Williams v. International Paper Co.

• Citation: 227 F.3d 706
• Decision Date: 27 September 2000
• Docket Number: No. 98-6514.,98-6514.
• Parties: Robert E. WILLIAMS, Plaintiff-Appellant, v. INTERNATIONAL PAPER COMPANY, Defendant-Appellee.
• Court: United States Courts of Appeals. United States Court of Appeals (6th Circuit)

227 F.3d 706

Robert E. WILLIAMS, Plaintiff-Appellant, v. INTERNATIONAL PAPER COMPANY, Defendant-Appellee.

No. 98-6514.

United States Court of Appeals, Sixth Circuit.

Submitted: November 5, 1999.

Decided and Filed: September 27, 2000.

Rehearing and Suggestion for Rehearing Denied October 31, 2000.^*

COPYRIGHT MATERIAL OMITTED

Martin E. Regan, Jr. (briefed), Regan & Boshea, New Orleans, Louisiana, for Plaintiff-Appellant.

David F. Dabbs (briefed), James A. Sonne (briefed), McGuire, Woods, Battle & Boothe, Richmond, Virginia, Robert D. Hudson (briefed), Greenebaum, Doll & McDonald, Covington, Kentucky, for Defendant-Appellee.

Before: KEITH, NORRIS, and CLAY, Circuit Judges.

Rehearing and Suggestion for Rehearing En Banc Denied October 31, 2000.^*

CLAY, J., delivered the opinion of the court, in which KEITH, J., joined. ALAN E. NORRIS, J. (p. 716), delivered a separate dissenting opinion.

AMENDED OPINION

CLAY, Circuit Judge.

Plaintiff, Robert E. Williams, filed an action against Defendant, International Paper Company ("IP"), for allegedly violating the Employee Retirement Income Security Act ("ERISA") 29 U.S.C. § 1132(a)(1)(B) by denying Williams disability retirement benefits. The district court granted summary judgment for IP and Williams appealed. For the following reasons, we REVERSE the district court's finding that the Plan Administrator did not act arbitrarily and capriciously in denying Williams' disability retirement benefits.

I. Factual Background

Williams worked for IP at its Natchez, Mississippi facility as a wastewater operator from 1968 until he retired in 1993. Williams participated in IP's Pension Plan ("the Plan") during his employment, and was fully vested in the Plan at the time of the events described herein. Williams was diagnosed has having suffered a major stroke and a series of passing strokes on February 17, 1993, while working at IP which left Williams paralyzed on his left side with speech difficulties and, according to Williams' attending physician, "totally disabled."¹ (J.A. at 274.) Williams was hospitalized for several days but did not return to work. Shortly thereafter, Williams applied for and received short-term disability benefits from IP.²

On December 8, 1993, Williams applied for permanent disability retirement benefits. IP sent Williams' file to its outside consultant, Dr. H. Michael Belmont at the Life Extension Institute in New York, New York requesting an evaluation of whether Williams was totally disabled. Dr. Belmont reviewed the file and prepared a memorandum wherein he concluded that Williams was not totally disabled within the meaning of the Plan on December 21, 1993. The Plan Administrator subsequently denied Williams' disability claim.

On January 18, 1994, a disability determination letter was prepared by the pension office stating in relevant part:

Please furnish Mr. Williams a copy of this memo and advise him of his rights to appeal our decision. Should Mr. Williams decide to appeal, he should submit evidence which would substantiate his claim of total and permanent disability.

(J.A. at 128).

On June 8, 1994, Williams appealed the denial of his benefits. IP forwarded the file to Dr. Belmont on June 24, 1994, for further review. On July 6, 1994, Dr. Belmont concluded once again that Williams did not meet the total disability standard required by the Plan. As a result, IP denied Williams' disability claim again. On September 7, 1994, an internal memorandum regarding Williams' disability determination was prepared by the pension office stating in part:

All the evidence in this case has been thoroughly evaluated, including any additional information received since the original submission of the claim. A careful review has been made, and we have concluded that the request for Disability Retirement must be denied. . . . Please furnish Mr. Williams with a copy of this memo and advise him of his rights to appeal our decision. Should he decide to appeal, he should submit evidence which would substantiate his claim of total and permanent disability.

(J.A. at 183).

