in Atlanta, GA (2100).1
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The Delta Family Care Disability and Survivorship Plan (“Plan”) is an
Security Act of 1974, as amended, 29 U.S.C. § 1001 et seq. (“ERISA”) (1943)
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27
FINDINGS OF FACT
employee welfare benefit plan subject to the Employee Retirement Income
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26
FINDINGS OF FACT AND
CONCLUSIONS OF LAW AFTER
COURT TRIAL
Defendants.
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Case No. 2:18-cv-02523-WDK-MRW
1
The administrative claim file has been jointly lodged with the Court under seal and
is labelled Delta-Odd 000001-1941. A copy of the Plan is filed as Exhibit A to the
Declaration of Connie Schultz, and labelled Delta-Odd 001942-2028. The Summary
1
2.
The Plan provides, among other things, short-term and long-term disability
2
benefits to eligible participants who are Delta Air Lines, Inc. (“Delta”)
3
employees. (1943).
4
3.
The Plan provides short-term disability benefits, usually for up to six months,
5
so long as a Plan participant generally cannot perform their customary
6
occupation as a result of demonstrable injury or disease as those terms are
7
defined by the Plan. (1959).
8
4.
If a participant is still unable to work after exhausting these benefits, she can
9
then seek long-term disability benefits that are initially available according to
10
the same substantive standard, as long as she also can show a loss of at least
11
20% of her earning capacity as measured by the participant’s prior wages. (Id.).
12
5.
to be disabled during this period the claimant must show:
the inability of an Employee to perform any Gainful
Occupation as a result of a demonstrable injury or disease
(including mental or nervous disorders and occupational
injuries and illnesses) or pregnancy.
A Gainful
Occupation is an occupation (1) for which the Employee
is, or may become, qualified by reason of education,
training or experience and (2) for which the potential for
earnings is expected to be 50% . . . or less of the
Employee’s Pre-Disability Earnings.
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14
15
16
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(1959).
6.
22
23
After the first six months of long-term disability eligibility, the Plan states that
A claimant could elect prior to the onset of a disability to have this 50%
threshold set at 60%, but Plaintiff did not make this election. (0027, 2045).
7.
Plaintiff received short-term disability benefits and then long-term disability
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25
26
27
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Plan Description is attached as Exhibit B to the Schultz Declaration and is labelled
Delta-Odd 002029-2113 (cites to these documents in this brief are made without
reference to the prefix as it is common to all of them and omits the first two zeros as
they are never used in the record).
2
1
benefits for more than six months, so the Gainful Occupation Standard could
2
have been applied to Ms. Odd as early as August of 2016 (0208) (showing
3
approval for long-term disability benefits for over nine months from February
4
8, 2016 to November 15, 2016).
5
8.
which administers to the Plan in Atlanta, Georgia (2100).
6
7
The Plan’s administrator is the Administrative Committee of Delta (1990)
9.
Section 12.02(b) of the Plan gives the Administrative Committee:
8
[t]he discretionary authority to interpret and construe the
terms of the Plan, and decide all questions of eligibility of
any employee, Eligible Family Member, or Beneficiary to
participate in the Plan, or to receive benefits under it, its
interpretations and decisions thereof to be final and
conclusive.
9
10
11
12
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(1990).
10.
duties as set forth to decide these claims.” (1990-92 (citing Sections 12.02(h)
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and 12.04)).
11.
Administrator, Sedgwick. (1945 (Section 1.11), 1967 (Section 4.05), 2089,
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The Administrative Committee has delegated decisions regarding the
continuing qualification for long-term disability benefits to the Plan’s Claims
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The Administrative Committee also has the power to “delegate its power and
2094, 2100).
12.
If a participant is unhappy with Sedgwick’s decision, the participant can appeal
that decision. (1982-83).
13.
The participant is permitted to submit evidence and argument in support of the
appeal in writing. (Id.).
14.
If that appeal is unsuccessful, the claimant can seek a second appeal. (1983).
15.
To the extent that there is any contention that there was a conflict of interest
that somehow affects the decision, that contention needs to be made in the
claims process or it is waived. (1984).
3
1
16.
Any long-term disability benefit award under the Plan is subject to offset of
2
various other benefits or amounts that the participant may receive.
