Green v. Holland

• Citation: 480 F.3d 1216
• Decision Date: 13 March 2007
• Docket Number: No. 06-10241.,06-10241.
• Parties: Herman J. GREEN, on behalf of himself and a class of persons similarly situated, Plaintiff-Appellant, v. Michael H. HOLLAND, Marty D. Hudson, Steven F. Schaab, B.V. Hyler, as Trustees of the United Mine Workers Pension Trust, United Mine Workers of America 1974 Pension Trust, et al., Defendants-Appellees.
• Court: U.S. Court of Appeals — Eleventh Circuit

480 F.3d 1216

Herman J. GREEN, on behalf of himself and a class of persons similarly situated, Plaintiff-Appellant, v. Michael H. HOLLAND, Marty D. Hudson, Steven F. Schaab, B.V. Hyler, as Trustees of the United Mine Workers Pension Trust, United Mine Workers of America 1974 Pension Trust, et al., Defendants-Appellees.

No. 06-10241.

United States Court of Appeals, Eleventh Circuit.

March 13, 2007.

Junius F. Guin, III, Tanner & Guin, P.C., Tuscaloosa, AL, for Green.

Christopher F. Clarke, UMWA Health & Retirement Funds, Washington, DC, for Defendants-Appellees.

Appeal from the United States District Court for the Northern District of Alabama.

Before BIRCH and PRYOR, Circuit Judges, and NANGLE,^* District Judge.

BIRCH, Circuit Judge:

Plaintiff-Appellant Herman Green brought this action pursuant to the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq., seeking to recover accrued interest on his disability benefits, which were delayed but eventually paid under his pension plan. The district court granted summary judgment in favor of defendants-appellees, the Trustees of the plan, the pension Trust, and the plan itself. Green now appeals that decision, arguing that the district court acted improperly in granting summary judgment on all of Green's claims. Upon review, we conclude that: (1) Green's attempt to allege a cause of action for interest under ERISA § 502(a)(1)(B), 29 U.S.C. § 1132(a)(1)(B), is clearly precluded by our decision in Flint v. ABB, Inc., 337 F.3d 1326 (11th Cir.2003); and (2) because Green has not presented evidence that the appellees violated ERISA or breached the terms of the pension plan in processing his disability claim, he is not entitled to interest pursuant to ERISA § 502(a)(3), 29 U.S.C. § 1132(a)(3). Accordingly, we AFFIRM the district court's judgment.

I. BACKGROUND

The facts of Green's case are undisputed. Green was employed as a coal miner with Jim Waters Resources, Inc., in Tuscaloosa, Alabama. As an employee, Green was offered employee benefits through the United Mine Workers of America 1974 Pension Trust ("the Trust"), an employee benefit trust included with a number of other trusts in the United Mine Workers of America Health and Retirement Funds. The Trust is administered by appellees Holland, Hudson, Schaab, and Hyler (collectively, "the Trustees"). The benefits that the Trust provides to employees are set forth at length in the United Mine Workers of America Pension Plan of 1974 (the "Plan"), which is subject to ERISA.

The Plan provides a monthly disability benefit for employees who become totally disabled as a result of a mine accident. The Plan states, in pertinent part, that a participant with a specified number of years of service who "becomes totally disabled as a result of a mine accident" shall "be eligible for a pension while so disabled." R1-33, Exh. A at 7. The Plan further provides a definition of "totally disabled":

A Participant shall be considered to be totally disabled only if by reason of such accident such Participant is subsequently determined to be eligible for Social Security Disability Insurance [SSDI] Benefits under Title II of the Social Security Act or its successor.

Id. Thus, in order to be eligible for a disability pension benefit under the Plan, a claimant must establish: (1) that he was involved in a mine accident; (2) that he has been awarded SSDI benefits, thus conclusively establishing that he has a disability; and (3) that the mine accident proximately caused, or was substantially responsible for, the disability. See, e.g., McCoy v. Holland, 364 F.3d 166, 170 (4th Cir.2004) (construing the requirements needed to attain disability benefits under the Plan). The Plan provides that "[t]he Trustees . . . shall have full and final determination as to all issues concerning eligibility for benefits." R1-33, Exh. A at 32.

