Philen v. Hartford Life & Accident Insurance Co et al

Filing 54

RULING re 50 REPORT AND RECOMMENDATIONS re 35 MOTION for Attorney Fees filed by Sherry Houck Philen, 35 MOTION for Summary Judgment filed by Sherry Houck Philen and 42 MOTION for Summary Judgment filed by Hartford Life & Accident Insurance Co. Signed by Judge Robert G James on 3/22/13. (crt,DickersonSld, D)

UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF LOUISIANA
MONROE DIVISION

SHERRY HOUCK PHILEN

CIVIL ACTION NO. 11-1609

VERSUS

JUDGE ROBERT G. JAMES

HARTFORD LIFE & ACCIDENT
INSURANCE COMPANY

MAG. JUDGE KAREN L. HAYES

RULING

Pending before the Court are cross-motions for summary judgment filed by Plaintiff
Sherry Houck Philen (“Philen”) [Doc. No. 35] and Defendant Hartford Life & Accident Insurance
Co. (“Hartford”) [Doc. No. 42]. Magistrate Judge Hayes issued a Report and Recommendation
(“Report”) [Doc. No. 50] on February 19, 2013. Philen filed Objections to Magistrate’s Report
and Recommendation (“Objections”) on March 4, 2013 [Doc. No. 52], and Hartford filed a
Response to Plaintiff’s Objections on March 18, 2013 [Doc. No. 53]. For the following reasons,
the Court adopts Magistrate Judge Hayes’ Report in its entirety. Hartford’s Motion for Summary
Judgment is GRANTED, and Philen’s Motion for Summary Judgment and Motion for Attorney’s
Fees are DENIED.
II.

LAW AND ANALYSIS
The Court reviews de novo a magistrate judge’s report and recommendation if a party files

specific, written objections within fourteen days of service. See 28 U.S.C. § 636(b)(1). In the
present case, Philen timely filed her Objections to the Report, thus warranting de novo review by
the Court.

The parties agree that the current case is governed by the Employment Retirement Income
Security Act (“ERISA”), 29 U.S.C. § 1001, et seq. In such cases, an “administrator’s factual
determinations are reviewed for abuse of discretion, regardless of the administrator’s ultimate
authority to determine benefit eligibility.” Chacko v. Sabre, Inc., 473 F.3d 604, 610 (5th Cir.
2006) (citations omitted). Moreover, when “a challenge to a denial of benefits . . . disputes
whether an individual’s conditions qualify as a disability, the inquiry involves factual
determinations . . .” which is subject to review for abuse of discretion. McDonald v. Hartford Life
Group Ins. Co., 361 Fed. App’x. 599, 607 (5th Cir. Jan. 19, 2010) (unpubl.) (citing Wade v.
Hewlett–Packard Dev. Co. LP Short Term Disability Plan, 493 F.3d 533, 540 (5th Cir. 2010)).
Here, the Court previously ruled that an abuse of discretion standard of review applied to this
action [Doc. No. 31].
In her Objections, Philen argues that the Court should not adopt the Report for three
reasons. First, Philen objects to the finding that Hartford’s conclusion that Philen was no longer
disabled within the meaning of the Policy was supported by substantial evidence. Philen
disagrees with the conclusions drawn from several medical reports and argues that too much
weight was given to her ability to perform activities of daily living. However, a review of the
administrative record confirms that substantial evidence supports Hartford’s determination. The
report by Dr. Majors, Philen’s then-treating physician, noted that Philen had improved since her
last evaluation and was doing well with her treatment and medication. Dr. Patton’s notes also
support this conclusion. Hartford elected to discount the diagnosis of Dr. Halim, but provided a
reasonable basis for doing so. Here, the Court’s task is to determine whether Hartford abused its
discretion in concluding that Philen was no longer disabled, and the Court concludes that it did
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not. Philen may disagree with the conclusion reached by Hartford, but that conclusion is
supported by substantial evidence.
Second, Philen objects to the finding that Philen is capable of performing the sedentary
jobs listed by Hartford’s vocational consultant, Marvin Bryant. Philen argues that the jobs
identified by Mr. Bryant do not accommodate the limitations necessitated by her medical
condition. She disagrees with the conclusions drawn from the evaluations by Dr. Mead and Dr.
Brock. However, Philen fails to acknowledge that the Fifth Circuit has cautioned against courts
inserting their own opinions of occupational requirements. “[T]he Plan Administrator, not the
district court, is in the best position to balance conflicting evidence about the occupational
requirements of various positions with the applicant’s employer and in the relevant community.”
Holland. v. Int’l Paper Co. Ret. Plan, 576 F.3d 240, 251 (5th Cir. 2009). Here, Mr. Bryant
determined that several occupations met Philen’s sedentary limitations, when they allowed for a
sit/stand option to account for the restriction of four hours of sitting in intermittent fashion with
rest periods. The Court declines Philen’s invitation to substitute its opinion for that reached by
Mr. Bryant.
Third, Philen objects to the finding that Hartford sufficiently considered her favorable
Social Security award in making its determination that she was no longer disabled. Philen
contends that Hartford’s consideration of her favorable Social Security award was nothing more
than a boiler plate acknowledgement indicative of a cursory review of this fact. Philen is correct
that a plan administrator must consider a contrary Social Security award when making a benefits
determination. However, the Fifth Circuit does not require an administrator “to give any
particular weight to the contrary findings.” Schexnayder v. Hartford Life and Accident Ins. Co.,
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600 F.3d 465, 471 fn. 3 (5th Cir. 2010). In Schexnayder, the Fifth Circuit concluded it was
procedurally unreasonable for the plan administrator to deny benefits when it completely failed to
acknowledge the contrary Social Security award. Here, Hartford acknowledged Philen’s Social
Security Disability award and noted that its disability determination criteria were different from
those used by the Social Security Administration. Thus, it is clear that Hartford considered
Philen’s contrary Social Security award and satisfied the requirements of Schexnayder.
Finally, Philen also objects to the prior determination that an abuse of discretion standard
of review applied to this case [Doc. No. 31], as well as the Order striking “Plaintiff’s Opposition
To Defendant’s Motion For Summary Judgment And Reply To Defendant’s Opposition To
Plaintiff’s Motion For Summary Judgment” [Doc. No. 48]. The Court has already addressed these
objections and finds no extraordinary circumstances requiring the Court to consider them further.
III.

CONCLUSION
For the foregoing reasons, the Court adopts in full Magistrate Judge Hayes’ Report and

Recommendation. Hartford’s Motion for Summary Judgment [Doc. No. 42] is GRANTED.
Philen’s Motion for Summary Judgment [Doc. No. 35] and Motion for Attorney’s Fees [Doc. No.
35] is DENIED. Philen’s Complaint [Doc. No. 1] is DISMISSED WITH PREJUDICE.
MONROE, LOUISIANA, this 22nd day of March, 2013.

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