3
example, all of the disability benefits that any participant may receive from the
4
Social Security Administration are to be offset against any benefit received
5
under this Plan. (1972).
6
17.
For
Further, the participant is required to notify Sedgwick of any third-party claim
7
that relates to the injury that is the alleged cause of the disability within 31 days
8
of making the third-party claim. (1989 (incorporates subrogation and right of
9
recovery terms from the SPD) & 2084 (SPD right of recovery provisions)).
10
18.
The Plan is entitled to recover from the third-party settlement an amount up to
11
the amount of benefits provided under the Plan regardless of how Plaintiff may
12
characterize the terms of that settlement (whether for medical losses, wages
13
losses or otherwise). (2083).
14
19.
To the extent a participant does not provide timely notice of such a resolution,
15
she is subject to complete disqualification from all benefits under the Plan.
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(2084).
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20.
preempted by ERISA, Georgia law would apply to all participants. (1996).
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In the unlikely event that some issue arose under the Plan that was not
21.
The Plan states that all claims will be decided under ERISA as that law would
20
be applied as if the matter were brought in the jurisdiction of the United States
21
Court of Appeals for the Eleventh Circuit regardless of where the case is filed.
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(1996-97). The Plan is administered by the Administrative Committee within
23
that jurisdiction. (2100).
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22.
The structure of the Plan calls for all of the benefits to be paid out of an
25
irrevocable trust that is administered by the Administrative Committee, the
26
named fiduciary for the Plan. (1988 (Section 11.04)). The Plan has separated
27
the responsibility for the payment of benefits (by the Administrative
28
4
1
Committee) from the decision on eligibility for benefits (by Sedgwick), thus
2
eliminating any structural conflict of interest.
3
23.
on August 8, 2015 (0208).
4
5
Plaintiff was injured in an automobile accident and began a leave from work
24.
According to the terms of the Plan, the applicable standard that applied to her
6
claim changed from the Customary Occupation to the Gainful Occupation
7
standard on or about August 8, 2016. (1959).
8
25.
though there is no requirement under ERISA that such a call be made. (1820).
9
10
Sedgwick called Plaintiff and explained this change to her personally even
26.
Despite claiming to be seriously injured, Plaintiff did not see her treating
11
physician for six weeks between September 1, 2015 and October 20, 2015.
12
(1787). Plaintiff later admitted in May of 2016 that she stopped physical
13
therapy “a long time ago.” (1820).
14
27.
headaches.” (0029).
15
16
28.
Ms. Odd’s long-term disability benefits under the Plan ultimately were
approved through December 1, 2016 at a rate of $2,686.50 per month. (0027).
17
18
Plaintiff claimed that she was disabled due to “upper back/neck pain [and]
29.
The information that Sedgwick had at that time included a physical evaluation
19
form completed by her own physician, Dr. Ojen Masrour, indicating that
20
Plaintiff could return to work 6 hours a day, 30 hours a week as of July 29,
21
2016, but that she would not be able to work without restrictions. (0092-93).
22
30.
It also included information from Ms. Odd’s chiropractor, Dr. Phillip Lewis,
23
who indicated on August 12, 2016 that she could return to work up to 40 hours
24
per week as of January 1, 2017 with some unstated restrictions, and with no
25
restrictions as of June 1, 2017. (0128-30).
26
27
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31.
Plaintiff's treating physician, Dr. Masrour, recommended Plaintiff see a pain
management specialist. (1828). Plaintiff, instead, went to see Dr. Lewis, a
5
chiropractor. (1883).
1
2
32.
In part due to the absence of treatment and the relative lack of information from
3
her chiropractor (1836), Sedgwick contracted with GENEX Services, LLC to
4
have Plaintiff seen by a neurologist. (0171).
5
33.
Neurology of the American Board of Psychiatry and Neurology. (0171-196).
6
7
GENEX selected Dr. Robert J. Shorr on September 29, 2016, a Diplomate in
34.
When seen by Dr. Shorr on September 29, 2016, Plaintiff complained of mild
8
to moderate headaches that did not interfere with her concentration, but were
9
associated with her neck pain that she also described as mild to moderate.
(0172-74).
10
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35.
Dr. Shorr included two pages of observations in his physical examination and
12
neurological examination of the Plaintiff (as indicated in part by the
13
examination of her eyes), that had no remarkable findings. (0178-79).
