Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-09-02625/USCOURTS-ca8-09-02625-0/pdf.json

Parties Involved:
American Republic Insurance Company
Appellee
Kim Iann Manning
Appellant

Document Text:

1

The Honorable Roberto A. Lange, United States District Court for the District

of South Dakota, sitting by designation.

2

The Honorable James Gritzner, United States District Judge for the Southern

District of Iowa.

United States Court of Appeals

FOR THE EIGHTH CIRCUIT

___________

No. 09-2625

___________

Kim Iann Manning, *

*

Plaintiff - Appellant, *

* Appeal from the United States

v. * District Court for the

* Southern District of Iowa.

American Republic Insurance Company,*

*

Defendant - Appellee. *

___________

 Submitted: January 14, 2010

 Filed: May 12, 2010

___________

Before GRUENDER and SHEPHERD, Circuit Judges, and LANGE,1

 District Judge.

LANGE, District Judge.

Kim Iann Manning (“Manning”) was denied short-term disability benefits and

subsequently terminated from employment by American Republic Insurance Company

(“ARIC”). She sought judicial review of the benefits decision under the Employee

Retirement Income Security Act. 29 U.S.C. § 1132 et seq. She also asserted ERISA

retaliation and interference claims. The district court2

 affirmed ARIC’s denial of

Appellate Case: 09-2625 Page: 1 Date Filed: 05/12/2010 Entry ID: 3663711
-2-

Manning’s benefits claim, finding that ARIC did not abuse its discretion in

determining that Manning was not disabled. In a separate order, the district court

granted ARIC’s motion for summary judgment on Manning’s ERISA retaliation and

interference claims. Manning appeals both orders. Having jurisdiction under 28

U.S.C. § 1391, this Court affirms.

I. MATERIAL FACTS NOT SUBJECT TO GENUINE DISPUTE.

Beginning on January 31, 2005, Manning worked for ARIC as a Senior

Account Specialist. Her job involved selling insurance products over the telephone

and was sedentary in nature, consisting of calling prospective customers and

determining their eligibility for insurance, providing insurance quotes, and data entry.

Manning worked a total of 50 days for ARIC. Her last day worked was April 26,

2005.

ARIC sponsored and administered a self-funded short-term disability plan (“the

Plan”) for its employees. As an ARIC employee, Manning was eligible to participate

in the Plan. To qualify for short-term disability benefits under the Plan, eligible

employees must: (1) be covered by the Plan; (2) be under the care of an “Approved

Health Care Provider”; (3) have a “Medically Certified Health Condition” that lasts

longer than the short-term disability waiting period; (4) receive appropriate care and

treatment for the Medically Certified Health Condition; and (5) receive approval of

short-term disability benefits in accordance with the provisions of the Plan. Under the

Plan, ARIC reserved the right to have claimants submit to an Independent Medical

Examination (“IME”) by an Approved Health Care Provider of its choice. 

The Plan defines Approved Health Care Provider as: (1) licensed doctors of

medicine or osteopathy; (2) licensed podiatrists, dentists, Ph.D.’s, psychologists,

optometrists, or chiropractors; and (3) licensed nurse practitioners or nurse midwives.

Appellate Case: 09-2625 Page: 2 Date Filed: 05/12/2010 Entry ID: 3663711
-3-

The Plan’s definition of Medically Certified Health Condition required the condition

to be “[d]ocumented by objective disabling signs and symptoms.”

On May 9, 2005, Manning submitted a claim for benefits under the Plan by

providing a Family Medical Leave Act Certification of Health Care Provider form

completed by Physician Assistant Andra Kennedy dated May 5, 2005. Kennedy

reported that Manning was experiencing “elevated blood pressure,” “increased

frequency of migraines,” and “increased anxiety.” Kennedy also wrote that

Manning’s conditions began approximately 90 days earlier. Kennedy recommended

that Manning receive short-term disability benefits for two to three months. Kennedy

failed to directly answer a question on the form asking whether Manning was “unable

to perform work of any kind,” instead indicating that Manning should “avoid long

periods of sitting or repetitive motion.”

