Yearwood v. United States

• Decision Date: 24 August 2015
• Docket Number: Case No. 5:14–cv–01599–TMP
• Citation: 124 F.Supp.3d 1204
• Parties: Roger D. Yearwood, Plaintiff, v. United States of America, Defendant.
• Court: U.S. District Court — Northern District of Alabama

124 F.Supp.3d 1204

Roger D. Yearwood, Plaintiff,

v.United States of America, Defendant.

Case No. 5:14–cv–01599–TMP

United States District Court, N.D. Alabama, Northeastern Division.

Signed August 24, 2015

Frank S. James, III, Baker Donelson Bearman Caldwell & Berkowitz PC, Birmingham, AL, for Plaintiff.

Jason R. Cheek, US Attorney's Office, Birmingham, AL, for Defendant.

MEMORANDUM OPINION

T. MICHAEL PUTNAM, UNITED STATES MAGISTRATE JUDGE

The above-styled case arises from Roger D. Yearwood's ("Plaintiff") Complaint asserting that he wrongfully was denied benefits under the Traumatic Servicemembers' Group Life Insurance ("TSGLI") program. Before the court are Cross Motions for Summary Judgment filed by the United States of America ("Defendant") and the plaintiff. (Docs. 6, 10). The motions have been fully briefed. The parties have consented to the exercise of dispositive jurisdiction by the undersigned (doc. 14); accordingly, the court enters this Memorandum Opinion.

STANDARD OF REVIEW

A. Summary Judgment

Under Federal Rule of Civil Procedure 56(a), summary judgment is proper "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a). The party asking for summary judgment "always bears the initial responsibility of informing the district court of the basis for its motion, and identifying those portions of ‘the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any’ which it believes demonstrate the absence of a genuine issue of material fact." Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986) (quoting former Fed. R. Civ. P. 56(c) ). The movant can meet this burden by presenting evidence showing there is no dispute of material fact or by showing that the nonmoving party has failed to present evidence in support of some element of its case on which it bears the ultimate burden of proof.

Celotex, 477 U.S. at 322–23, 106 S.Ct. 2548. There is no requirement, however, "that the moving party support its motion with affidavits or other similar materials negating the opponent's claim." Id. at 323, 106 S.Ct. 2548.

Once the moving party has met its burden, Rule 56"requires the nonmoving party to go beyond the pleadings and by her own affidavits, or by the ‘depositions, answers to interrogatories, and admissions on file,’ designate ‘specific facts showing that there is a genuine issue for trial.’ " Id. at 324, 106 S.Ct. 2548 (quoting former Fed. R. Civ. P. 56(e) ). The nonmoving party need not present evidence in a form necessary for admission at trial; however, he may not merely rest on his pleadings. Celotex, 477 U.S. at 324, 106 S.Ct. 2548. "[T]he plain language of Rule 56(c) mandates the entry of summary judgment, after adequate time for discovery and upon motion, against a party who fails to make a showing sufficient to establish the existence of an element essential to that party's case, and on which that party will bear the burden of proof at trial." Id. at 322, 106 S.Ct. 2548. In the instant case, the facts set forth by the parties in the cross Motion for Summary Judgment are virtually identical. The parties are asking the court to determine a question of law—whether the decision by the Army Board for Correction of Military Records ("ABCMR") was arbitrary and capricious under the Administrative Procedure Act.

B. Review of Administrative Decision

The plaintiff filed the instant action as a challenge to the ABCMR's affirmance of the Office of Servicemembers' Group Life Insurance's ("OSGLI") denial of his application for TSGLI benefits. The standard of review for a decision by the ABCMR is directed by the Administrative Procedure Act ("APA"), which states, in pertinent part:

To the extent necessary to decision and when presented, the reviewing court shall decide all relevant questions of law, interpret constitutional and statutory provisions, and determine the meaning or applicability of the terms of an agency action. The reviewing court shall—

(1) compel agency action unlawfully withheld or unreasonably delayed; and

(2) hold unlawful and set aside agency action, findings, and conclusions found to be—

(A) arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law;

...

In making the foregoing determinations, the court shall review the whole record or those parts of it cited by a party, and due account shall be taken of the rule of prejudicial error.

5 U.S.C. § 706. "Board decisions are subject to judicial review and can be set aside if they are arbitrary, capricious or not based on substantial evidence." Chappell v. Wallace, 462 U.S. 296, 303, 103 S.Ct. 2362, 2367, 76 L.Ed. 586 (1983). Accordingly, to prevail in an action against the ABCMR, the burden is on the plaintiff to show that "the decision of the ABCMR was ‘... arbitrary, capricious, unsupported by evidence, or contrary to the laws and regulations....' " Nolen v. Rumsfeld, 535 F.2d 888, 889 (5th Cir.1976),¹ quoting Hutter v. United States, 345 F.2d 828, 829 (1965).