14
36.
Dr. Shorr spent an additional six pages reviewing the prior medical records that
15
had been given to him. After examining Plaintiff, Dr. Shorr concluded that he
16
could not find any evidence of disability other than her self-reported pain.
17
(0180-86).
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37.
After considering all of this information, Dr. Shorr noted that Plaintiff did self-
19
report symptoms of headaches, but there were no clinical findings to support
20
the report of pain, and that she did not have “disabling symptoms or medical
21
findings preventing her from performing normal job duties.” (0188).
22
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38.
Dr. Shorr concluded that:
All that is required at this time would be observation and
a home-based exercise program with range-of-motion and
strengthening and stretching exercise for the neck and
upper back, along with judicious use of over-the-counter
non-steroidal and anti-inflammatory medications such as
Advil or Aleve. The claimant is not in need of active
treatment at this time.
6
1
(0188).
2
39.
Even though the applicable standard at the time was the any Gainful
3
Occupation standard, Dr. Shorr specifically opined that Plaintiff could perform
4
the job of flight attendant/steward after reviewing the job description for those
5
duties. (0189).
6
40.
Dr. Shorr reaffirmed these opinions after receiving additional medical records
7
following his initial report. (0192-98). Dr. Shorr initially requested a nerve
8
conduction study, and Sedgwick approved that request within 30 minutes even
9
though the request was made while the Sedgwick employee who received it
10
was at lunch. (0597-98 (the parties emailing were in two time zones, 1 hour
11
offset)). Dr. Shorr did not think the test was significant enough to have Plaintiff
12
wait for that approval. (Id. at 0597).
13
41.
Sedgwick received and then sent Dr. Shorr’s report to Dr. Masrour and Dr.
14
Lewis, who were given 10 days to submit a response if they disagreed with
15
these findings. (0208).
16
42.
that both doctors were in agreement with Dr. Shorr’s findings. (Id.).
17
18
43.
44.
Based on the information at hand, Sedgwick then denied Plaintiff any benefits
after December 1, 2016. (0207).
21
22
Sedgwick unilaterally extended Plaintiff's long-term disability benefits through
November 30, 2016 so they would not lapse during its review. (1856).
19
20
Neither doctor responded to the IME so Sedgwick proceeded on the assumption
45.
Sedgwick’s letter set forth the standard for long-term disability benefits and,
23
following a thorough review of the documents submitted, concluded that the
24
medical evidence received to date did not support Plaintiff’s inability to
25
perform her job as a result of her condition. (0207-08). It specifically noted
26
that:
27
28
Dr. Shorr reviewed the MRI which showed no injuries resulting
7
from the auto accident;
1
Dr. Shorr noted only mild tenderness in three areas and no
2
neurological impairment; and
3
Dr. Shorr concluded that Plaintiff could return to her job as a flight
4
attendant.
5
6
7
8
(Id. at 0208.)
46.
standard is the Gainful Occupation standard, it found that in light of the medical
9
evidence, Plaintiff did not meet the Customary Occupation standard anymore.
10
As the Gainful Occupation standard is harder to meet, Plaintiff would have
11
12
13
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failed that one as well. (1959).
47.
Plaintiff then appealed on December 6, 2016, after securing counsel. (0257).
48.
On December 6, 2016, Plaintiff's counsel requested the entire claim file and a
copy of the Plan (0211). Sedgwick sent it to Plaintiff’s counsel on December
15
16, 2016 (1864 (receipt) & 1868 (confirmation of shipment) & 0573 (package
16
weighed three pounds)). In the ensuing communication, during the appeal,
17
Plaintiff’s counsel never asserted any documents were missing. (0551-52, 554,
18
19
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559, 560, 562-63, 565, 567-68, 572).
49.
bring relating to her accident. (0269) (The letter is dated January 9, 2016, but
22
was actually sent on January 9, 2017 (1870)). According to the Administrative
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On January 9, 2016, Sedgwick contacted Plaintiff’s counsel alerting him to the
fact that the Plan held a lien on the settlement of a tort claim that Plaintiff might
21
24
If anything, Sedgwick erred in favor of Plaintiff. Even though the applicable
Record, Sedgwick received no response to this letter. (0001-1941).
50.
On February 2, 2017, the United States Social Security Administration denied
Plaintiff’s claim for Social Security disability benefits. (0278-82).
