Hall v. Liberty Life Assur. Co. of Boston
| Decision Date | 08 February 2010 |
| Docket Number | No. 08-4739.,No. 08-4738.,08-4738.,08-4739. |
| Citation | 595 F.3d 270 |
| Parties | Sonya L. HALL, Plaintiff-Appellant/Cross-Appellee, v. LIBERTY LIFE ASSURANCE COMPANY OF BOSTON, Defendant, National City Corporation Welfare Benefits Plan, Defendant-Appellee/Cross-Appellant. |
| Court | U.S. Court of Appeals — Sixth Circuit |
Before: SILER, GILMAN, and ROGERS, Circuit Judges.
Sonya Hall received long-term disability benefits for nearly five years through the National City Corporation Welfare Benefits Plan (the Plan). Liberty Life Assurance Company of Boston (Liberty Life), the third-party claims administrator, terminated these benefits when it determined that Hall was no longer totally disabled. The Plan then sought reimbursement for overpayments caused by retroactive Social Security benefits' being awarded to Hall. Hall responded by filing suit against the Plan.
Concluding that the termination of her long-term disability benefits was not arbitrary and capricious, the district court denied Hall's claim for reinstatement and further found that the Plan was entitled to partial reimbursement. The court also imposed an equitable lien on Hall's Social Security benefits to allow the Plan to recover the overpayments. Hall has appealed these decisions, and the Plan has cross-appealed the district court's denial of its request for attorney fees pursuant to 28 U.S.C. § 1927. For the reasons set forth below, we AFFIRM the judgment of the district court regarding the Plan's termination of benefits and its claim for partial reimbursement, VACATE the district court's imposition of an equitable lien on Hall's Social Security benefits and its denial of attorney fees to the Plan, and REMAND the case to the district court for reconsideration of the equitable-lien and attorney-fees issues.
Hall was a full-time employee at the National City Corporation and eligible for benefits under the Plan. She started receiving short-term disability payments in May 2001 following spinal-fusion surgery. In November 2001, Hall began receiving long-term disability payments in monthly installments of $2,333.45 each. Liberty Life informed Hall by letter that she was required to apply for Social Security benefits and, if she was approved, that those benefits would partially offset the amount paid by the Plan. The letter further stated that Hall's eligibility to continue receiving long-term disability benefits was predicated on certification of her continued disability.
In December 2002, Hall received notice that she was required to undergo an evaluation to determine whether she still met the definition of "totally disabled." Hall underwent an independent medical examination in June 2003. The examining doctor concluded that although Hall might be able to return to work at some point in the future, she was still totally disabled. As a result of this examination, Liberty Life informed Hall by letter that she would continue receiving long-term disability benefits, but added that it would conduct periodic reevaluations to verify that she still met the "totally disabled" definition.
As part of these reevaluations, Liberty Life in 2005 submitted Hall's medical records for review by Dr. Gale G. Brown, Jr., board-certified in physical medicine, rehabilitation, and internal medicine, and Dr. Peter M. Mirkin, board-certified in psychiatry and neurology. Both doctors opined that Hall could return to work. Dr. Brown concluded that although Hall was impaired, she was able to perform her job duties, noting that Hall frequently engaged in such activities as driving, walking, and reading. Focusing on Hall's psychiatric condition, Dr. Mirkin similarly found nothing that would prevent Hall from resuming her job duties.
As an additional component of its review, Liberty Life requested a skills analysis from a vocational expert. The expert issued a report, based on recommendations contained in Dr. Brown's report, finding that Hall could perform the duties of several occupations, including a receptionist at a small business, a new-account clerk, an information clerk, or an accounting clerk.
Based on this review, Liberty Life concluded that Hall was no longer "totally disabled" under the terms of the Plan. It therefore terminated her benefits in May 2006. Hall appealed that decision, relying largely upon reports of Dr. Norton Winer from 2002 to 2004 in which he stated that Hall could not tolerate an eight-hour workday. Dr. Winer was Hall's treating physician.
Following a review by an independent medical panel, Liberty Life upheld its determination that Hall was no longer eligible to receive benefits. As part of its assessment, the panel solicited Drs. Stephen Vanna and Judith Willis, two physicians who were both board-certified in psychiatry and neurology, to conduct separate file reviews to determine whether Hall was "totally disabled" under the Plan's terms. The two physicians concluded that Hall no longer met this definition. Dr. Willis highlighted a report from Dr. Winer in which Dr. Winer opined that Hall could "sit, push, pull, reach, grasp, and repetitively move her wrist, elbow, shoulder, and ankle frequently, stand, walk, and occasionally, drive up to two hours." In a second report relied upon by Dr. Willis, Dr. Winer had also acknowledged that Hall could work as a clerk. Dr. Vanna, in his analysis, relied in part on a telephone conversation with Dr. Winer, during which Dr. Winer told Dr. Vanna that Hall showed "some disability, but probably [was] not totally disabled." Based on this conversation and his review of Hall's medical records, Dr. Vanna concluded that Hall's complaints were of a subjective nature.