On August 21, 1996, IP received a letter from United States Senator Trent Lott requesting that IP reevaluate Williams' disability claim. As a result, IP initiated a second appeal of the decision to deny Williams disability retirement benefits on August 28, 1996. IP forwarded Williams' file for evaluation to Wausau Insurance Company, its outside consultant in Wausau, Wisconsin, on August 28, 1996.

During Williams' second appeal, he submitted additional medical evidence consisting of two letters. One of the letters, dated May 15, 1996, was from Dr. Aziz Ahmed, and stated in relevant part as follows:

It is important to note that Mr. Robert Williams has suffered a major stroke affecting his left side that has rendered his left side, hand, upper and lower extremities and his face completely disabled. He has severe physical limitations in terms of walking and holding objects. On account of his facial nerve paralysis, he has difficulty speaking clearly, also. His balance and safety are also of concern. If he is allowed to be in a situation where he needs to walk up and down stairs or handle machinery, that could be detrimental to him or to his health. On account of his speech problem, he has a difficult time expressing his thought process to other people. His age also needs to be under consideration being 50 years old and suffering from high blood pressure that tends to run up and down during his previous visits with me. It makes him a difficult candidate for vocational training because, again, stress can aggravate his high blood pressure and that could cause further stroke. It is to be noted that I have known Mr. Robert Williams personally for some time and he has tried to get some jobs, but his main problem is that his physical limitation has barred him from other people hiring him for any kind of jobs.

(J.A. at 278.) The second letter dated May 24, 1996, was from Williams' physician, Dr. Gold, and stated in relevant part as follows:

Mr. Williams is a patient of mine who had a stroke which caused paralysis involving his left side. He has limitations in walking and would be detrimental to his health. He also has multiple other medication sic problems that his other physicians are caring for. At this point from my neurologic point of view I believe he's disabled....

(J.A. at 277.)

The Plan Administrator instructed the consultants in Wausau, Wisconsin not to consider the two additional letters from Dr. Ahmed and Dr. Gold in evaluating Williams' claim for disability benefits. After reviewing Williams' file without the additional medical evidence, IP rejected Williams' request for disability benefits and sent Williams a denial letter on December 6, 1996 stating in part:

Upon receipt of your request for Disability Retirement and following your submission of further medical evidence, your claim was independently reviewed by our medical consultants . . . . All the evidence in your case has been thoroughly evaluated, including any additional information received since the original submission of your claim.... Should you decide to appeal, you should submit additional medical evidence which would substantiate your claim of total and permanent disability.

(J.A. at 194).

IP claims that it did not consider Williams' additional medical evidence in support of his claim, on the basis that these letters indicated that Williams suffered the stroke which left him totally disabled after he left IP's employ, thereby rendering Williams ineligible for disability benefits. Williams, on the other hand, contends that the 1996 letters make reference to the stroke that he suffered in 1993, that he has not suffered a major stroke since that time, that his current state of disablement is a result of the stroke that he suffered in 1993, and that his disablement today is as it was in 1993.

On January 16, 1998, Williams filed a lawsuit pursuant to ERISA, § 502(a)(3), 29 U.S.C. § 1132(a)(1)(B), alleging that Defendant wrongfully denied him disability benefits under the retirement plan of IP. On September 9, 1998, IP filed a motion for summary judgment. The district court granted IP's motion. In granting summary judgment, the district court acknowledged that the additional letters submitted by Williams were not considered by the Plan Administrator at the time of its final decision, inasmuch as the letters reflected that Williams suffered a stroke after terminating his unemployment with IP, and that the Plan only provided coverage for disabilities incurred while under IP's employ. As such, the district court declined to consider the letters in reaching its decision. The district court further concluded that even if it were to consider the letters, its decision would not be different as neither letter made reference to the length of Williams' disability.

II. Discussion

A.

We review the district court's grant of summary judgment in an action involving an ERISA claim de novo. Killian v. Healthsource Provident Adm'rs, Inc., 152 F.3d 514, 520 (6th Cir.1998). Summary judgment is appropriate so long as "the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Smith v. Ameritech, 129 F.3d 857, 863 (6th Cir. 1997) (quoting FED.R.CIV.P. 56(c)). A fact is material only if it might affect the outcome of the case under the governing law. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). To determine whether summary judgment is appropriate, we view the evidence and draw all reasonable inferences therefrom in a light favorable to the non-moving party. Id.

A denial of benefits challenged under § 1132(a)(1)(B) is to be reviewed under a de novo standard unless the benefit plan gives the administrator or...