Ross v. Indiana State Teacher's Ass'n Ins. Trust
| Decision Date | 03 September 1998 |
| Docket Number | 97-3263,Nos. 97-3153,s. 97-3153 |
| Citation | 159 F.3d 1001 |
| Parties | 130 Ed. Law Rep. 480, 8 A.D. Cases 1273, 13 NDLR P 99 Marvin O. ROSS, Plaintiff-Appellee, v. INDIANA STATE TEACHER'S ASSOCIATION INSURANCE TRUST, Defendant-Appellant. Marvin O. ROSS, Plaintiff-Appellant, v. INDIANA STATE TEACHER'S ASSOCIATION and Indiana State Teacher's Association Insurance Trust, Defendants-Appellees. |
| Court | U.S. Court of Appeals — Seventh Circuit |
James P. Fenton (argued), Alan VerPlanck, Eilbacher Scott, P.C., Fort Wayne, IN, Cathleen M. Shrader, Barrett & McNagny, Fort Wayne, IN, for Marvin O. Ross.
Bart A. Karwath, Howard E. Kochell (argued), Barnes & Thornburg, Richard J. Darko, Lowe, Gray, Steele & Darko, Indianapolis, In, for Indiana State Teacher's Association Insurance Trust.
Wayne O. Adams, III (argued), Johnson, Smith, Pence, Densorn, Wright & Heath, for Indiana State Teacher's Association.
Before BAUER, RIPPLE and ROVNER, Circuit Judges.
Marvin O. Ross filed this action in the district court on July 27, 1995, against the Indiana State Teacher's Association ("ISTA") and the Indiana State Teacher's Insurance Trust (the "Trust"). In his complaint, he alleged a claim against the Trust under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. §§ 1001-1461, claims against both defendants under the Americans with Disabilities Act ("ADA"), 42 U.S.C. §§ 12101-12213, and several pendent state law claims against both defendants. 1 On February 7, 1997, the district court granted summary judgment in favor of ISTA on Mr. Ross' ADA claim and dismissed the remaining state law claims against ISTA without prejudice under 28 U.S.C. § 1367(c). See Ross v. Indiana State Teacher's Ass'n, 955 F.Supp. 1025, 1030-32 (N.D.Ind.1997). In addition, the district court granted the Trust's motion for partial summary judgment with respect to the ERISA claim. See id. at 1028-30. In April 1997, the case proceeded to trial on the only remaining claim--the ERISA claim against the Trust. Following a bench trial, the district court found in favor of Mr. Ross on that claim.
In this appeal, the Trust seeks reversal of the district court's judgment in favor of Mr. Ross on his ERISA claim. Mr. Ross cross-appeals from the district court's grant of summary judgment in favor of ISTA on his ADA claim. For the reasons set forth in the following opinion, we reverse the district court's judgment in favor of Ross on the ERISA claim and remand for further proceedings; we affirm the grant of summary judgment in favor of ISTA on the ADA claim.
Marvin Ross worked for the Indiana State Teacher's Association from 1971 2 until his termination in December 1994 as the UniServ Director for Fort Wayne, Indiana. ISTA is a labor organization that represents teachers throughout the State of Indiana. As an ISTA UniServ Director, Mr. Ross was responsible for representing the Fort Wayne Education Association and its teacher members by providing advice and consultation to them with respect to matters including collective bargaining, grievance processing, unfair labor practices, organizing, program development and other employment-related matters. Mr. Ross' position required that he visit various schools in his territory and that he attend a number of community events and meetings, including teacher meetings, collective bargaining meetings and school board meetings.
Mr. Ross has suffered from a degenerative hip condition since 1958. That condition has caused him to undergo numerous surgeries, including full hip replacements. In fact, he had undergone five surgical procedures prior to his employment with ISTA in 1971, and he had five additional surgeries during his tenure with ISTA. ISTA was aware of Mr. Ross' medical problems at the time it hired him, and it accommodated him throughout his 23-year employment with ISTA. 3
In September 1992, Mr. Ross visited the Mayo Clinic and was examined by Dr. Miguel Cabanela. Dr. Cabanela wrote a report concluding In February 1993, Dr. Cabanela performed another total hip replacement surgery on Mr. Ross. On March 29, 1993, Mr. Ross completed the 180-day waiting period required to be eligible to receive long-term disability benefits under the disability policy administered by the Trust. 5 Mr. Ross had applied for long-term disability benefits under the policy, and he began receiving them after the waiting period. The parties do not dispute that he was "totally disabled" within the meaning of the policy at that time. The policy defines the term "total disability":
that Mr. Ross' condition was such that he could not "function effectively at his work" and therefore that he "should be taken off work on an indefinite basis." R.87, Ex.12. Moreover, Dr. Cabanela expressed his opinion that Mr. Ross' condition was "permanent." As a result of this recommendation, Mr. Ross went on indefinite sick leave. 4 Because he indicated that his condition was permanent, ISTA posted a vacancy in the UniServ Director position in Fort Wayne. However, Mr. Ross expressed his desire to return to his position after further surgery, and ISTA agreed to delay filling the position until Mr. Ross received a post-operative prognosis from his doctor
"Total Disability" (or Totally Disabled) for the first sixty (60) months of disability means that the Participant is disabled and unable to perform the substantial duties of the Participant's employment....
