REVISED, July 22, 1998

IN THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

No. 97-31029

GREGORY A. TOLSON,

Plaintiff-Appellant,

versus

AVONDALE INDUSTRIES, INC.,

AVONDALE INDUSTRIES, INC.,

SHIPYARDS DIVISION, AVONDALE

HEALTH PLAN AND AVONDALE

INDUSTRIES, INC., SHIPYARDS

DIVISION, GROUP INSURANCE PLAN,

Defendants-Appellees.

Appeal from the United States District Court

for the Eastern District of Louisiana

June 3, 1998

Before WIENER, BARKSDALE and DEMOSS, Circuit Judges.

WIENER, Circuit Judge.

In appealing from the district court’s summary judgment that

dismissed his claims for medical and long-term disability benefits1 Employee Retirement Income Security Act of 1974, 29 U.S.C.

§ 1001 et seq.

2 under two ERISA 1 plans sponsored by his employer, PlaintiffAppellant Gregory A. Tolson insists that the court erred in thus

rejecting his claims for benefits and for breach of fiduciary duty

as well as in assessing court costs against him. The thrust of

Tolson’s argument is that the costs of treatment for his depression

should have been covered by the Avondale Industries, Inc. Shipyards

Division Avondale Health Plan (the “AHP”), and that benefit s for

the disability that resulted from such depression should have been

paid under the Avondale Industries, Inc. Shipyards Division Group

Insurance Plan (the “GIP”). Tolson argues that, despite the

express, unambiguous limitations on coverage of “mental and nervous

conditions” by these plans, he should nevertheless be covered

because his depression was secondary to or caused by his Hepatitis

C or by the Interferon treatment for that condition and was

therefore “ unusual.” More particularly, Tolson insists that the

plan administrator for the AHP and the GIP (collectively, “the

Plans”) erred in its legal interpretation of the Plans’ provisions

and abused its discretion in denying Tolson benefits under the

Plans. According to Tolson, this occurred when the administrator

treated his depression as a mental or nervous condition or disorder

instead of recognizing that the Hepatitis C/Interferon-caused

depression fit a narrow exception that Tolson perceives this court

to have recognized in Lynd v. Reliance Standard Life Insurance2 94 F.3d 979 (5th Cir. 1996).

3 Co.

. 2 Tolson reads some dicta in L ynd to forecast the possibility

that some day there might be an unusual case in which treatment of

a mental disorder is necessitated by, and disability is caused by,

something other than the cause of most other kinds of debilitating

depressive conditions. And, of course, Tolson asserts that his is

that unusual case. Disagreeing with Tolson’s reading of Lynd , we

affirm the summary dismissal of Tolson’s action and the taxing of

costs to him.4 I

FACTS AND PROCEEDINGS

Despite Tolson’s insistence to the contrary, the material

facts of this case are undisputed. Tolson was employed by Avondale

f rom 1981 through April 1987 and was a participant in and a

qualified beneficiary of the Plans. He was diagnosed in December

1994 by Dr. Robert Perillo, a liver specialist at New Orleans’

Ochsner Clinic and an approved medical provider under the AHP, as

having “moderate chronic Hepatitis C, with mild but definite

chronic active component.” Tolson was successfully treated by

Dr. Perillo in an experimental program using Interferon-Alpha 2a,

and the AHP paid for all eligible medical charges and prescription

drugs. The following May, Tolson applied to the GIP for weekly

disability benefits on the basis of a statement from Dr. Perillo

that Tolson suffered “Interferon-induced adverse effects (insomnia,

fatigue) causing temporary disability.” Following the GIP’s

approval of his application, Tolson started receiving w eekly

disability benefits. In August 1995, Tolson applied to the GIP for

long-term disability benefi ts based on his chronic Hepatitis C.