On May 12, 2005, Jodi Lanphier, an ARIC benefit specialist, called Manning

to request more information regarding her claim. Lanphier told Manning that ARIC

needed Manning to specify why she was unable to work. In response, Manning faxed

Lanphier a document the next day, signed by Kennedy, stating “dangerously high

blood pressure,” “[i]ncrease in frequency, severity, and duration of migraines,” and

“hypertension.” However, the note did not explain why those conditions prevented

Manning from working for an extended period.

On May 20, 2005, Lanphier again called Manning for more information in order

to process her claim. Lanphier sent Manning a letter on May 24, 2005, explaining that

the Plan required claims to be completed by an Approved Health Care Provider. The

letter set forth in full the Plan’s definition of Approved Health Care Provider, which

did not include physician assistants. The letter further notified Manning that her claim

could not be considered until an Approved Health Care Provider submitted evidence

of disability. The letter also explained that “[a] decision on STD eligibility will not

be made until objective medical evidence to support your disability is received by the

Appellate Case: 09-2625 Page: 3 Date Filed: 05/12/2010 Entry ID: 3663711
-4-

company.” Finally, Lanphier wrote that, consistent with the Plan’s terms, Manning

had fifteen days after receipt of the letter to submit the required information to ARIC.

On June 8, 2005, Kennedy sent ARIC a handwritten letter, attaching two

medical records from office visits during which Manning was examined by Dr.

Kenneth Moon. The first record, from March 11, 2005, noted that Manning’s blood

pressure was 148/110, that “she feels the best that she has felt in a long time,” and that

she could return to work the following Monday. In the second record, from April 26,

2005, Kennedy reported that Manning’s blood pressure was 152/100 and that

Manning felt “stressed out.”

On June 16, 2005, ARIC Senior Human Resources Business Partner Gina

Moeckly Vernon sent a letter to Dr. Moon requesting a telephone conversation

regarding Manning’s health status. Vernon attached a copy of ARIC’s job description

for Manning’s position. On July 19, Vernon, Lanphier, and Manning participated in

a conference call, during which Vernon advised Manning that she needed to speak

with Dr. Moon regarding Manning’s medical condition. Vernon also explained that,

under the Plan’s terms, ARIC could not make a determination as to Manning’s claim

without documentation from an Approved Health Care Provider. On July 25, Vernon

sent a second letter to Dr. Moon - with a copy to Manning - requesting a telephone

conference regarding Manning’s claim. 

On July 29, 2005, Vernon, Lanphier, and Dr. Moon participated in a

teleconference to discuss Manning’s condition. Dr. Moon explained that he had not

examined Manning since March 2005, but that upon examination of Kennedy’s

records and notes, he found that Manning’s blood pressure level did not require

placement on disability status. Inconsistent with this statement, however, Dr. Moon

said that he believed Manning would not be able to return to work due to her blood

pressure and migraines. He then said that he was not able to determine Manning’s

Appellate Case: 09-2625 Page: 4 Date Filed: 05/12/2010 Entry ID: 3663711
-5-

eligibility to return to work at that time, and he would require further examination to

make a disability determination.

On August 6, 2005, Dr. Moon returned to ARIC a completed Certification of

Health Care Provider form and notes from an August 1, 2005 examination of

Manning. On the form, Dr. Moon noted that Manning had been under stress from her

bankruptcy, but that the stress would likely be lifted upon the upcoming completion

of the bankruptcy proceedings around September 4, 2005. He also reported that

Manning’s blood pressure was improving and her migraines were becoming less

frequent. In response to the certification form’s question, “is the employee unable to

perform work of any kind,” Dr. Moon answered “yes” without any explanation.

On August 8, 2005, Vernon sent Manning a letter denying her short-term

disability claim. Manning appealed the determination, but she did not provide ARIC

any additional information regarding her medical status. On August 29, 2005, ARIC

upheld the decision denying Manning’s claim and sent Manning a letter stating that

it had reviewed the contents of her medical file and was upholding denial of the claim

“due to lack of objective medical information that illustrates that you are disabled

from performing your job duties, as defined by American Republic’s Short Term

Disability Plan.”