During this time period, Hall was also pursuing Social Security benefits. Despite denying her initial requests, the Social Security Administration in 2006 awarded Hall retroactive benefits dating back to January 2002, the point in time at which it determined that Hall was totally disabled.
Hall filed suit in March 2007, seeking reinstatement of her benefits. Concluding that the Plan's termination of benefits was not arbitrary and capricious, the district court denied Hall's motion for a judgment awarding benefits and instead granted the Plan's motion for judgment on the administrative record. Shortly before the court ruled on those two motions, the Plan filed a motion to add a counterclaim seeking reimbursement for its overpayments to Hall. The Plan contended that the overpayments came about when the Social Security Administration awarded Hall long-term disability benefits retroactively, which entitled the Plan to an offset per the terms of the Plan.
Following what it described as a "hailstorm of motions," the court granted the Plan's motion for summary judgment on its claim for partial reimbursement. In that same order, the court denied the Plan's request for attorney fees that the Plan had incurred due to the allegedly vexatious conduct of Hall's attorney.
Hall appeals the district court's findings that the Plan's termination of her disability benefits was proper and that the Plan is entitled to reimbursement for the overpayments that it made to Hall. On cross-appeal, the Plan contends that the district court erred by not granting its request for attorney fees pursuant to 28 U.S.C. § 1927. We address each of these issues in turn.
Hall first argues that the Plan's termination of her benefits was improper, and she further asserts that the district court erroneously reviewed the Plan's decision under the arbitrary-and-capricious standard. After carefully considering the record on appeal, the briefs of the parties, and the applicable law, and having the benefit of oral argument, we agree with the district court's analysis of these two issues. Hall has made no persuasive claims of error on appeal, including her argument that the Plan is estopped from terminating her disability benefits because it required Hall to seek Social Security benefits. Because the district court articulated its reasoning in a thorough and comprehensive opinion, the issuance of a detailed written opinion by us regarding these issues would be unduly duplicative. The judgment rendered by the district court regarding the proper standard of review and the Plan's termination of Hall's benefits is accordingly affirmed on the basis of the reasoning detailed in its Opinion dated April 25, 2008.
Notwithstanding our affirmation of the district court's analysis, we note two inaccuracies in its opinion. First, in evaluating the Plan's May 2006 determination that Hall was no longer permanently disabled, the district court observed that both a neurosurgeon and Dr. Winer called the results of a magnetic resonance imaging (MRI) of Hall's lumbar spine "completely normal." But the MRI did not cover Hall's cervical spine, which was the source of her primary complaint of disability. Even without the MRI, however, there is was sufficient evidence in the record to support the conclusion that Hall's injuries did not continue to render her completely disabled.
Secondly, the district court erroneously stated that Hall "unsuccessfully" appealed a 2004 decision by an administrative law judge (ALJ) denying her Social Security benefits, when in fact that decision was overturned on appeal to the district court in 2006. Hall was subsequently found to be disabled and entitled to benefits by a different ALJ. The 2006 district court opinion is not particularly helpful to Hall, however,...
To continue reading
Request your trial
-
In re Royal Manor Mgmt., Inc.
...Sanctions require “more than negligence or incompetence” but “something less than subjective bad faith.” Hall v. Liberty Life Assurance Co. of Boston, 595 F.3d 270, 276 (6th Cir.2010) (citation omitted). Sanctions under § 1927 may not be imposed because a claim was ultimately unsuccessful. ......
-
In re Royal Manor Mgmt., Inc.
...Sanctions require “more than negligence or incompetence” but “something less than subjective bad faith.” Hall v. Liberty Life Assurance Co. of Boston, 595 F.3d 270, 276 (6th Cir.2010) (citation omitted). Sanctions under § 1927 may not be imposed because a claim was ultimately unsuccessful. ......
-
ACS Recovery Servs., Inc. v. Griffin
...currently having either actual or constructive possession of the funds at issue. See, e.g., Hall v. Liberty Life Assur. Co. of Boston, 595 F.3d 270, 275 (6th Cir.2010) (concluding that a plan seeking reimbursement could not impose an equitable lien on a beneficiary's future social security ......
-
In re Gorges
...require "more than negligence or incompetence " but "something less than subjective bad faith." Hall v. Liberty Life Assurance Co. of Boston , 595 F.3d 270, 276 (6th Cir. 2010) (citation omitted) ... "Discrete acts of vexatious conduct should be identified and a determination made whether t......