Four da ys later Tolson was released by Dr. Perillo to return to

work. Even though the physician’s statement said that Tolson was

not totally disabled, he was approved for long-term benefits for 21

days, being the number of days between the end of his 90-day

elimination period and the date of his return to work. Tolson

received no other long-term disability benefits under the GIP.5

T he recommencement of Tolson’s work was unremarkable until

March 1996, when Dr. Gerald Heintz, a psychiatrist with Ochsner to

whom Tolson had been referred by Dr. Perillo, diagnosed Tolson as

suffering from “major depress ion” and treated him for that

condition. According to Tolson, his depression is a secondary

symptom resulting directly from his Hepatitis and the Interferon

treatment he received for it.

The following month, almost eight months after he had returned

to work from disability leave, Tolson quit his job. He blamed his

depression for his inability to continue working.

The entire documentation for each of the Plans is contained in

its Summary Plan Description (“SPD”); there are no separate trust

indentures. The AHP provides comprehensive health care benefits

for eligible employees and their beneficiaries, covering medical

costs incurred in conformity with that plan’s requirements. In the

AHP, coverage of treatment of men tal conditions is limited as

follows:

a) Introduction:

Note in particular that covered treatment for Mental and

Nervous conditions or Substance Abuse will be prov ided

only by West Jefferson Behavioral Medicine Center

[”WJBMC”].

b) Benefit Limitations:

Note: Cover a ge for Mental and Nervous conditions is

p rovided ONLY by [WJBMC] and is subject to different

limitations, deductibles and co-payments.

c) Summary of Benefits:6

In order that treatment for mental and nervous conditions

be covered by the [AHP], treatment must be pre-certified

and provided by [WJBMC]. There is no plan benefit for

services received from other sources.

Parallel provisions limiting coverage of disability by reason

of mental conditions under the GIP are as follows:

a) Weekly disability Benefits (NonOccupational) - Benefit Limitations

. . . .

Also, benefits will not be payable for disability because

of mental or nervous disorders unless hospitalized. If

hospitalized, then later discharged, benefits will not

continue beyond 30 days following discharge.

b) Long-Term Disability Benefits

-

Benefit

Limitations

. . . .

Also, benefits will not be payable for disability because

of mental or nervous disorders, unless hospitalized. If

hospitalized, then later discharged, benefits will not

continue beyond 30 days following discharge.

Both plans establish an ERISA Review Committee (the “ Committee”)

and endow the Committee with discretionary powers to interpret the

terms of the Plans and to evaluate claims for benefits. Among

other things, those provisions specify that the Committee has “sole

and exclusive discretion and power to grant and/or deny any and

all cla ims for benefits, and construe any and all issues of Plan

interpretation and/or facts or issues relating to eligibility for

benefits.” “All findings, decisions, and/or determinations of any

type made by the [Committee] shall not be disturbed unless the

[Committee] act(s) in an arbitrary and/or capricious manner or3 Tolson attempts to skirt the problem of having been treated

by a non-approved referral provider, first by urging that his

referral to Dr. Heintz by Dr. Perillo should be sufficient and,

second, by stating that the original administrative record does not

contain a list of approved referral providers, the latter

contention being countered by the Plans which point out that the

subject list was presented to the court in an exhibit to their

reply brief.

7 abuses the discretion and powers conferred by the Plan’s sponsor.”

Aft er he quit working, Tolson claimed coverage of his

treatment for a “major depressive disorder” and sought disability

benefits on that basis as well. As no part of Tolson’s treatment

for depression took place at WJMBC, the plan administrator for the

AHP denied his claim for psychological treatment. Similarly, his

application to the GIP for long-term disability benefits was denied

because he wa s never hospitalized for his depression. An

additional road block to Tolson’s coverage is the fact that Dr.