Within the denial letter, ARIC informed Manning that because her claim had

been denied, she had the following two options: (1) “Return to work on Wednesday,

August 30, with certification from your Approved Health Care Provider that you are

able to return to work”; or (2) “Provide us with objective medical information, from

your Approved Health Care Provider, that you are disabled from performing your job

duties.” (emphasis in original). ARIC purportedly required certification of ability to

return to work as part of an internal policy to shield itself from liability by ensuring

that employees do not risk their health or aggravate an injury by returning to work for

financial reasons. 

Appellate Case: 09-2625 Page: 5 Date Filed: 05/12/2010 Entry ID: 3663711
-6-

The letter also warned Manning that ARIC expected her employment would be

terminated if she failed to return to work on August 31, 2005. Manning did not return

to work. ARIC terminated her employment on September 6, 2005, which was

communicated to Manning through a letter stating in part: 

Because your absence is not covered by FMLA, you failed to provide objective

medical information that you are disabled from performing your job duties as

required by our Short-Term Disability Plan, and you have not returned to active

status, your employment with American Republic is being terminated effective

August 31, 2005. 

Manning was ultimately released by her doctor to return to work in October

2005. She never applied for long-term disability benefits from ARIC and, even had

she remained employed with ARIC, she would not have been eligible for long-term

disability benefits because the six-month short-term disability period would not have

expired by October 2005.

After exhausting her administrative remedies, Manning filed a complaint on

May 17, 2007, bringing claims for: (1) judicial review of ARIC’s denial of her shortterm disability benefits under ERISA, pursuant to 29 U.S.C. § 1132(a)(1)(B); (2) an

ERISA retaliation claim asserting ARIC terminated Manning based on her application

for short-term disability benefits, pursuant to 29 U.S.C § 1140; and (3) an ERISA

interference claim that ARIC’s wrongful termination prevented Manning from

obtaining future rights and benefits under ARIC’s long-term disability benefits plan.

Finding that ARIC did not abuse its discretion and that its decision to deny benefits

was supported by substantial evidence, the district court affirmed ARIC’s decision on

February 24, 2009. On June 19, 2009, the district court granted summary judgment

to ARIC on Manning’s ERISA retaliation and interference claims. Manning appealed.

Appellate Case: 09-2625 Page: 6 Date Filed: 05/12/2010 Entry ID: 3663711
-7-

II. STANDARD OF REVIEW.

We review de novo the district court’s grant of summary judgment regarding

an ERISA plan administrator’s benefits determination. Wakkinen v. UNUM Life Ins.

Co. of America, 531 F.3d 575, 580 (8th Cir. 2008). Summary judgment is appropriate

if there are no disputed issues of material fact and the moving party is entitled to

judgment as a matter of law. Fed. R. Civ. P. 56(c); Aviation Charter, Inc. v. Aviation

Research Group/US, 416 F.3d 864, 868 (8th Cir. 2005). We view the evidence and

inferences that may reasonably be drawn from the evidence in the light most favorable

to the nonmovant. Id.

When a plan reserves “discretionary power to construe uncertain terms or to

make eligibility determinations . . . the administrator’s decision is reviewed only for

‘abuse . . . of his discretion’” by the district court. King v. Hartford Life & Accident

Ins. Co., 414 F.3d 994, 998-99 (8th Cir. 2005) (en banc) (quoting Firestone Tire &

Rubber Co. v. Bruch, 489 U.S. 101, 111 (1989)); see also Conkright v. Frommert, No.

08-810, 559 U.S. (slip. op., at 5) (Apr. 21, 2010) (following Firestone and noting

that Firestone established a “broad standard of deference without any suggestion that

the standard was susceptible to ad hoc exceptions”). Under the abuse of discretion

standard, the court must affirm the plan administrator’s interpretation of the plan

unless it is arbitrary and capricious. Midgett v. Wash. Group Int’l Long Term

Disability Plan, 561 F.3d 887, 896-97 (8th Cir. 2009). 

To determine whether a plan administrator’s decision was arbitrary and

capricious, the court examines whether the decision was “reasonable.” King, 414 F.3d

at 998-99. Any reasonable decision will stand, even if the court would interpret the

language differently as an original matter. Id.; see also Rutledge v. Liberty Life

Assurance Co., 481 F.3d 655, 659 (8th Cir. 2007) (“[W]e must affirm if a reasonable

person could have reached a similar decision, given the evidence before him, not that

a reasonable person would have reached that decision.”); Midgett, 561 F.3d at 897.