51.
On February 13, 2017, Sedgwick received a copy of this denial from one of its
vendors. (1873). The denial letter concluded that “her condition is not severe
8
enough to be considered disabling.” (0278).
1
2
52.
The Social Security Administration also concluded that “[t]he [e]vidence does
3
not show any other impairment which would significantly restrict her from
4
performing work-related functions.
5
concluded that your condition should not limit your ability to work.” (Id.). In
6
short, the Social Security Administration reached a conclusion similar to
7
Sedgwick.
8
53.
Plaintiff tolled the appeal period repeatedly at Plaintiff's counsel's request
(1880) for approximately five months before she submitted a letter from a new
9
physician, Dr. Leon Barkodar, on May 1, 2017. (0303 & 0305).
10
11
Based upon the evidence, we have
54.
The letter, only 9-lines long, includes no medical findings, no reference to any
12
tests that were performed, and no indication of what work she could not
13
perform other than simply saying that he does not believe that Ms. Odd can
14
perform the job of an airline “stewardess.” (0305).
15
55.
Plaintiff did not state how long Dr. Barkodar’s examination of Plaintiff lasted
16
nor did she provide this information for any other physician she relied upon.
17
(0001-0194).
18
56.
substantiate her claim. (Id.).
19
20
Dr. Barkodar’s opinion relies totally on Plaintiff’s self-report of pain to
57.
At the same time, Plaintiff submitted statements of Plaintiff’s family members
21
(and her significant other) in support of her claim that she was unable to work.
22
(0306-311). These statements were anecdotal by non-professionals, and not
23
related to any medical or Plan criteria. (Id.).
24
58.
After receiving the information submitted, Sedgwick then sought a peer review
25
of Plaintiff’s records and contracted with Dane Street LLC for such a review.
26
(0318 & 0328-34).
27
28
59.
Dane Street LLC referred the file for examination by Dr. David Hoenig, who
9
is Board Certified in Neurology and Pain Management. (0334).
1
2
60.
After reviewing all of the documentation provided, the requirements of the
3
flight attendant position, and unsuccessfully attempting to reach Dr. Barkodar
4
by phone, in his May 24, 2017 report, Dr. Hoenig acknowledged the self-
5
reported pain by Plaintiff and Dr. Barkodar’s conclusory opinion, but noted that
6
there is no clinical evidence supporting Ms. Odd’s complaints or Dr.
7
Barkodar’s opinion. (0332 & 1893).
8
61.
no clinical documentation submitted for review by her
treating neurologist. There is no documentation of neurodiagnostic study submitted for review.
There is
documentation of a neurological IME. This independent
assessment revealed no neurological deficits, and there are
no neurologically based restrictions or limitations.
9
10
11
12
13
14
15
(0332).
62.
history, and providing a detailed physical examination demonstrating abnormal
17
pathology. There is no documentation of any significant diagnostic studies
18
20
submitted for review demonstrating significant abnormal pathology.” (Id.).
63.
23
24
25
26
27
28
Thus, in the absence of any clinical findings to support the complaints by
Plaintiff, Dr. Hoenig concluded that Plaintiff was not impaired at all from
21
22
In addition, Dr. Hoenig noted that there is no “clinical documentation from any
treating provider, including a pain management specialist, providing a detailed
16
19
Specifically, Dr. Hoenig acknowledged the complaint, but noted that there was:
working. (0332-33).
64.
Following the receipt of this information on May 30, 2017, Sedgwick denied
Ms. Odd’s appeal because of the relative lack of evidence supporting her claim
that she could meet the Plan’s standard for long-term disability. (0338-341).
The letter specifically acknowledged the report of pain. (0339). It also pointed
out the diagnoses by her neurologist and the various types of documentation
that could be probative but were missing, including:
10
1
clinical documentation by her treating neurologist; and
2
documentation of neurodiagnostic studies.
3
(0339). The letter did note that the neurological IME showed no neurological
4
deficits, or neurologically based restrictions or limitations (340). It also noted
5
the absence of the same information Dr. Hoenig found lacking. (Compare 0340
6
with 0332).
7
8
65.
what specific types of documents were lacking as noted above, the letter
9
advised Plaintiff that if she wished to appeal, she should “state the reason(s)
10
you believe your claim was improperly denied.