Heintz is not on the list o f approved referral providers. 3

Tolson’s claim for coverage of psychological treatment was denied

because it was not pre-certified and none of it was provided by

WJBMC. Likewise, his claim for disability benefits was denied

because he was never hospitalized for his nervous or mental

condition. The Plans classified Tolson’s claims as stemming from

a distinct and separate “mental or nervous disorder or condition,”

terms that, Tolson notes, are not defined in the Plans. He

appealed the denial of his claim, but the Commi ttee unanimously

upheld denial.

Tolson sued in March 1997, alleging wrongful denial of4 FDIC v. Myers , 955 F.2d 348, 349 (5th Cir. 1992).

8 benefits or, in the alternative, breach of the fiduciary duty to

avoid misrepresenting the terms of av ailable coverage. His

complaint asserted that he was improperly denied payment of medical

c laims in connection with his treatment for depression under the

AHP, and was improperly denied payment of disability benefits under

the GIP. He grounded his alternative breach of fiduciary claim in

the alleged misrepresentation of the terms of the Plans, both of

which are employee welfare benefit plans governed by ERISA.

After some preliminary procedural skirmishing, which included

the Plans’ filing a motion to dismiss and Tolson’s amendment of his

complaint, the defendants filed a motion for summary judgment, and

Tolson filed an opposition. Shortly thereafter, the district court

granted the Plans’ motion and entered judgment dismissing Tolson’s

clai ms and assessing costs to him. Tolson filed a motion for

review of the taxation of costs which the co urt denied. Tolson

timely filed a notice of appeal.

II

ANALYSIS

A. Standard of Review

All grants of summary judgment are reviewed d e novo

. 4

“Whethe r the district court employed the appropriate standard in

reviewing an eligibility determination made b y an ERISA plan5 L ynd

, 94 F.3d 979, 980-81 (citing Chevron Chem. Co. v. Oil,

Chem. & Atomic Workers Local Union 4-447

, 47 F.3d 139, 1 42 (5th

Cir. 1995)).

6 Id. at 981.

7 W ildbur v. A RCO Chem. Co. , 974 F.2d 631, 636 (5th Cir.),

modified , 979 F.2d 1013 (1992). See also Firestone Tire & Rubber

Co. v. Bruch

, 489 U.S. 101, 113-17, 109 S. Ct. 948, 956-57, 103 L.

Ed. 2d 80 (1989).

9 a dministrator is a question of law.” 5 “Therefore, we review the

district court’s decision de novo .” 6 When an ERISA plan vests its

administrator or fiduciary with discretionary authority to

determine eligibility for benefits or to construe the terms or the

plan, or both, our standard of review is abuse of discretion. 7

There is no question but that the language of the AHP and GIP vests

their plan administrator with such authority.

The district court found that the Plans’ language vested the

p lan administrator with sufficient discretion to make abuse o f

discretion the appropriate standard for reviewing the Committee’s

denial of Tolson’s claims for benefits. The district court applied

the de novo standard to reviewing Tolson’s breach of fiduciary

claim.

B. Plan Interpretation

In Wildbur v. ARCO Chemical Co.

, we set forth the appropriate

two-step methodology for testing the plan administrator’s

interpretation of the plan for abuse of discretion:

First, a court must determine the legall y correct

interpretation of the plan. If the administrator did not

give the plan the legally correct interpretatio n, the8 W ildbur

, 974 F.2d at 637-38 (citing Jordan v. Cameron Iron

Works, Inc.

, 900 F.2d 53, 56 (5th Ci r.), c ert. denied

, 498 U.S.

939, 111 S. Ct. 344, 112 L. Ed. 2d 308 (1990 ) (internal citation

omitted).