Appellate Case: 09-2625 Page: 7 Date Filed: 05/12/2010 Entry ID: 3663711
-8-

However, this standard does not apply if the plan administrator has committed “a

serious procedural irregularity” causing “a serious breach of the plan administrator’s

fiduciary duty to the claimant,” in which case the court applies a less deferential

standard of review. Pralutsky v. Metro. Life Ins. Co., 435 F.3d 833, 837 (8th Cir.

2006) (internal citations omitted).

A conflict of interest exists when a plan administrator holds the dual role of

evaluating and paying benefits claims, such as when the employer both determines

eligibility for benefits and pays the benefits. Metro. Life Ins. Co. v. Glenn, 128 S. Ct.

2343, 2346 (2008). If such a conflict exists, then a reviewing court should consider

that conflict as a factor in determining whether the plan administrator has abused its

discretion in denying benefits. The significance of this factor depends on the

circumstances of the particular case. Id. When an insurer has a history of biased

claims administration, the conflict “may be given substantial weight.” Id. When an

insurer has taken steps to reduce the risk that the conflict will affect eligibility

determinations, the conflict “should be given much less weight.” Id.

Here, ARIC was both the evaluator of whether benefits were owed and the

entity responsible for paying those benefits. The record contains evidence of neither

biased claims administration nor efforts to reduce the risk of such administration.

Accordingly, like in Darvell v. Life Ins. Co. of North America, 597 F.3d 929, 934 (8th

Cir. 2010), the court gives the conflict some weight.

Appellate Case: 09-2625 Page: 8 Date Filed: 05/12/2010 Entry ID: 3663711
-9-

III. DISCUSSION.

A. ARIC’s Denial of Short-Term Disability Benefits to Manning was

Reasonable.

The Plan stated that the Administrator “retains the sole right to interpret and

construe the terms of the STD policy and to make the final determination of the

validity of each claim and the length of time for which payments, if any, shall be

made.” Because the Plan vested the Administrator with discretionary authority to

determine eligibility for benefits and to construe the terms of the Plan, this Court

reviews ARIC’s decision denying Manning’s benefits claims for an abuse of

discretion. See Glenn, 128 S. Ct. at 2350; King, 414 F.3d at 998-99. Therefore,

ARIC’s decision will stand if reasonable. King, 414 F.3d at 998-99.

To qualify for short-term disability benefits, the Plan required Manning to show

that she (1) was covered by the Plan; (2) was under the care of an Approved Health

Care Provider; (3) had a Medically Certified Health Condition that lasted longer than

the 60 working day waiting period; (4) received appropriate care and treatment for the

Medically Certified Health Condition; and (5) received approval of short-term

disability benefits in accordance with Plan provisions. ARIC denied Manning’s claim

due to her failure to establish that she had a Medically Certified Health Condition.

ARIC's decision will stand if it is reasonable, and a decision is reasonable if supported

by substantial evidence. Midgett, 561 F.3d at 897 (finding that substantial evidence

is more than a scintilla but less than a preponderance) (citing Schatz v. Mutual of

Omaha Ins. Co., 220 F.3d 944, 949 (8th Cir. 2000)). Substantial evidence supports

ARIC’s decision because the records submitted to ARIC did not constitute objective

medical evidence of disability. Thus, ARIC did not abuse its discretion.

First, the certification and disability opinions of the physician assistant did not

satisfy the Plan’s requirement that an Approved Health Care Provider certify a health

Appellate Case: 09-2625 Page: 9 Date Filed: 05/12/2010 Entry ID: 3663711
-10-

condition. The Plan’s unambiguous language required Manning to demonstrate that

she had a disabling health condition “as certified by an Approved Health Care

Provider.” The language of the Plan defined who is an Approved Health Care

Provider, and a physician assistant is not an Approved Health Care Provider.

Therefore, ARIC reasonably declined to consider Kennedy’s opinions.

