Slomcenski v. Citibank, N.A.

• Decision Date: 14 December 2005
• Docket Number: No. 04-11245.,04-11245.
• Citation: 432 F.3d 1271
• Parties: Kimberly SLOMCENSKI, Plaintiff-Appellant, v. CITIBANK, N.A., a foreign corporation, Citibank Long Term Disability Plan, John Does, (1 through 6) as plan administrator for the Citibank Medical Benefits Plan, Citibank Vision Care Benefits Plan, Citibank Life Insurance Benefits Plan, Citibank Dental Care Benefits Plan, Citibank Accidental Death & Disability Benefits Plan, Citibank Pharmaceutical Benefits Plan, Defendants-Appellees.
• Court: U.S. Court of Appeals — Eleventh Circuit

432 F.3d 1271

Kimberly SLOMCENSKI, Plaintiff-Appellant, v. CITIBANK, N.A., a foreign corporation, Citibank Long Term Disability Plan, John Does, (1 through 6) as plan administrator for the Citibank Medical Benefits Plan, Citibank Vision Care Benefits Plan, Citibank Life Insurance Benefits Plan, Citibank Dental Care Benefits Plan, Citibank Accidental Death & Disability Benefits Plan, Citibank Pharmaceutical Benefits Plan, Defendants-Appellees.

No. 04-11245.

United States Court of Appeals, Eleventh Circuit.

December 14, 2005.

Marcus A. Castillo, Haas & Castillo, P.A., Clearwater, FL, William D. Mitchell, Mitchell Law Group, P.A., Tampa, FL, for Plaintiff-Appellant.

James R. Wiley, Cathleen G. Bell, Carlton Fields, P.A., Tampa, FL, Adam Scott Tanenbaum, {Pub. Defender's Office, Orlando, FL, for Defendants-Appellees.

Appeal from the United States District Court for the Middle District of Florida.

Before EDMONDSON, Chief Judge, and BIRCH and COX, Circuit Judges.

BIRCH, Circuit Judge:

This appeal requires us to address, inter alia, whether a fact-based argument first made by plaintiff-appellant, Kimberly Slomcenski upon a motion for reconsideration of the district court's order granting summary judgment in favor of defendant-appellee Citibank, N.A. ("Citibank") provides a basis for denial of summary judgment in favor of Citibank. The district court — after refusing to void a provision limiting long-term disability ("LTD") benefits for conditions related to mental or nervous disorders, which Slomcenski had challenged pursuant to the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq. — determined that Citibank's denial of Slomcenski's claim for continued LTD benefits was not arbitrary and capricious. Accordingly, the district court entered summary judgment in favor of Citibank on Slomcenski's ERISA claim. In addition, the district court entered summary judgment in favor of Citibank on Slomcenski's claim brought under the Americans with Disabilities Act of 1990 ("ADA"), 42 U.S.C. § 12101 et seq. Because we agree with the district court that Slomcenski failed to carry her burden of demonstrating any genuine issue of material fact as to the validity of the limiting provision, we AFFIRM the district court's grant of summary judgment on Slomcenski's ERISA claim. The district court's disposition of Slomcenski's ADA claim is also AFFIRMED.

I. BACKGROUND

Slomcenski was hired as an information technology specialist in Citibank's human resources department in November 1997. In this capacity, she was required to develop, implement, and maintain high quality systems, interface with managers about the department's systems needs, and provide training and documentation for system users. This position required an employee with five to ten years of experience and strong analytical, organizational, and communications skills.

As a Citibank employee, Slomcenski was covered by Citibank's Long Term Disability Plan ("Plan"). The Human Resources Policy Committee of Citibank ("Committee") was administrator of the Plan. Pursuant to the Plan, the Committee had the authority to "interpret and construe the provision[s] of the Plan and to finally decide any matters arising under the Plan." R1-33 (Exhibits), Tab A, Exh. 1 at 10. The Plan also specified that the Committee might "at any time, by written notice, amend or terminate th[e] Plan in whole or in part." Id. at 14. In addition, the Plan provided the Committee with the authority to delegate some or all of its responsibilities as it deemed appropriate. Pursuant to this provision, Citibank entered into an Administrative Services Agreement with Continental Casualty Company ("Continental") which granted Continental sole responsibility for managing the Plan and making final disability claim determinations. The agreement with Continental remained in effect from 1 January 1998 through 31 December 2001. Thereafter, Citibank entered into a similar Administrative Services Agreement with Metropolitan Life Insurance Company ("MetLife"). This agreement, which has been in effect since January 2002, provided that MetLife had all "discretionary authority for approving or denying Plan Benefits in whole or in part." Id. Exh. 3 at 6.