On May 14, 1993, Dr. Cabanela wrote that Mr. Ross was recuperating satisfactorily but that it was "unpredictable when and if he will be able to return to work." R.87, Ex.16. Because the UniServ Director spot had been left open since September 1992, ISTA wrote Mr. Ross and explained that the position could not be left vacant any longer unless ISTA could be assured that he would return by September 1, 1993. Mr. Ross did not respond to this letter, and ISTA hired a new director for Fort Wayne.
On September 15, 1993, Mr. Ross applied for additional disability benefits from the Indiana State Teacher's Retirement Fund, and he began receiving those benefits in October 1993. Therefore, Mr. Ross at that time was receiving Social Security disability benefits, long-term disability benefits from the Trust 6 and benefits from the Retirement Fund.
In February 1994, the Trust's third-party administrator, the Huttleston Benefit Group ("Huttleston"), requested that Dr. Cabanela complete a questionnaire to determine whether Mr. Ross remained "totally disabled" under the Trust's disability plan. Although Dr. Cabanela's response indicated that Mr. Ross was still "totally disabled," he also indicated that Mr. Ross could perform sedentary work if it did not require excessive walking or use of stairs. This mixed response led Huttleston to question further whether Mr. Ross was still entitled to receive long-term disability benefits from the Trust. Consequently, Huttleston contacted Bruce Rogers, the CEO and Director of the Trust, to determine whether an independent medical examination ("IME") of Mr. Ross should be obtained to ascertain whether he remained "totally disabled." Rogers replied that he believed it likely that Mr. Ross would be returning to work and therefore suggested that Huttleston defer seeking an IME By July 1994, Mr. Ross had not returned to work and Huttleston again requested permission from Rogers to obtain an IME; at that time, Rogers agreed to request an IME. The examination was conducted by Dr. Michael Keating, a physician at the Center for Hip and Knee Surgery in Mooresville, Indiana. Dr. Keating concluded that Mr. Ross was capable of working if he was not required to move very often, lift objects or climb stairs, and if he could use a cane full time. Dr. Keating noted that the hip "actually looks outstanding" and that Mr. Ross would be capable of doing "some type of work" in keeping with the restrictions Dr. Keating set forth. R.87, Ex.72. After this report, Huttleston requested subsequent clarification from Dr. Keating. In response, Dr. Keating suggested that Mr. Ross would be able to return to work if he could use a wheelchair to prevent him from getting up and down too often.
until Mr. Ross had additional time to recuperate.
After considering Dr. Cabanela and Dr. Keating's reports and the job requirements of a UniServ Director, a three-person committee at Huttleston determined that Mr. Ross was no longer "totally disabled" under the terms of the Trust policy because he was able to perform the substantial duties of his employment. Accordingly, Huttleston advised Rogers that it believed Mr. Ross' benefits should be terminated. Rogers, though authorized to overturn that decision, did not disagree. Consequently, Huttleston sent Mr. Ross a letter on October 11, 1994, indicating that his long-term disability benefits would be terminated as of October 31, 1994. 7
On October 17, 1994, Mr. Ross' PSO 8 representative, Donald Thompson, contacted ISTA and stated that Mr. Ross was ready to return to work. ISTA responded that it had a vacant UniServ Director position in its Shelbyville, Indiana office. ISTA also inquired when Mr. Ross would be able to start work and what accommodations would be necessary. On October 28, 1994, Thompson sent a letter reporting that Mr. Ross was available to return to work as of November 1, 1994. Attached with the letter was a list of suggested accommodations required of ISTA. Thompson made it clear in forwarding those suggested accommodations that "[t]he wording is Mr. Ross' and not that of PSO." R.87, Ex.23. This list of 19 accommodations was broad in scope. It included such requests as "[m]eetings with teachers shall be held in the UniServ Office" and accommodation "by insuring that I never have to move quickly, such as to avoid a running student." Id. Mr. Ross points out that Warren Williams, Executive Director of ISTA, was angered by the suggested accommodations....
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