ARIC provided Manning ample notice of this deficiency in her claim. ARIC

repeatedly explained to Manning what the Plan required and notified her that the

opinions of a physician assistant were inadequate. Despite these notifications,

Manning waited nearly three months to provide ARIC with a certification from an

Approved Health Care Provider, Dr. Moon. ARIC did not abuse its discretion in

declining to consider the certification or opinions of Kennedy because she was not an

Approved Health Care Provider as defined by the Plan.

Manning contends that ARIC abused its discretion in rejecting Dr. Moon’s

opinion that Manning was disabled. Dr. Moon, after providing inconsistent opinions

in a phone conference on July 29, 2005, later offered a conclusory opinion that

Manning’s hypertension and migraines rendered her to be disabled. However, the

Plan required more. Under the Plan, an allegedly disabling medical condition needed

to be documented by “objective disabling signs and symptoms.”

As explained by Lanphier in a letter to Manning dated May 24, 2005, objective

medical evidence includes “data and records from your attending Approved Health

Care Provider, narrative reports, x-rays, and laboratory findings and consulting

Approved Health Care Provider reports.” The Plan required this information “at the

inception of [Manning’s] STD claim and periodically thereafter as requested by the

enterprise.”

Neither Manning nor Dr. Moon submitted objective evidence that Manning was

disabled by hypertension. Hypertension can be objectively measured by blood

Appellate Case: 09-2625 Page: 10 Date Filed: 05/12/2010 Entry ID: 3663711
-11-

pressure readings. The record contains only four specific blood pressure readings, and

only one of the reports characterized Manning’s blood pressure as high. This reading

occurred on April 26, 2005, during a period in which Manning independently decided

to discontinue her blood pressure medication. Manning submitted no other

documentation of high blood pressure or any information regarding the intensity or

duration of any hypertension. On June 2, 2005, Dr. Moon reported that Manning had

a “good” blood pressure reading that would not warrant placing her on disability

status. Additionally, the one blood pressure reading characterized as high was

procedurally insufficient to establish her entitlement to benefits. Manning elected a

60-business-day waiting period, and the sixtieth business day after Manning’s claimed

disability onset date of April 27 was in late-July. Even if Manning experienced high

blood pressure in April, she presented ARIC with no evidence that this condition

continued after the waiting period. 

Manning’s migraines - and their allegedly debilitating nature - were not

documented by objective disabling signs and symptoms either. Her medical records

established that her migraines could be controlled with medication. Dr. Moon’s

reports did not address the nature, duration or severity of the headaches, whether the

migraines could be disabling over an extended period of time, or how they could

render her unable to perform work of any kind.

In summary, ARIC did not receive objective evidence of disabling signs and

symptoms from Dr. Moon. Rather, Dr. Moon provided a subjective opinion, with no

explanation regarding how Manning’s condition might prevent her from performing

her regular job duties, which ARIC had described in writing to Dr. Moon. ARIC

reasonably requested Manning to supplement her claim with objective medical

evidence of disability, but none was provided. Consequently, ARIC reasonably

denied Manning’s claim for insufficient evidence of a medically certified health

condition.

Appellate Case: 09-2625 Page: 11 Date Filed: 05/12/2010 Entry ID: 3663711
-12-

B. ARIC’s Request for Objective Medical Evidence and Decision not to

Conduct an Independent Medical Examination did not Constitute

a Procedural Irregularity.

Manning contends that ARIC’s disregarding of Dr. Moon’s opinion without

conducting an IME amounted to a procedural irregularity, requiring this court to apply

a less deferential standard of review of ARIC’s decision. ARIC counters that because

Manning provided no objective medical evidence of disability, it was not required to

conduct an IME to rebut the opinion prior to denying her claim. Hence, the issue at

hand is whether ARIC should have obtained an IME prior to denial of Manning’s

claim.

Generally, “[i]t is not unreasonable for a plan administrator to deny benefits

based upon a lack of objective evidence.” Johnson v. Metro. Life Ins. Co., 437 F.3d

809, 813 (8th Cir. 2006) (quoting McGee v. Reliance Standard Life Ins. Co., 360 F.3d

921, 925 (8th Cir. 2004)); see also Rutledge v. Liberty Life Assurance Co. of Boston,

481 F.3d 655, 661 (8th Cir. 2007); Pralutsky, 435 F.3d at 839-40; Groves v. Metro.

Life Ins. Co., 438 F.3d at 875. In Johnson, the plan required objective medical

evidence of disability, which the claimant argued created a procedural irregularity,

justifying a less deferential standard of review than the ordinary abuse of discretion.