A. Eligibility and Coverage Provisions

The Plan was issued and made effective on 1 October 1993. Employees became eligible to receive benefits under the Plan on the first day of their employment at Citibank. If an employee became disabled, then he or she was eligible to receive short term disability benefits ("STD") for 180 days. If the employee remained disabled after the expiration of the STD period, the receipt of LTD benefits was conditioned on an inability to perform each and every material duty pertaining to his or her regular occupation. After twenty-four consecutive months of disability, inclusive of the initial 180-day STD period, the employee could continue to receive LTD benefits only if unable to perform every occupation for which he or she was or could become qualified.

As required by ERISA, Citibank provided its employees with a summary plan description ("SPD"), which explained benefits options to employees in a straightforward manner. The SPD in place at the time of Slomcenski's employment explained that a disabled employee could receive 180 days of STD benefits, followed by eighteen months of LTD benefits if the employee was medically unable to perform the material and substantial duties of the employee's own occupation, followed by continued LTD benefits if the employee was medically unable to perform the essential duties of any occupation for which the employee was or could become reasonably qualified. If the employee was disabled due to a mental or nervous disorder, however, the SPD reflected a limit on disability payments to a total of thirty months from the date the mental or nervous disorder began, unless the employee was confined as an inpatient in a hospital or other treatment center.

It is undisputed that this mental or nervous disorder benefits limitation was not included in the Plan when it was issued in 1993. Because the issue of Committee activity was raised for the first time after the summary judgment record had closed, that record contains no direct evidence of Committee activity or lack thereof in connection with the adoption of a mental or nervous disorder limitation or its inclusion in the SPD. The district court found that Citibank first gave its employees notice of the new limitation by way of a summary of material modifications ("SMM") issued in 1997. The amendment was included in the SPD issued in March of 1997, which was subsequently filed with the Department of Labor in compliance with 29 C.F.R. § 2520.104a-3 (1997). All SPD's issued from 1997 on, including the 1998 SPD issued to Slomcenski, contained the mental or nervous disorder limitations provision.

B. Slomcenski's Disability

On 21 July 1999, Slomcenski applied for disability benefits. She claimed that she suffered from headaches, nausea, insomnia, depression, loss of caring, loss of interest, and allergies. According to Slomcenski, these conditions developed following a change of management at her work. Dr. Gilson Webb, a psychiatrist who examined Slomcenski, diagnosed her with major depressive disorder. On the basis of Dr. Webb's diagnoses and Slomcenski's failure to respond to antidepressants and psychotherapy, Continental awarded Slomcenski disability benefits under the Plan.

Following this initial benefits determination, Slomcenski's condition was routinely monitored and re-evaluated. In December 1999, Continental referred Slomcenski to Dr. Daniel Sprehe for an independent psychiatric medical evaluation. Dr. Sprehe confirmed that Slomcenski still suffered from severe depression. Under a category for physical medical problems, Dr. Sprehe diagnosed Slomcenski with Hashimoto's Thyroid Disease. In March 2000, Continental arranged for Dr. Charles Paskewicz, a licensed psychologist, to conduct an independent review of Slomcenski's file. Paskewicz found that all the available evidence indicated that Slomcenski was continuing to suffer from severe depression. As a result of these diagnoses, Continental informed Slomcenski that she would continue to receive benefits. However, in the benefits award letter, Continental stated that, if Slomcenski remained disabled, her receipt of benefits would be limited to thirty months because her disability was the result of a mental or nervous disorder. According to the letter, her benefits would terminate in January 2002.

In October 2000, Dr. Robert Gilbert diagnosed Slomcenski with irritable bowel syndrome. In January 2001, Dr. Webb re-examined Slomcenski and found that, while Slomcenski continued to suffer from major depressive disorder, "some of [her] symptoms [appeared to be] related to her physical condition." R1-31 (Exhibits) at SYN00035. In September 2001, Dr. Paul Winters examined Slomcenski after she complained of fatigue, numbness on part of her foot, and lower back pain. Dr. Winters noted that Slomcenski was scheduled to be evaluated for fibromyalgia. During this time, Slomcenski was also evaluated by a rheumatologist, Dr. Michael Burnette, for her complaints of persistent joint pain and chronic fatigue. Dr. Burnette found that Slomcenski had some trigger points for pain in her upper back and some pain with the movement of her spine. Dr. Burnette concluded that Slomcenski "ha[d] manifestations of a fibromyalgia disorder, and [that] her history suggest[ed] chronic fatigue." Id. at SYN00038.

Following Burnette's evaluation, Slomcenski sent a letter to Continental which indicated that she had been diagnosed with fibromyalgia and chronic fatigue syndrome. Slomcenski also reported that she experienced severe pain on a daily basis. In December 2001, Continental responded that Slomcenski's letter and supporting documentation were insufficient to support the finding that Slomcenski suffered...