Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alsd-2_06-cv-00850/USCOURTS-alsd-2_06-cv-00850-0/pdf.json

Parties Involved:
International Paper
Defendant
Ollie McWilliams
Plaintiff

Document Text:

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

OLLIE MCWILLIAMS, )

 )

Plaintiff, )

 )

v. ) CIVIL ACTION 06-0850-WS-C

 )

RETIREMENT PLAN OF )

INTERNATIONAL PAPER, )

 )

Defendant. )

ORDER 

This matter is before the Court on the defendant’s motion for summary judgment. 

(Doc. 20). The parties have filed briefs and evidentiary materials in support of their

respective positions, (Docs. 21-23, 25-27), and the motion is ripe for resolution. After

carefully considering the foregoing, the Court concludes that the motion for summary

judgment is due to be denied.

BACKGROUND

 The plaintiff was employed by International Paper Company for a number of

years. In August 2004, he applied for disability retirement benefits, which the defendant

denied. In the one-count amended complaint, brought pursuant to ERISA, the plaintiff

seeks a declaration that he is entitled to disability retirement benefits and accompanying

relief. (Doc. 7).

DISCUSSION

The controlling definition of disability is provided in plan documents as follows:

“Disability” or “Disabled” means a total disability which is a medically

determinable physical or mental impairment or diagnosed terminal illness 

which renders the Participant incapable of performing any occupation or

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The plaintiff points to an alternate definition that limits the inquiry to the

employee’s ability to perform the duties of his current position. (Doc. 25 at 12 (citing

Doc. 22, Exhibit B at Plan 0016)). That definition, however, by its terms applies “unless

otherwise defined in a Benefit Schedule.” The definition quoted in text appears in

Benefit Schedule A-1, which schedule applies to the plaintiff’s place of employment. 

(Doc. 22, Exhibit B at Plan 0075). 

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The plaintiff did not claim to be disabled, in whole or in part, by any mental

condition. (Doc. 22, Exhibit C at McWilliams 0009, 0014-15).

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employment for which the Participant is qualified by education, training 

or experience and which is likely to be permanent during the remainder of 

the Participant’s life .... 

(Doc. 22, Exhibit B at Plan 0075).1

The parties agree that the Court’s standard of review is “pure” arbitrary and

capricious review. (Doc. 21 at 14; Doc. 25 at 11). The defendant asserts that a decision

is arbitrary and capricious under this standard if it is not “reasonable,” (Doc. 21 at 13-14),

and the Court utilizes the defendant’s definition. The defendant argues that its decision to

deny benefits was not merely reasonable but correct. (Id. at 15-21). 

In support of its position, the defendant notes that nine health care professionals

(“HCPs”) “reviewed plaintiff’s claim and each concluded that plaintiff’s alleged

psychiatric and physical impairments failed to render him totally disabled as defined by

the Retirement Plan.” (Doc. 21 at 16). There is in this assertion a considerable degree of

exaggeration. For example, Dr. Miller rendered no opinion as to disability but instead

“deferred [his opinion] based on incomplete information available.” (Doc. 22, Exhibit C

at McWilliams 0041, 0043). Dr. Mansheim concluded the plaintiff was not disabled, but

his limited opinion was that “[n]o psychiatric symptoms are reported which would

preclude the claimant from functioning occupationally ...” (Id. at McWilliams 0045-46,

0047 (emphasis added)). Likewise, Dr. Palmer concluded the plaintiff was not disabled

but limited his opinion to the absence of “psychiatric limitations to prevent him from

working.” (Id. at McWilliams 0053-54 (emphasis added)).2

 Physical therapist Nichols

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and industrial rehabilitation coordinator Obranovich, in their functional capacity

evaluation, concluded only that the petitioner could perform in the “light work” category,

without expressing an opinion as to disability. (Id. at McWilliams 0070). 

