Lane v. Structural Iron Workers Local No.1 Pension Tr. Funds
| Docket Number | 20 C 6769 |
| Decision Date | 30 December 2021 |
| Parties | JEFFERY LANE, Plaintiff, v. STRUCTURAL IRON WORKERS LOCAL NO. 1 PENSION TRUST FUND, Defendant. |
| Court | U.S. District Court — Northern District of Illinois |
Following the denial of his application for disability pension benefits, plaintiff, Jeffery Lane, filed this civil action claiming that defendant, the Structural Iron Workers Local No. 1 Pension Trust Fund (“the Fund”), violated § 502(a)(1)(b) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(1)(b). The parties have filed cross-motions for summary judgment. For the reasons set forth below, the Court grants defendant's motion for summary judgment and denies plaintiff's.
The following facts come from the parties' Local Rule 56.1 statements and the certified administrative record (ECF No 13). Based on the parties' Local Rule 56.1 responses, these facts appear to be undisputed. Plaintiff has worked as an iron worker at various times over the past thirty years. He is a member of the Iron Workers Local #1 Union and a participant in the Structural Iron Workers Local No. 1 Pension Trust Fund. He has earned nine pension credits, where a participant earns a credit for working one thousand or more hours in covered employment during a calendar year. Defendant is a multiemployer pension plan administered by a Board of Trustees, which is composed of an equal number of representatives of management and labor. The parties agree that the Board of Trustees are the designated plan administrator under 29 U.S.C. § 1002(16)(A)(i), and they are therefore a fiduciary of the Fund under 29 U.S.C. § 1002(21)(A).
On May 28, 2014, plaintiff tore the meniscus in his left knee and injured his left shoulder while working as an iron worker. Plaintiff applied for and received worker's compensation benefits that year. His meniscus was surgically repaired in July 2014, and he had surgery on his left shoulder in 2015. In June 2016, plaintiff asked Dr. Scott Cordes, his orthopedist, to approve his return to work as a welder if he worked with a partner “in a low impact, nonrepetitive, nonoverhead situation as a ‘return-to-work trial.'” (Defs.' LR 56.1 Resp. ¶ 25, ECF No. 28.) Dr. Cordes agreed, and plaintiff attempted on several occasions to resume his career as an iron worker. However, he reinjured his shoulder, and in 2017, he was forced to apply for Social Security Disability Insurance (“SSDI”). Following a lengthy application (and reapplication) process, plaintiff received a Notice of Award letter from the Social Security Administration (“SSA”), which indicated that the SSA found plaintiff to be disabled as of July 1, 2018. This letter did not provide reasons for the decision in any detail.
In August 2019, plaintiff emailed John Gardiner, the Fund's Administrative Manager, to ask how to apply for disability pension benefits. Gardiner instructed plaintiff as follows:
First, we would need a copy of your complete Social Security Award Letter. Second, was the disability award the result of an on the job injury? If so, which job? If we are unable to tie the exact date of the disability to on the job injury, we will need to know what Social Security based their determination on. This may include medical records Social Security used in making their determination.
( Gardiner explained that, under the terms of the Pension Plan of Structural Iron Workers Local No. 1 Pension Trust Fund Restated as of January 1, 2014 (“Plan”), given that plaintiff had fewer than fifteen pension credits, plaintiff needed to be able to tie his disability to a specific injury on the job in order to obtain disability benefits.
Plaintiff sent Gardiner the Notice of Award and informed him that he had not received anything describing the reasons for the award in any more detail. Gardiner responded that, since the Notice of Award did not “tie the exact date of the disability to an on the job accident/injury, ” plaintiff should show “what Social Security based their determination on, ” including, for example, “medical records Social Security used in making their determination.” (Id., Aug. 20, 2019 Email from Gardiner to Pl., ECF No. 13-1 at 4.)
Approximately two weeks later, plaintiff sent Gardiner certain medical records. Gardiner reviewed the records and responded as follows:
(Id., Sep. 6, 2019 Email from Gardiner to Pl., ECF No. 13-1 at 17.) Plaintiff replied that there “should be a workers comp accident on file from May 28/29, 2014.” (Id., Sep. 6, 2019 Email from Pl. to Gardiner, ECF No. 13-1 at 19.) But Gardiner responded that the Fund had no information on that accident or the worker's compensation claim other than “the record from [the] Illinois Industrial Commission website” that the Fund used “in applying [plaintiff's worker's compensation] credit.” (Id., Sep. 6, 2019 Email from Gardiner to Pl., ECF No. 13-1 at 19.) For “‘Body Part, '” Gardiner explained, that document listed the “‘Whole Body,' not specifically the shoulder, back or neck.” (Id.)
After another two weeks, Gardiner sent plaintiff a follow-up email to ask if he had been able to obtain any other documentation regarding his disability. Plaintiff responded that he had not because the “determination was made on a combination of factor[s] and not just the . . . accident in May of 2014, ” so he could not “connect it to a specific event/date.” (Id., Sep. 17, 2019 Email from Pl. to Gardiner, ECF No. 13-1 at 25.)
On March 20, 2020, plaintiff emailed Gardiner with “everything [he could] supply” to support his application for disability pension benefits (id., ECF No. 13-1 at 31-32), including his formal application for disability pension benefits and a letter from Dr. Cordes. On his application form, plaintiff circled “yes” to the question, “Did you become totally and permanently disabled as a result of an on-the-job accident in covered employment?” (Id., Ex. B, Application for Retirement Benefits, ECF No. 13-2 at 201.) On the blank for “Date you became disabled, ” plaintiff wrote, “May 28, 2014.” (Id.) Dr. Cordes's letter stated as follows, in pertinent part:
[Plaintiff's] past medical history is significant for several work-related injuries leading to his present status where he is on social security disability. He has been under my care from an injury from May 28, 2014, at which time he tore his meniscus and injured his left shoulder requiring surgical intervention as well. He has also had a previous cervical spine fusion as well as right shoulder injury requiring arthroscopic intervention. All these injuries have been due to work-related events. He is an iron worker. Presently satisfied with the outcome of his right shoulder. His left shoulder still causes his symptoms. He has tried to modify his activities of daily living in an exercise regimen. He is aware possible future arthroscopic intervention may be warranted pending his symptoms. He has been in extensive physical therapy including work hardening and was not ever able to meet the criteria required to be an unrestricted iron worker due to his accident from May 28, 2014.
(Admin. R. Ex. B, Feb. 14, 2020 Cordes Letter, ECF No. 13-2 at 194.) Gardiner acknowledged receipt and responded that he would be in touch after the Fund and its attorney had reviewed the materials.
On April 2, 2020, the Fund denied plaintiff's application for a disability pension. In a letter authored by Sara Herring, the Fund's Pension Manager, the Fund explained that plaintiff was required to “submit evidence showing that [his] disability as determined by Social Security [was] the result of an on-the-job injury.” However, the Fund found that he had not done so:
The Notice of Award Letter does not state the disabling condition that is the basis for determining you are disabled as of July 1, 2018. While Dr. Corde[s]'s letter states that your current disability is due to several work-related injuries, including an injury from May 28, 2014, the information submitted does not provide evidence that Social Security made its determination based on a disabling condition that is the result of the on-the-job accident from May 28, 2014.
(Id., Ex. C, Apr. 2, 2020 Letter, ECF No. 13-3 at 3.)
Attached to this letter were the key provisions of Articles 4 and 7 of the Plan. Article 4 governs disability pensions. Section 4.01 provides that there are two ways a participant can qualify for a disability pension. The first requires the participant to have earned at least fifteen pension credits by the time he becomes...
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