The Eleventh Circuit Court of Appeals elaborated upon the arbitrary and capricious standard of review in Miccosukee Tribe of Indians of Florida v. United States, stating:

The arbitrary and capricious standard is "exceedingly deferential." Sierra Club v. Van Antwerp, 526 F.3d 1353, 1360 (11th Cir.2008) (quotation marks omitted). We are not authorized to substitute our judgment for the agency's as long as its conclusions are rational. Id. We may, however, find an agency action

arbitrary and capricious where the agency has relied on factors which Congress has not intended it to consider, entirely failed to consider an important aspect of the problem, offered an explanation for its decision that runs counter to the evidence before the agency, or is so implausible that it could not be ascribed to a difference in view or the product or agency expertise.

Alabama–Tombigbee Rivers Coal. v. Kempthorne, 477 F.3d 1250, 1254 (11th Cir.2007) (citing Motor Vehicle Mfrs. Ass'n v. State Farm Mut. Auto. Ins. Co., 463 U.S. 29, 43, 103 S.Ct. 2856, 2867, 77 L.Ed.2d 443 (1983) ). The Supreme Court has instructed us that when an agency "is making predictions, within its area of special expertise, at the frontiers of science ... as opposed to simple findings of fact, a reviewing court must generally be at its most deferential." Balt. Gas & Elec. Co. v. Natural Res. Def. Council, 462 U.S. 87, 103, 103 S.Ct. 2246, 2255, 76 L.Ed.2d 437 (1983).

566 F.3d 1257, 1264 (11th Cir.2009). "[E]ven in the context of summary judgment, an agency action is entitled to great deference. Under the Administrative Procedure Act, a court shall set aside an action of an administrative agency where it is arbitrary, capricious, or an abuse of discretion," but "[t]he court shall not substitute its judgment for that of the agency." Preserve Endangered Areas of Cobb's History, Inc. v. U.S. Army Corps of Engineers, 87 F.3d 1242, 1246 (11th Cir.1996), citing 5 U.S.C. § 706(2)(A) ; Citizens to Preserve Overton Park, Inc. v. Volpe, 401 U.S. 402, 416, 91 S.Ct. 814, 823–24, 28 L.Ed.2d 136 (1971).

Of particular importance when reviewing the denial of benefits administered by the Secretary of Veterans' Affairs are the provisions of 38 U.S.C. § 5107. The Traumatic Servicemembers' Group Life Insurance ("TSGLI") program is administered by the Secretary of Veterans' Affairs, and thus § 5107 is applicable to it. While § 5107(a) requires the veteran seeking benefits "to present and support a claim for benefits," § 5107(b) states:

(b) Benefit of the doubt. — The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under the laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant.

In its denial of reconsideration, the ABCMR acknowledged the applicability of this standard to its review of the plaintiff's claim, saying, "[u]nder this standard, servicemember claims should not be denied unless the evidence clearly weighs against finding the claimant's injury is not covered by the policy." (CAR 000191) (italics added). At least one court has applied this standard to the Air Force Board for Correction of Military Records ("AFBCMR") review of a disability for a servicemember. See Taylor v. United States, 106 Fed.Cl. 443 (Fed.Cl.2012), aff'd 530 Fed.Appx. 963, 2013 WL 5203422 (Fed.Cir.2013).

As an analytical framework for use in this case, § 5107(a) first requires the court to determine whether the ABCMR's conclusion that the claimant failed to "present and support" his claim is arbitrary, capricious, or unsupported by substantial evidence. That poses the question in this case whether the claimant presented substantial evidence² that his injury was the direct result of a "traumatic event." If so, the ABCMR's conclusion otherwise is arbitrary and capricious. Even so, the denial of benefits still can be affirmed if the record evidence preponderated against a finding that the plaintiff experienced a traumatic event that directly caused his admitted traumatic injury. On this second step of the analysis, the court must assess whether the conclusion reached by the ABCMR that the government proved by a preponderance of the evidence that the plaintiff's injury was not the direct result of a traumatic event is arbitrary or capricious.

FACTS

Ordinarily, in deciding a motion for summary judgment, the court must take the facts in the light most favorable to the non-moving party. In the instant case, each party has filed its own motion for summary judgment and, therefore, both parties are "movants" for the purposes of summary judgment. The facts submitted by the parties in the Motions for Summary Judgment are almost identical. Accordingly,...