The other relevant Plan provision pertains to the timing of the monthly pension benefits-disability or otherwise. The Plan states that "[t]he first payment on any pension shall be made as soon as possible after an application for pension has been received. . . ." R1-33, Exh. A at 15. The Plan also states that the first benefit payment shall be made "for the month following the month in which the Participant retires and becomes eligible for a pension in accordance with Article II [the Eligibility section of the Plan] . . . ." Id.¹

Green filed an accident report with his employer in May of 1990, indicating that he had been injured on the job on 9 March 1990, while operating a Terex pan, a piece of heavy equipment. The accident report suggested that Green suffered back strain as a result of the incident. Green, however, did not seek disability benefits at that time.

Over three years later, in October 1993, Green applied for SSDI benefits from the Social Security Administration, claiming a disability due to a back strain from an on-the-job injury. His SSDI application was denied in 1994, and Green sought reconsideration of that denial. Meanwhile, while the appeal of his SSDI application was pending, in 1995 Green applied for a disability pension with the Trustees, pursuant to the terms of the Plan. He maintained that his injury had occurred on 9 March 1990, and described the injurious event as a continuous bouncing up and down that had caused him back pain. In February 1996, the Trustees contacted Green and inquired whether he had received an SSDI award. Green advised that he was still awaiting a decision on his SSDI benefits. On 8 July 1996, the Trustees denied his claim for disability benefits, based on the fact that he had not yet established that he was eligible for SSDI benefits, which is a prerequisite for total disability benefits under the Plan. Subsequent to the Trustees' denial, the separate denial of Green's SSDI benefits was upheld on appeal by an Administrative Law Judge ("ALJ").

In November 1997, however, the Appeals Council of the Social Security Administration vacated the ALJ's decision on the SSDI benefits and remanded Green's case, ordering that additional medical evidence, including psychiatric evidence, be obtained and considered. After a different ALJ reviewed Green's medical records, he concluded that Green suffered from chronic back pain from an on-the-job injury that had occurred in 1990. Accordingly, on 2 May 1998, the ALJ found that Green was disabled as of 1993 (the time Green began to complain of pain, and, eventually, ceased working) due to degenerative disc disease of the lumbar and cervical spine, hiatial hernia, duodenal ulcer, and adjustment disorder with depression. Therefore, on 2 May 1998, the ALJ awarded Green SSDI benefits.

A year later, on 18 May 1999, the Trustees received a copy of Green's 1998 SSDI award, and thus Green's file was reopened. Upon further review, however, the Trustees again denied Green's application for a disability pension, based this time on their conclusion that the evidence concerning the alleged 9 March 1990, incident was too indefinite to meet the Plan's definition of a "mine accident."²

In their assessment of Green's claim, the Trustees first observed that the accident report only stated that Green had suffered back strain while operating a Terex pan, but that the records failed to reflect a definite injurious event that caused his disability. The Trustees also noted that Green did not seek medical treatment for the putative injury until May of 1990, three months after the alleged incident, and that he had continued to operate heavy equipment at that time. In addition, the Trustees observed that Green's medical records reflected intermittent complaints of back pain every six months or so, without any additional trauma. In light of this evidence, the Trustees determined that Green's hiatial hernia and duodenal ulcers bore no causal relationship to the alleged mine accident; that his degenerative disc disease was a progressive condition rather than an injurious event; and that his cervical problems were likely brought about by a separate 1993 automobile accident and were not work-related.

After explaining the basis for the Trustees' denial, Green requested, and was granted, an extension of time to submit additional evidence concerning his 1990 mine accident. Upon a second review, however, the Trustees again denied Green's claim in April 2000, based on their conclusion that his alleged injury was too indefinite, both in terms of when the claimed injury occurred and what the injury-causing event was.

Thereafter, litigation ensued. Green sued the Trustees in state court in 2000, alleging the wrongful denial of his disability pension benefit. In February 2001, the Trustees advised Green that if he would agree to dismiss his action, they would permit him to submit additional medical evidence and would agree to re-consider his claim for total disability pension benefits. Consequently, the case was dismissed, and Green submitted additional evidence to the Trustees in July 2001, concerning the nature of his injury, including his testimony that the injury on 9 March 1990, had been caused instantly from hitting a bump while he was driving mining equipment. Additional evidence was submitted in March 2002, and a hearing was held on Green's application on 29 March 2002.

In April 2002, after re-reviewing the record in its entirety, including Green's newly submitted evidence, the Trustees concluded that Green's incident did indeed meet the definition of a "mine accident" under the Plan. Specifically, the Trustees concluded that the new evidence established that Green had been injured by a definite, injurious event. They found credible a written statement from Green's co-worker, indicating that Green had complained aloud of back pain after his equipment had hit a pothole. The Trustees also observed that Green's new evidence suggested that the equipment he had been driving was repaired around the time he was injured, thereby...