9 Id.

10 Chevron , 47 F.3d at 146.

10 court must then determine whether the administrator’s

decision was an abuse of discretion. In answering [this]

question, . . . a court must consider:

(1) whether the administrator has given

the plan a uniform construction,

(2) whether the interpretation is

consistent with a fair reading of

the plan, and

(3) any unanticipated costs resulting

from different interpretations of

the plan. 8

Only if the court determines that the administrator did not give

the legally correct interpretation, must the court then determine

whether the administr ator’s decision was an abuse of discretion. 9

We need not proceed to the second step of the Wildbur analysis to

search for abuse of discretion if we determine in applying the

first step that the plan administrator’s leg al interpretation of

the plan provisions is correct. 10

Like the district court before us, we conclude that the plan

administrator correctly interpreted the pertinent provisions of the

Plans. The first element of the first W ilbur step—— uniformity of

construction —— is neutral here, as the applicable provisions of

the Plans have not previously been interpreted in light of claims11

like Tolson’s.

The second element of the first step of W ildbur

—— a fair

reading of the plan

—— clearly favors the administrator of the

Plans. Under the AHP, medical costs for the treatment of “mental

and nervous conditions” are covered only if they are (1) precertified, and (2) provided by WJBMC. Under the GIP, neither

weekly nor long -term disability benefits are payable unless the

participant or beneficiary is hospitalized, and even then benefits

continue for on ly 30 days following discharge from the hospital.

Thus, the Wildbur “fair reading” element is met by the Committee’s

determination that AHP limits coverage for mental and nervous

conditions to pre-certified treatment at WJBMC and that GIP limits

disability payments on account of such disorders or conditions to

those for which hospitalization is required. Tolson does not claim

to have complied with these prerequisites.

The third element of the first step of Wildbur likewise favors

the administrator: Any variance from the interpretation placed on

the provisions in the Plans by the Committee wo uld be likely to

produce costs not anticipated by the Plans. All costs of covering

treatment provided by others than WJMBC and all costs of disability

payments to non-hospitalized participants would produce costs not

anticipated by the Plans.

Clearly, then, the le gal interpretation of the terms of the

Plans by the Committee passes the first step of the Wildbur test

——11 Wildbur , 974 F.2d at 637-38.

12 Id.

13 Spacek v. Maritime Ass’n, ILA Pension Plan

, 134 F.3d 283,

292 (5th Cir. 1998).

12 “legally correct interpretation of the plan” 11

—— with flying

colors. Inasmuch as the administrator made the legally correct

interpretation, we are not compelled to proceed to the second step

of Wildbur to determine whether the administrator’s denial of

benefits was an abuse of discretion 12 because under a correct

interpretation “no abuse of discretion could have occurred.” 13

We infer that, despite his argument, Tolson is not really

disagreeing with the legal interpretation of the Committee that

coverage of treatment costs for nervou s or mental disorders are

predicated on pre-certification and treatment at WJBMC, a nd that

payments for long-term di sability caused by such disorders are

predica ted on hospitalization. Rather, we understand Tolson’s

argument to be that payments for the treatment of his “unusual”

kind of depression and benefits for his “unusual” disability do not

properly come within th e undefined terms “mental and nervous

conditions” or “mental or nervous disorders,” as used respectively

in the AHP and the GIP, because his depression is secondary to and

caused by his hepatitis and the treatment of it with Interferon.

Tolson would have us conclude that his depression is part and

parcel of his hepatitis and its Interferon treatment, and thus

should not be restricted by the coverage limitations for mental or14 L ynd

, 94 F.3d at 983 (quoting Brewer v. Lincoln Nat’l Life

Ins. Co.

, 921 F.2d 150, 154 (8 th Cir. 1990), c ert. denied

, 501

U. S. 1238, 111 S. Ct. 2872, 115 L. Ed. 2d 1038 (1991)).

13 nervous disorders or conditions. He contends that, for purposes of

the Plans, his treatment for depression and his depression-caused

disability should receive the same coverage as is afforded to his

hepatitis. It is for this proposition that he relies on L ynd as

creating a narrow exception for those instances —— such as his ——

when a traditiona l mental or nervous disorder is not a mental or

nervous disorder within the intendment of the Plans. This reliance

is badly misplaced.