11
comments you deem appropriate for us to give your Appeal proper
13
15
16
17
consideration.” (0340).
66.
20
21
22
67.
25
26
27
28
Persuaded by Dr. Hoenig’s conclusion and the lack of new medical information
provided with the appeal, Sedgwick denied the appeal and noted that Plaintiff
had the right to a second appeal. (Id.).
68.
The decision letter also highlighted the relevant terms of the Plan and listed the
information that was reviewed in making that decision. (0339-40).
69.
Plaintiff at that time elected a further appeal under the terms of the Plan. The
consideration of the appeal was tolled four times at Plaintiff's counsel's request.
23
24
The appeal was handled by a different person. The original claim was handled
by reviewer "K Marks" and the appeal by Amy Greenwald. (1855, 1864).
18
19
You may also submit
additional medical or vocational information, and any facts, data, questions or
12
14
In summarizing Plaintiff’s further appeal options, and after previously sharing
(1921).
70.
On June 5, 2017, Plaintiff asked for a copy of the entire claim file. (0343).
71.
Six days later, Sedgwick delivered five pounds of documents to Plaintiff’s
counsel. (0532-33).
72.
At no time during the second appeal did Plaintiff’s counsel assert he was
11
1
missing any documentation from either his request during the first appeal or
2
this request. (0350-51, 0506, 0516, 1003-04, 1007-08, 1040, 1055-58, 1062-
3
63, 1067-69, 1737-38).
4
73.
(1980).
5
6
Sedgwick had a different reviewer, Richie Marchand, handle the second appeal.
74.
On November 14, 2017, Plaintiff submitted information from Dr. Vimal Lala
and a supplemental letter and treatment notes from Dr. Barkodar. (1069).
7
8
75.
Dr. Lala did diagnose the various conditions regarding Plaintiff’s back. (1261).
9
76.
Dr. Lala concluded that Plaintiff could not perform her job or “steady
employment.” (1262).
10
11
77.
only on Plaintiff’s self-report of pain. (1763).
12
13
Dr. Barkodar’s letter included observations of an MRI, but otherwise focused
78.
Sedgwick contracted again with Dane Street LLC which enlisted two new peer
14
reviewers: Dr. Leo Lombardo, a pain management specialist, and Dr. Michael
15
Chilungu, a neurologist, to consider this information. (1751-57 & 1759-66).
16
79.
Dr. Lombardo’s December 11, 2017 report indicated that there were self-
17
reports of pain but that they were inconsistent with the underlying pathology.
18
(1751-57).
19
80.
Specifically, Dr. Lombardo noted that “since the independent medical
20
examination by Dr. Shorr, there was no note of interim clinical changes, new
21
test findings, or other clinical rationale for new work restrictions or
22
limitations.” (1756).
23
81.
Dr. Lombardo then addressed the testing performed by Dr. Lala and stated:
24
“electrodiagnostic testing revealed only mild peripheral neuropathy. Ongoing
25
complaints of headaches do not correlate with evidence of underlying
26
pathology that would explain these headaches. The cervical MRI revealed only
27
mild degenerative changes. The painful complaints are out of proportion to
28
12
mild underlying pathology.” (1756).
1
2
82.
Dr. Chilungu’s peer review found that the findings in “the neurological physical
3
examinations, at their worst, were modest abnormalities that are not likely to
4
translate into any significant functional impairment.” (1764).
5
83.
physicians before making their decision. (1923-31).
6
7
Both Dr. Lombardo and Dr. Chilungu sought to speak with Plaintiff's
84.
Sedgwick's December 15, 2017 decision recognized the concerns that Dr. Lala,
8
Dr. Lewis and Dr. Barkodar had, but noted that they were considered non-
9
impairing by other physicians. Specifically, the letter detailed the findings of
10
Dr. Lombardo and Dr. Chilungu to that effect.
(1769-70).
The letter
11
specifically noted the complaints of pain. (1769-70). In denying her claim, the
12
letter stated that Plaintiff had submitted “insufficient medical evidence” – of
13
any type, objective or subjective – to substantiate an objective, clinical or
14
demonstrable basis for disabling conditions that rendered Plaintiff functionally
15
impaired from performing her customary occupation under the Plan. (1770).