The plaintiff complains about these and other apparent imperfections in the

defendant’s decision, but only one need be addressed in order to resolve the pending

motion. As noted, the definition of disability includes the requirement that the employee

be unable to perform any occupation or employment “for which [he] is qualified by

education, training or experience.” That is, it is not enough to conclude (as several HCPs

did) that the plaintiff remains capable of performing sedentary (or, according to one

report, light) work. Such a conclusion, to the extent it is sound, shows only that the

plaintiff can perform the exertional requirements of a category of jobs described by the

Dictionary of Occupational Titles. The opinions of Drs. Mansheim and Palmer, to the

extent sound, show only that the plaintiff has no psychiatric problem that would interfere

with his ability to work. What remains to be considered is whether the plaintiff, given his

education, training and experience, is qualified to perform some job in the sedentary (or,

perhaps, light) work category. 

The defendant was plainly aware that this was a separate consideration. In the

functional assessment form it sent the plaintiff’s treating physician, the defendant first

asked the physician to identify the exertional category into which the plaintiff fell. The

form then asked, in a separate question, “Does the claimant have the qualification by

reason of education, training, or experience to perform the limited sedentary duties for

which he/she is physically capable [?]” (Doc. 22, Exhibit C at McWilliams 17). 

The defendant nevertheless ignored this aspect of the disability determination in its

opening brief. Instead, it assumed that the HCPs’ determinations as to the plaintiff’s

exertional level, and their conclusions that the plaintiff had no relevant psychiatric

problem, of themselves satisfied the disability definition. (Doc. 21 at 16-18). After the

plaintiff raised the issue in his responsive brief, the defendant addressed it in reply,

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offering these arguments: (1) the HCPs were “fully aware of the plaintiff’s training,

education and experience” when they rendered their opinions that the plaintiff was not

disabled; and (2) under the relevant case law, the defendant was not required to obtain

vocational evidence. (Doc. 27 at 6-10). The Court addresses these arguments in turn.

None of the HCPs on which the defendant relies expressly found the plaintiff

qualified to perform some occupation or employment at the sedentary (or light) exertional

level. Only Dr. Mansheim mentioned the requirement at all, and he made clear that he

was expressing no opinion on the issue. (Doc. 22, Exhibit C at McWilliams 0045-46 (the

plaintiff reported no psychiatric symptoms that would preclude him from working “at any

level for which he is adequately prepared by virtue of education, training or

experience”)). Nichols and Obranovich refused to identify “possible types of work the

claimant would be able to perform,” precisely because they had insufficient information

about job requirements. (Id. at McWilliams 0078).

The defendant is left to rely on at least three assumptions: (1) that the HCPs opined

sub silentio that the plaintiff is qualified to perform some occupation or employment at a

given exertional level; (2) that they had sufficient information about the plaintiff’s

education, training and experience, and about the non-exertional requirements of various

jobs, to do so; and (3) that the defendant relied on the HCPs’ unstated opinions in denying

benefits. The defendant has identified, and the Court can find, no evidence to support any

of these propositions.

As to the first proposition, the defendant appears to suggest that, because the HCPs

were provided the definition of disability and concluded that the plaintiff is not disabled,

they must have concluded that he was qualified to perform jobs within a given exertional

category (since that is part of the definition of disability). (Doc. 27 at 7-8). As noted

above, three HCPs offered no opinion that the plaintiff was disabled, and two did so

based solely on psychiatric criteria. The remaining four HCPs made it plain in their

reports that they did not consider whether the plaintiff is qualified to perform jobs in any

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residual exertional category. Dr. Eng opined only that “Mr. McWilliams would not be

considered totally disabled based upon the plan definition of disability as provided, as he

would be capable of performing work within the sedentary category.” (Doc. 22, Exhibit

C at McWilliams 0063) (emphasis added). Nurse Beastrom concluded the plaintiff was

not disabled “PER MEDICAL AND BEHAVIORAL HEALTH IME’s [of Drs. Palmer

and Eng],” (id. at McWilliams 0069), so her opinion goes no further than theirs. Dr.

Pachman and Nurse Christensen, in their joint report, noted the absence of a psychiatric

disability and the plaintiff’s ability to perform the exertional requirements of sedentary

and/or light work and concluded that, “[a]s a result, I am unable to recommend that the

applicant be considered to be permanently and totally disabled ....” (Id. at McWilliams

0088) (emphasis added). 