In Lynd , we expressly held that depression is a “mental

disorder,” irrespe ctive of its physical causes or symptoms. As

noted earlier, we cannot read the holding in Lynd

—— even its dicta

—— to admit o f a situation (and Tolson claims that his is such a

situation) that would be a narrow exception to the universal

conclusion that depression is a mental disord er or nervous

condition. Try as we may, we can discern no such proposition in

the Lynd opinion.

Indeed, we concluded in Lynd that the appropriate standard for

interpret ing ERISA plan terminology is its ordinary meaning, not

specialized meanings. 1 4 We have already noted that here the SPDs

are the only substantive plan documents. And, SPDs are required by

law to be couched in ordinary, conversational language that is

understandable by lay participants. This realization explains not15 Id. at 984.

14

only the absence of definitions of the terms at issue here but also

the propriety of the Committee’s implicit conclusion that, in the

contemplation of the Plans, Tolson’s depression is a mental or

nervous condition or disorder.

In discussing the physical symptoms of mental disabilities in

Lynd , we stated:

If we begin with the premise that the cause of a

disability is “mental”

—— an d the Eighth and Ninth

Circuits, as well as the American Psychiatric

Association, characterize “depression” as a “mental”

disorder

—— then to find that a disability falls outside

of the term “mental disorder” (as used in an ERISA plan)

because the disability has “physical” symptoms would

render the term “mental disorder” obsolete in this

context. As the ERISA plan in the instant case pointedly

refers to “mental or nervous d isorders,” it would be

inappropriate to effectively collapse the term “mental

disorder” to include only those illnesses, if any exist,

which have no “physical” manifestations. 15

The converse is equally true: Simply because a medical problem and

an ensuing disability are produced by depression (a stereotypical

mental condition or disorder) that is itself the product of a

pathological disease (Hepatitis) or of the medication used to treat

such a disease (Interferon), the fact is not altered that the

depression is and remains a mental disorder or condition. It

follows inescapably that (1) coverage of the costs of treating that

depression, like treating of any depression, is subject to the precertification and WJBMC limitations of the AHP, and (2) payment of

benefit s for disability produced by that depression, like16 Spacek , 134 F.3d at 292.

15 disability produced by any nervous or mental disorder, is subject

to the hospitalization limitations of the GIP.

Again, as the Committee sa tisfied the first step of the

W ildbur test by making the legally correct interpretation of the

Plan, we never reach the s econd, abuse of discretion step. A

determination that a plan administrator’s interpretation is legally

correct pretermits the possibility of abuse of discretion. 16

C. Breach of Fiduciary Duty

Tolson’s efforts to justify assertion of breach of a fiduciary

duty claim against the Plans by distinguishing such a claim from

his claims for cove rage and benefits claims are woefully

unavailing. If they are distinctions at all, they are without

differences. This was succinctly and correctly explained by the

district court:

Because Tolson has adequate redress for disavowed claims

through his right to bring suit pursuant to section

1132(a)(1), he has no claim for breach of fiduciary duty

un der section 1132(a)(3). Section 1132(a)(2) allows a

beneficiary to bring a standard breach of fiduciary duty

suit for the benefit of the subject plan. M assachusetts

Mut. Life Ins. Co. v. Russell

, 105 S. Ct. 3085 (1985).

In Varity Corp. v. Howe

, 116 S. Ct. 1065 (1996), the

Supreme Court interpreted section 1132(a)(3) to allow

plaintiffs to sue for breach of fiduciary duty for

personal recovery when no other appropriate equitable

relief is available. Because Tolson has adequate relief

available for the alleged improper denial of be nefits

through his right to sue the Plans directly under section

1132(a)(1), relief through the application of Section

1132(a)(3) would be inappropriate.