16
Thus, it did not insist on objective evidence. (1768). This is consistent with
17
the evidence it relied upon. (1768-70). As a result, Sedgwick concluded that
18
Plaintiff was not impaired from performing her customary occupation as
19
defined under the terms of the Plan. (1769-70). Since Plaintiff could not meet
20
this standard, even though Sedgwick did not have to apply it, she obviously
21
could not meet the Gainful Occupation standard either. (1959).
22
85.
Plaintiff did not appear to testify at trial.
23
86.
Manuel Navarro did not appeal to testify at trial.
24
87.
No testimony was offered at trial to provide a foundation for, or a basis of
25
admissibility for, any evidence offered by Plaintiff outside of the administrative
26
record.
27
28
///
13
B.
1
2
1.
CONCLUSIONS OF LAW
Although Defendants argue the decision by Sedgwick should be considered as
3
if it were brought in a court in the United States Court of Appeals for the
4
Eleventh Circuit, Wang Labs v. Kagan, 990 F.2d 1126, 1129 (9th Cir. 1993)
5
(upholding choice of law provision under ERISA as less burdensome than
6
forum-selection provision); In re Mathias, 867 F.3d 727, 728 (7th Cir. 2017),
7
cert denied, 138 S. Ct. 756 (2018) (upholding forum-selection provision under
8
ERISA); Smith v. Aegon Companies Pension Plan, 769 F.3d 922 (6th Cir.
9
2014), the Court has indicated it need not do so because the law of the Eleventh
10
11
and Ninth Circuits is effectively the same.
2.
The language of the Plan is such that it reserves discretion for Sedgwick, as that
12
discretion has been delegated by the Administrative Committee, to decide
13
benefit claims under the Plan, such that the abuse of discretion standard of
14
review applies to the decisions by Sedgwick under this Plan, including the one
15
Plaintiff challenges. See Firestone Tire and Rubber Company v. Bruch, 489
16
U.S. 101, 111 (1989) (citing Central States, Southeast and Southwest Areas
17
Pension Fund v. Central Transport, Inc., 472 U.S. 559, 568 (1985)); Taft v.
18
Equitable Life Ass. Soc’y, 9 F.3d 1469, 1471 (n.2 (9th Cir. 1993).
19
3.
Given the structure of the Plan – that separates the decision maker from the
20
payor – there is no structural conflict of interest affecting Sedgwick’s decision.
21
Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105, 117-18 (2008); Day v.
22
AT&T, 698 F.3d 1091, 1096 (9th Cir. 2012).
23
4.
In addition, considering the points that Plaintiff claims show some procedural
24
irregularity, and the points that Defendants raise including those that show the
25
additional time Plaintiff was given and that Sedgwick applied a standard more
26
favorable than was called for, in total, the Court finds that Sedgwick did not act
27
as a conflicted administrator even if the lack of a structural conflict is put to the
28
14
side.
1
2
5.
With the evidence submitted to it in conflict, some of it supporting the decision
3
by Sedgwick and some of it supporting the Plaintiff’s claim, Sedgwick’s denial
4
of the final appeal was not an abuse of discretion under the Plan’s Customary
5
Occupation standard. Jordan v. Northrop Grumman Corp. Welfare Plan, 370
6
F.3d 869, 880 (9th Cir. 2004) (upholding denial in the face of conflicting
7
evidence); Jebian v. Hewlett-Packard, 344 F.3d 1098, 1110 (9th Cir. 2003) (on
8
deferential review, review is limited to the administrative record). While
9
Plaintiff has claimed that Jordan has been abrogated, it has not been abrogated
on this point, but on how a conflict of interest is assessed.
10
11
6.
Because Sedgwick’s decision was not an abuse of discretion, the Court need
12
not consider whether the benefits should be terminated for failure to comply
13
with the requirement that Plaintiff report third-party settlements to Sedgwick,
14
and/or calculation of the potential offsets with respect to her Social Security
15
benefit eligibility and third-party settlement amount.
16
7.
Further, for the same reason, the Court need not consider whether Delta did not
17
act as a Plan Administrator and is therefore not a proper party defendant to an
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ERISA benefit claim.
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8.
Judgment is entered in favor of Defendants.
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IT IS SO ORDERED.
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Dated: April 23, 2019
________________________________
WILLIAM D. KELLER
UNITED STATES DISTRICT JUDGE
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