As to the second proposition, while it appears that some of the HCPs had access to

some information about the plaintiff’s background, there is no suggestion that any of the

HCPs had information about the non-exertional requirements of any job or jobs in the

sedentary or light exertional categories. There is certainly no reason to assume a priori

that a psychiatrist, physiatrist, occupational clinical psychologist, or R.N. is sufficiently

conversant in such matters to offer a credible opinion. The only HCPs whose job titles —

physical therapist and industrial rehabilitation coordinator — might suggest such

familiarity expressly disavowed any opinion as to the plaintiff’s ability to perform

particular jobs. (Doc. 22, Exhibit C at McWilliams 0078). 

As to the third proposition, the defendant has identified no evidence that it relied

on any supposed medical opinion that the plaintiff is qualified by reason of education,

training or experience to perform any light or sedentary employment. On the contrary,

the defendant’s internal notes reflect that benefits were denied simply because the

plaintiff “was deemed capable of light or sedentary work.” (Doc. 22, Exhibit C at

McWilliams 0007). After the plaintiff appealed the decision, the defendant’s internal

notes reflect that the appeal was denied because the plaintiff again “was deemed capable

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of light or sedentary work.” (Id. at McWilliams 0101). There thus appears to be no

evidence that the defendant — either in review of the HCPs’ opinions or on its own —

considered whether the plaintiff was qualified by education, training or experience to

perform any jobs in a residual exertional category. 

This leaves the defendant to its fallback argument: that the case law allowed it to

deny benefits without vocational evidence. In Duhon v. Texaco, Inc., 15 F.3d 1302 (5th

Cir. 1994), the Court stated it “will not hold that absent vocational rehabilitation evidence

a plan administrator necessarily abuses his discretion in making a final determination of

disability.” Id. at 1309. “Instead, we will allow the reviewing court to decide, on a caseby-case basis, whether under the particular facts the plan administrator abused his

discretion by not obtaining the opinion of a vocational rehabilitation expert.” Id. The

defendant reads Duhon for the proposition that, whenever there is “clear evidence of

record” that the plaintiff can perform light and sedentary work, vocational evidence is

unnecessary. (Doc. 27 at 8-9). 

The applicability of Duhon to this case remains unclear. First, of course, it is not a

decision of the Eleventh Circuit. Second, the definition of disability at issue in Duhon

was more lax than that in this case. In Duhon, an employee could not be disabled if he

“may become” qualified for another job, which definition precluded disability if the

employee, although presently unqualified for any job, could become qualified in the

future by training or otherwise. Here, in contrast, an employee is disabled unless he is

currently qualified for another job, and the possibility of future qualification (which

typically would expand the range of available jobs) is irrelevant. 

Ultimately, Duhon is unhelpful to the defendant because it addresses a different

situation. In Duhon, the plan administrator “conclude[d] that [the plaintiff] would be able

to perform the functions of some identifiable job,” albeit without identifying any

particular such job. 15 F.3d at 1308. That is, the defendant addressed the element of

qualification for another job and resolved it adversely to the employee. Here, as noted

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That the plaintiff has been found to be disabled by the Social Security

Administration, (Doc. 22, Exhibit C at McWilliams 94), does not bolster the defendant’s

argument that its decision was correct.

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above, the evidence suggests that the defendant never considered whether the plaintiff

was qualified for another job but based its decision solely on the plaintiff’s residual

exertional category and his lack of psychiatric disability. (Doc. 22, Exhibit C at

McWilliams 0007, 0101). While Duhon excuses the failure to obtain specific vocational

evidence in some cases, it does not purport to excuse the failure to address the

requirement of qualification for another job altogether. Nor has the defendant attempted

to show that the Eleventh Circuit upholds denials of benefits when the administrator has

failed to address an essential aspect of such a determination. 

CONCLUSION 

Because the defendant has not offered evidence that the plaintiff is qualified by

education, training or experience for a job within his residual exertional capacity, it has

not met its initial burden on motion for summary judgment of showing that its decision

was correct.3

 Because the defendant has left critical legal and factual issues unanswered,

it has not met its initial burden of showing that its decision was reasonable. Because of

these deficiencies, the Court need not reach the plaintiff’s other arguments.

For the reasons set forth above, the defendant’s motion for summary judgment is

denied.

DONE and ORDERED this 17th day of September, 2007.

s/ WILLIAM H. STEELE

UNITED STATES DISTRICT JUDGE

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