Unlike the plain tiffs in V arity

, Tolson was the17 The district court relied in part —— correctly, we conclude

—— on Wald v. Southwestern Bell Corp. Customcare Medical Plan

, 83 F.3d 1002 (8th Cir. 1996) (determining that plaintiff failed to

state a cause of action for breach of fiduciary duty in reviewing

claim as she sought no different relief than that available under

claim for benefits under another section of ERISA).

18 We have also carefully considered the other issues and

assignments of error that Tolson ascribes to the rulings of the

district court by reviewing counsel’s appellate brief and hearing

his arguments to the court, including his complaints regarding the

court’s grant of summary judgment and its rulings on discovery. It

suffices that we discern no reversible error in any of the rulings

of the district court.

16 benef iciary of two viable plans whom [sic] he had

standing to sue and did sue. Further, both Plans are

v iable and before the Court. Because this relief was

available and, indeed, utilized, it would be

i nappropriate for the Court to fashion any further

equitable relief under Secti on 1132(a)(3). The simple

fact that Tolson did not prevail on his claim under

section 1132(a)(1) does no t make his alternative claim

under section 1132(a)(3) viable. 17

No purpose would be served by discussing this issue further.

The district court’s analysis is accurate and clear, so we adopt it

as our own. 18

D. Costs

T he district court rejected Tolson’s motion to review and

reverse taxation of costs. The court observed that F.R.C.P. 54(d)

contemplates that costs will be allowed to the prevailing party as

a matter of course unless the court directs otherwise. The Plans

were the prevailing parties and the court di d not “otherwise

direct,” so the Clerk of Court properly taxed costs to Tolson as a

matter of course.

In particular, Tolson objects to the P lans’ seeking19 L ouisiana Power & Light Co. v. Kellstrom

, 50 F.3d 319, 334

(5t h Cir.), c ert. denied

, 516 U.S. 862, 116 S. Ct. 173, 113

L. Ed. 2d 113 (1995).

17 reimbursement of the costs of reproducing the whole administrative

record, insisting that the entire record was not necessary for

summary judgment disposition. Tolson also advances equitable

arguments, contending that his suit was neither frivolous nor

instituted in bad faith because his novel contention is,

essentially, res nova

. He also pleads financial inability to pay.

We agree with the Plans’ contention that the taxing of costs

was routine and appropriate her e

. Given the burgeoning

jurisprudence in this circuit and elsewhere concerning the extreme

deference that courts must give to plan administrators vested with

discretionary authority to interpret plans and to award or deny

benef its, Tolson’s self-proclaimed r es nova argument is more

correctly seen as specious sophistry, approaching frivolousness.

Indeed, plan participants and beneficiaries who continue to mount

attacks such as Tolson’s in the face of such an established body of

law may well find themselves assessed with much more than court

costs. Be that as it may, it suffices here that, as we do not

reverse a district court’s taxation of costs in the absence of

clear abuse of discretion, 19 we will not disturb that assessment

against Tolson.18 III

CONCLUSION

For the foregoing reasons we hold that the legal

interpretation of the pertinent language of the Plans by the plan

administrator was correct, ending the need to continue our review,

(albeit the plan administrator’s determination that Tolson’s

depression was subject to the Plans’ provisions limiting coverage

of nervous or mental conditions or disorders was neither incorrect

nor an abuse of discretion). We also hold that the district court

correctly dismissed Tolson’s breach of fiduciary duty cla ims and

did not abuse its d iscretion in taxing costs to Tolson. For

essentially the same reasons, we assess costs of this appeal to

Tolson and caution him

—— and future ERISA plan participants and

beneficiaries similarly situated

—— that fomenting and prosecuting

litigation of this ilk in the face of plan provisions vesting

administrators with disc retion to interpret provisions of ERISA

plans and entitlement to benefits under such plans, could result in

sanctions more stringent than mere assessment of costs, including,

without limitation, attorneys’ fees and double costs under F.R.A.P.

38 for frivolously appealing adverse dispositions of the district

court. The judgment of the district court is

AFFIRMED at appellant’s cost.