Chadbourne v. Marathon Petroleum Company LP et al
Filing
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MEMORANDUM AND OPINION entered. The Court OVERRULES Chadbourne's objection to Defendants' proposed administrative record, and DENIES Chadbourne's 17 MOTION to Supplement Defendants' Proposed Administrative Record. (Signed by Magistrate Judge Andrew M Edison) Parties notified. (wbostic, 4)
United States District Court
Southern District of Texas
ENTERED
UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF TEXAS
GALVESTON DIVISION
KATRINA
CHADBOURNE
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Plaintiff.
VS.
MARATHON PETROLEUM
COMPANY LP, et al.
Defendant.
August 23, 2018
David J. Bradley, Clerk
CIVIL ACTION NO. 3: 17-CV-00284
MEMORANDUM AND OPINION
Plaintiffs Objection to and Motion to Supplement Defendants' Proposed
Administrative Record ("Motion to Supplement") (Dkt. 17) has been referred to this
Court by United States District Court Judge George C. Hanks, Jr. Dkt. 36. This Court
has authority to enter this order pursuant to 28 U.S.C. § 636(b)(l)(A). Having considered
the Motion to Supplement, the response, and applicable legal authorities, the Court
overrules Plaintiffs objection and denies the Motion to Supplement.
I.
BACKGROUND
Plaintiff Katrina Chadbourne ("Chadbourne") is an employee of Blanchard
Refining Company, a wholly owned subsidiary of Defendant Marathon Petroleum
Company LP. Marathon Petroleum Company LP created the Marathon Petroleum Long
Term Disability Plan ("LTD Plan"), which is an Employee Retirement Income Security
Act ("ERISA") plan· that provides long term disability benefits to eligible plan
participants. Chadbourne participated in the LTD Plan, and sometime prior to February
20 16, she submitted a claim for long term disability benefits based on her fibromyalgia
diagnosis. 1
On February 9, 2016, the LTD Plan's third-party administrator acknowledged
receipt of Chadbourne's claim. The third-party administrator denied Chadbourne's LTD
claim on May 23, 2016. Chadbourne promptly appealed the denial of her claim to the
LTD Plan Administrator. The LTD Plan Administrator, acting through Assistant Plan
Administrator James P.F. Dowling, M.D., denied Chadbourne's appeal on October 17,
2016.
On September 5, 2017, exactly 323 days after Dr. Dowling's decision,
Chadbourne's "counsel forwarded correspondence to ... [Dr.] Dowling asking him to
reconsider his denial of Plaintiffs appeal relying on the conclusion that 'there is no
objective evidence associated with this diagnosis' (fibromyalgia)."
Dkt. 17 at 2.
Attached to the September 20 17 correspondence were various documents reflecting the
following: 2
•
The National Institutes of Health (NIH), a part of the U.S.
Department of Health and HumanServices, recognizes fibromyalgia
as a common and chronic disorder event though there is no generally
accepted, objective test for fibromyalgia and recognizes that a
diagnosis of fibromyalgia can be made based on the criteria
established by the American College of Rheumatology (ACR).
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Fibromyalgia is a form of chronic pain syndrome or soft-tissue rheumatism, which are broad
terms used to describe a group of disorders that cause pain and stiffness around the joints and in
muscles and bones.
2
The Court collectively refers to the September 2017 correspondence and its attachments as "the
Reconsideration Request."
2
•
The Social Security Administration relies on the ACR Diagnostic
Criteria to determine if a person has a medically-determinable
impairment of fibromyalgia.
•
The Centers for Medicare and Medicaid and National Center for
Health Statistics have formally recognized fibromyalgia by giving it
its own ICD diagnostic code in their International Classification of
Diseases, 1Oth Revision, Clinical Modification.
Id. at 4-5.
On September 20, 2017, only 15 days after sending the Reconsideration Request,
Chadbourne filed this suit. Dkt. 1. Fifteen days later, on October 5, 2017, Which is
exactly 30 days after Chadbourne sent the Reconsideration
Request~
Dr. Dowling
· responded to the Reconsideration Request by "notify[ing] Plaintiff . . . that he did not
reconsider his denial of Plaintiffs appeal as requested because his decision of October
17,2016 was final and Plaintiffhad exhausted all of her administrative remedies." 3 Dkt.
17 at 5.
Based on this sequence of events, Chadbourne seeks to supplement the
administrative record in this case to include the Reconsideration Request and
Reconsideration Denial.
Defendants rejected and continue to refuse. Chadbourne's
request to supplement the administrative record. Having failed to convince Defendants to
supplement the administrative record, Chadbourne now asks the "Court to sustain [her]
objection to Defendants' refusal to supplement the administrative record, [and] grant
[her] motion to supplement the administrative record." Id. at 8-9.
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This Court refers to the October 5, 2017 letter as the "Reconsideration Denial."
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II.
APPLICABLE LAW
ERISA provides the federal courts with jurisdiction to review determinations made
by certain benefit plans. 29 U.S.C. § 1132(a)(l)(B).
When assessing factual questions in benefits cases, "a long line of Fifth
Circuit cases stands for the proposition that . . . the district court is
constrained to the evidence before the plan administrator." Vega v. Nat'!
Life Ins. Servs., Inc., 188 F.3d 287, 299 (5th Cir.1999) (collecting cases),
overruled on other grounds by Metro. Life Ins. Co. v. Glenn, 554 U.S. 105,
112 (2008). Before filing suit, "the claimant's lawyer can add additional
evidence to the administrative record simply by submitting it to the
administrator in a manner that gives the administrator a fair opportunity to
consider it." Id. at 300. Such a "fair opportunity" must come in-time for
the administrator to "reconsider his decision." Id.