Johnson, 437 F.3d at 813. The court, however, applied the abuse of discretion

standard and held that the plan administrator acted reasonably in denying benefits

based on its interpretation of the plan language and the absence of objective evidence

of allegedly disabling fibromyalgia. Id.

Similar to the facts in Johnson, Manning argues that a less deferential standard

of review applies because ARIC arbitrarily decided to require objective medical

evidence rather than relying solely on consideration of Dr. Moon’s subjective opinion.

However, as in Johnson and Pralutsky, the administrator reasonably interpreted the

plan to require objective medical evidence to prove the claimant’s disability. ARIC’s

Appellate Case: 09-2625 Page: 12 Date Filed: 05/12/2010 Entry ID: 3663711
-13-

interpretation requiring objective medical evidence did not constitute a procedural

irregularity and does not trigger a less deferential standard of review. 

Manning next argues that ARIC abused its discretion by not performing an

IME. However, it is not an abuse of an ERISA plan administrator’s discretion "to

ignore an opinion when the physician did not 'provide reliable objective evidence of

testing or other proof to support the finding'" of disability. Darvell, 597 F.3d at 935

(quoting McGee, 360 F.3d at 924-25). A plan administrator is not required to order

an IME when the claimant’s evidence is facially insufficient to support a finding of

disability. Rutledge, 481 F.3d at 661 (8th Cir. 2006) (citing Layes v. Mead Corp., 132

F.3d 1246, 1251-52 (8th Cir. 1998)). This case is similar to Groves, where a treating

physician stated that the claimant “may be able to perform at the sedentary level” and

then later said that claimant was “incapable of even the most sedentary occupation.”

438 F.3d at 875. Because the doctor’s opinion provided no reliable objective

evidence, such as testing, to support the finding, this Court found that “[i]t is not

unreasonable for a plan administrator to deny benefits based upon a lack of objective

evidence. Id. (quoting Pralutsky, 435 F.3d at 839).

The five factors set out in Finley v. Special Agents Mut. Benefit Ass’n, 957

F.2d 617, 621 (8th Cir. 1992), guide the Court in determining the reasonableness of

a plan administrator’s interpretation of a plan. The factors are the following: (1)

whether the administrator’s language is contrary to the clear language of the plan; (2)

whether the interpretation conflicts with the substantive or procedural requirements

of ERISA; (3) whether the interpretation renders any language in the plan meaningless

or internally inconsistent; (4) whether the interpretation is consistent with the goals

of the plan; and (5) whether the administrator has consistently followed the

interpretation. Id. However, “the dispositive principle remains . . . that where plan

fiduciaries have offered a reasonable interpretation of disputed provisions, courts may

not replace it with an interpretation of their own - and therefore cannot disturb as an

Appellate Case: 09-2625 Page: 13 Date Filed: 05/12/2010 Entry ID: 3663711
-14-

abuse of discretion the challenged benefits determination.” Darvell, 597 F.3d at 935

(citation omitted).

All five Finley factors support ARIC’s interpretation of the Plan. First, the

requirement of objective medical evidence of disability is not only consistent with the

language of the Plan, but also is expressly required for short-term disability eligibility.

Second, the substantive and procedural requirements of ERISA do not prohibit a plan

administrator from asking for a certain quality or quantity of information from

claimants. Third, ARIC’s interpretation does not render any language in the plan

meaningless or internally inconsistent. Fourth, ARIC’s interpretation is consistent

with the Plan’s goal “to provide [its employees] with income replacement in the event

[an employee is] unable to perform some or all of [his or her] job duties due to a

Medically Certified Health Condition that extends beyond the STD elimination or

waiting period.” This goal is consistent with the requirement of requiring objective

evidence, as such a requirement will allow only claimants who are unable to perform

some or all job duties with income replacement. Finally, Manning submitted no

evidence suggesting that ARIC does not require all applicants for short-term benefits

to provide objective medical evidence of disability.