Killen v. Reliance Standard Life Ins. Co., 776 F.3d 303, 312 (5th Cir. 2015). "The plan
administrator has the obligation to identify the evidence in the administrative record and
the claimant must be afforded a reasonable opportunity to contest
wheth~r
that record is
complete." Colvin v. 88 Bd., Joint Bd. ofTrs. for 88 Plan, No. SA-17-CV-974-XR, 2018
WL 1756738, at *3 (W.D. Tex. Apr. 11, 2018) (citing Estate of Bratton v. Nat'! Union
Fire ins. Co., 215 F.3d 516, 521 (5th Cir. 2000)).
"Once the administrative record has been determined, the district court may not
stray from it but for limited exceptions, such as the admission of evidence related to· how
an administrator has interpreted terms of the plan in other instances, and evidence,
including expert opinion, that assists the district court in understanding the medical
terminology or practice related to a claim." Bratton, 215 F.3d at 521.
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III.
LEGAL ANALYSIS
Chadbourne seeks to include the Reconsideration Request and Reconsideration
Denial in the administrative record for purposes of this Court's review. She first argues
that the Reconsideration Request was "made available to the administrator prior to the
filing of the lawsuit and in a manner that gave the administrator a fair opportunity to
consider it." Dkt. 17 at 6.
As detailed above, Chadbourne's counsel submitted the Reconsideration Request
almost a year after her LTD claim was denied on appeal, and only 15 days before this suit
was filed. In the Reconsideration Denial, which is dated after this lawsuit was filed, Dr.
Dowling indicated that he did not possess a written authorization for Chadbourne's
counsel, "so the Plan cannot respond and has no obligation to disclose any information
requested in your letter." Dkt. 17-3 at 43. Dr. Dowling also stated that his decision
denying LTD benefits had been final since October 2016, and Chadbourne had already
exhausted the LTD Plan's administrative procedures with respect to her claim. !d. These
facts are substantially similar to--and slightly worse than-the facts discussed by the
Fifth Circuit in Killen.
In Killen, the Fifth Circuit reviewed a district court's decision to deny a claimants
attempt to supplement the administrative record.
Pertinent here, the Killen court
explained: "Here, the file was already closed and [Claimant] had exhausted two internal
appeals. We cannot say that such a late submission of evidence, only four weeks before
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[Claimant] filed suit, gave [the Plan Administrator] the 'fair opportunity' contemplated
by Vega." Killen, 776 F.3d at 312.
Here, Chadbourne's file had been closed for almost a full year before her counsel
sent the Plan Administrator the Reconsideration Request. At that time, Chadbourne had
already exhausted the LTD Plan's administrative procedures.
And again, the
Reconsideration Request was submitted just 15 days before this suit was filed. The Court
finds that under these facts, Chadbourne's attempt to add additional evidence to the
administrative record by submitting it to the Plan Administrator was ineffective because
the submission of the Reconsideration Request a mere 15 days before filing suit did not
provide the Plan Administrator a fair opportunity to consider it. · Thus, neither the
Reconsideration Request nor the Reconsideration Denial should be included in the
administrative record. See Bratton, 215 F.3d at 521 ("the administrative record consists
of relevant information made available to the administrator prior to the complainant's
filing of a lawsuit and in a manner that gives the administrator a fair· opportunity to
consider it") (citation omitted).
Chadbourne next argues that supplementation of the administrative record is
warranted because the Reconsideration Request "will assist the court in understanding the
medical terminology and practice related to Plaintiffs disease of fibromyalgia." !d. at 8.
This argument conflates two distinct concepts: (1) supplementation of the administrative
record; and (2) consideration of evidence beyond the administrative record. As discussed
above, the Court has determined the Reconsideration Request was not s11bmitted to the
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Plan Administrator in a timely manner and supplementation of the administrative record
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is therefore inappropriate. This is all the Court can decide at this time. The question of
whether the Court will consider evidence beyond the administrative record is for another
day.
To be clear, the Reconsideration Request has two components: (1) Chadbourne's
counsel's letter to the Plan Administrator ("Counsel's Letter") and (2) medical
information related to fibromyalgia that was compiled/promulgated by various agencies
("Medical Pamphlets"). The Court can imagine no scenario in which it would rely upon
Counsel's Letter to assist in understanding fibromyalgia. The Medical Pamphlets, on the
other hand, represent a type of evidence that courts have utilized (when necessary) even
though outside the administrative record. See, e.g., Dowdy v. Hartford Life & Ace. Ins.
Co., 458 F. Supp. 2d 289, 292 n.5 (S.D. Miss. 2006) ("Although [Defendant] takes issue
with plaintiff attaching this [fibromyalgia] brochure to her response to its motion for
summary judgment, this court is allowed to look beyond the administrative record at
evidence that assists in understanding the medical terminology or practice related to a
claim.") (citation, internal quotation marks, and alterations omitted) (emphasis added).
Thus, although the Court declines to order the Defendants to include the Reconsideration
Request in the administrative record, Chadbourne can certainly request as part of a
dispositive motion that the Court consider the Medical Pamphlets for -the purpose of
assisting the Court in understanding relevant medical terminology and medical practices.
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IV.
CONCLUSION
For the reasons stated above, the Court OVERRULES Chadbourne's objection to
Defendants' proposed administrative record, and DENIES Chadbourne's Motion to
Supplement (Dkt. 17).
SIGNED at Galveston, Texas, this 23rd day of August, 2018.
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