C. Summary Judgment was Appropriate on the ERISA Retaliation and

Interference Claims.

Section 510 of ERISA makes it unlawful for an employer to discharge a

participant in an employee benefit plan “for exercising any right to which he is

entitled under the provisions of an employee benefit plan” (retaliation) or “for the

purpose of interfering with the attainment of any right to which such participant may

become entitled under the plan” (interference). 29 U.S.C. § 1140. An ERISA-based

retaliation or interference claim can be established through direct evidence, or in the

absence of direct evidence, through the McDonnell Douglas three-part burden-shifting

framework common to Title VII and Age Discrimination in Employment Act cases.

Appellate Case: 09-2625 Page: 14 Date Filed: 05/12/2010 Entry ID: 3663711
-15-

McDonnell Douglas Corp. v. Green, 411 U.S. 792 (1973); Libel v. Adventure Lands

of Am., Inc., 482 F.3d 1028, 1035 n.7 (8th Cir. 2007) (holding because “[plaintiff’s]

ERISA claim is based on alleged circumstantial evidence . . . [the Court analyzes the

claim] under the McDonnell Douglas framework.”) (citing Kinkead v. Sw. Bell Tel.

Co., 49 F.3d 454, 456-57 (8th Cir. 1995). Under this framework, if a claimant is able

to establish a prima facie case of a section 510 violation, the burden shifts to the

employer to articulate a legitimate, nondiscriminatory reason for its action. Rath v.

Selection Research, Inc., 978 F.2d 1087, 1089 (8th Cir. 1992). If the employer does

so, then the burden shifts back to the claimant to prove that the proffered reason is

pretextual. Id. at 1089-90.

Manning provided no direct evidence that ARIC terminated her either in

retaliation for making an ERISA benefits claim or in interference with any right to

attain future benefits. Manning argues that ARIC’s August 29, 2005 letter constitutes

direct evidence of a section 510 violation, claiming it presented her with a “Hobson’s

choice,” in which she had to choose between relinquishing her short-term disability

claim and giving up her job. See Lindemann v. Mobil Oil Corp., 141 F.3d 290, 298

(7th Cir. 1998). However, by its own terms the letter did not require Manning to make

such a choice. Rather, the letter communicated that she could still receive benefits for

the time period between April 26 and August 31 if she either reported for work with

a note from an Approved Health Care Provider certifying medical ability to work, or

she did not report for work and produced a note from an Approved Health Care

Provider containing objective medical evidence supporting her short-term disability

claim. According to ARIC’s policy, obtaining a work release would not have

prevented Manning from continuing to pursue her short-term disability claim. The

record contains no direct evidence that ARIC ordered Manning to give up her past

short-term disability benefits claim or risk termination. Additionally, section 510 does

not prevent ARIC from implementing and executing legitimate business interests

under ERISA, such as terminating an employee due to job abandonment or excessive

absenteeism. Id. (“[S]ection 510 is not intended to prevent an employer from firing

Appellate Case: 09-2625 Page: 15 Date Filed: 05/12/2010 Entry ID: 3663711
-16-

an employee due to excessive absenteeism which ultimately harms productivity, but

to prevent that employer from discharging or harassing an employee with the specific

intent of preventing the employee from obtaining vested pension rights.”). 

ARIC’s request for a medical certification form does not constitute direct

evidence of a section 510 violation, as such a request does not establish a causal link

between the alleged discriminatory animus and the challenged decision denying

benefits. See Krensavage v. Bayer Corp., 314 Fed. Appx. 421, 426 (3d Cir. Jan. 22,

2008) (affirming summary judgment on a section 510 claim because “[t]he undisputed

facts [were] that [the employee] did not receive medical clearance to return to work

. . .”). Therefore, to have her section 510 claim survive summary judgment, Manning

must establish a prima facie case under the McDonnell Douglas framework. 

To establish a prima facie case of ERISA retaliation, Manning must prove: (1)

she participated in a statutorily protected activity (i.e., making a reasonable claim for

ERISA benefits); (2) an adverse employment action was taken against her; and (3) a

causal connection existed between her participation in a statutorily protected activity

and an adverse employment action. See Curby v. Solutia, Inc., 351 F.3d 868, 871 (8th

Cir. 2003). Here, it is undisputed that Manning has satisfied the first two elements,

so she can establish a prima facie case of retaliation if she has demonstrated a causal

connection between her application for ERISA benefits and her termination. See

Kinkead, 49 F.3d at 456. A causal connection may be based upon circumstantial

evidence. Id.

Manning cites the following as evidence showing the existence of a causal

connection: (1) ARIC required a medical release from Manning’s Approved Health

Care Provider before she could return to work; (2) this requirement was not pursuant

to a written policy; and (3) ARIC's unwritten policy constitutes a post-hoc justification

for termination. However, none of this demonstrates that ARIC terminated Manning’s

employment because she sought short-term disability benefits. As discussed above,

Appellate Case: 09-2625 Page: 16 Date Filed: 05/12/2010 Entry ID: 3663711
-17-

that ARIC required Manning to obtain a work release prior to returning from a fourmonth absence is not evidence of ERISA retaliation. This was not an illegitimate

requirement under the circumstances. Therefore, the district court properly held that

Manning failed to present a prima facie case of retaliation under section 510.

To establish a prima facie case of ERISA interference, Manning must show that

(1) ARIC subjected her to an adverse employment action; (2) Manning was likely to

receive future benefits; and (3) a causal connection existed between the adverse action

and the likelihood of future benefits. See Fischer v. Anderson Corp., 483 F.3d 553,

556 (8th Cir. 2007). In order to establish a claim for interference with prospective

benefits, Manning must prove that ARIC possessed “a specific intent to interfere” with

her ERISA benefits. See Pendleton v. QuikTrip Corp., 567 F.3d 988, 992 (8th Cir.

2009) (citing Register v. Honeywell Fed. Mfg. & Techs., LLC, 397 F.3d 1130, 1137

(8th Cir. 2005)).

Manning admitted that she was ineligible for long-term disability benefits

because she was released to return to work in October 2005. Because Manning was

never eligible for long-term disability benefits, she cannot establish a prima facie case

of ERISA interference. See Feldman v. Am. Mem’l Life Ins. Co., 196 F.3d 783, 792

(7th Cir. 1999) (affirming summary judgment denying claim because plaintiff was not

a member of the protected class for long-term disability benefits).

Assuming arguendo that Manning had presented a prima facie section 510 case,

the McDonnell Douglas framework would require ARIC to provide a legitimate,

nondiscriminatory reason supporting Manning’s termination. See Rath, 978 F.2d at

1089. As the reason for termination, ARIC cited Manning’s absenteeism for four

months without any form of recognized leave. Absenteeism constitutes a legitimate,

non-discriminatory reason for termination. See Kinkead, 49 F.3d at 456; see also

Godfrey v. BellSouth Telecommc’ns. Inc., 89 F.3d 755, 759 (11th Cir. 1996) (noting

that “an employer may demand that an employee return to work after determining that

Appellate Case: 09-2625 Page: 17 Date Filed: 05/12/2010 Entry ID: 3663711
-18-

the employee is not disabled, and then discipline the employee for unexcused

absences”). 

Because ARIC provided a legitimate, non-discriminatory reason supporting

Manning’s termination, the burden would shift to Manning, under the McDonnell

Douglas analysis, to demonstrate that ARIC’s purported reason for her termination

was pretextual. See Pendleton, 567 F.3d at 992. Manning failed to generate any

genuine issue of material fact that ARIC’s stated reasons for her termination were

pretextual. Manning’s assertion that ARIC retaliated or interfered is based solely on

conjecture and undermined by the record. See Jefferson v. Vickers, Inc., 102 F.3d

960, 964 (8th Cir. 1997) (a plaintiff cannot prove an ERISA claim through “mere

conjecture.”). As a result, the district court properly held that ARIC’s reason for

terminating Manning’s employment was not pretext for retaliation or interference

under ERISA.

For the foregoing reasons, we affirm the judgment of the district court.

______________________________

Appellate Case: 09-2625 Page: 18 Date Filed: 05/12/2010 Entry ID: 3663711