FI L ED U.S. COURT OF A P P E A LS E LE V E N T H C IR C U IT J AN 07 2008 THOMAS K. KAH

N CL ERK [PUBLIS H] IN THE UN ITED STATES COURT OF APPEALS FO R T HE EL EV EN TH CIRC UI T

____ ____ ____ ____ ____ ____ N o. 07- 1034 8

____ ____ ____ ____ ____ ____ D. C. Docket N o. 05-00133 CV -3-RV -E MT ROBIN DOYLE, Pl ai nti ff -Appe llant,
ve rs us LIBERTY LIFE ASSURANCE COM PANY OF BOSTON, De fendant-Appellee.

____ ____ ____ ____ ____ ____ Appeal f rom the United State s District Court fo r the N orthe rnD istri ct

of F lor ida

____ ____ ____ ____ ____ ____ (J an ua ry 7, 200 8) Be fo re BI RC H , BA RKE T T a nd C O X , Ci rc uit Jud ge s. COX , C ircuit Judg e: I. IN TRO DU CTION The principal issue in this ca se is whether the district court applied the corre ct standard of r ev ie w in de te rm ini ng tha t an E RI SAa dm ins tr at or ’ s de ci sio n de ny ing2

be ne fi ts t o aplan be ne fi ci ar y w as not ta int ed by it s c onf lic t of int er es t. W e re ve rs e the dis tr ic t c ourt’ s grant of sum m ar y j udgm en t in fav or of the adm ini str at or be ca use the cour t u s ed t h e wr ong st andard of reviewand because w e cannot say that ap pl ic at io n o f th e p ro pe r st an da rdwou ld y ie ld th e sa m e res ul t.

II . FACTS AND P ROCEDURAL HI STO RY T he P la int if

f, Ro binD oy le , be ga n w orkin g f or Ch oic eP oin t S erv ic es on Fe br ua ry 24, 200 3, a s aRe gis te re d N ur se /C lin ic al I nf orm at ionL ine S peci al ist. ChoicePoint spo nsored for its eligible em ploy ees a long-term

disabilit y (“ LT D” ) be ne fi t pl angov er

ne d by the E m plo y ee Re tir em en t I nc om e Se cu ri ty A ct of 1974 , 29 U
. S. C. § 10 01 et seq . T he D ef en da nt, L ibe rty

L if e A ssu ranc e Co m

pa ny of Bo sto n, in su red th e p la n p ur su an t t o a gro up po li cy , and ad m in is te red th e p la n. O n Janu ary 3 0, 20 04, D oy le f ile d ac la im

w ithCh oic eP oin t f

or dis ab ili ty be ne fi ts unde r the plan, cl ai m ing tha t ana na l f iss ur e, e nlarg ed

int er na l he m or

rh oid s,
an d e xte rn al an al ski n ta gs pr ev en te d he r fr om w orkin g. O n F eb ru ar

y 10, 200 4, she unde rw en t a

f iss ur oto m y a nd s phi nc te ro tom

y in an at te m

pt t o a lle via te the se pr obl em s. L ibe rty L if

e gr an te d D oy le shor

t- te rm dis ab ili ty (“ ST D ”) be ne fi ts thr ough the m ax im

um da te a va ila

ble , May 9, 200 4. While Doy le w as rec eiving STD benefits, L iberty Lif e obta i ned her m edical records to determ ine whether she would qualify for LT D benefits, for which she had3

ap pli ed , af

te r he r ST D be ne fi ts exp ir ed
. A ft er re ce ivi ng m ed ic al r ec or ds f ro m six of Doy le’ s treating phy sici an s , an independent phy sician retained by Liberty Lif e revie w ed he r re co rd s. L ibe rty L if e not if ie d D oy le tha t she w oul d not re ce ive LTD benefit s be cause she did not m eet the “ own occupation” standard of “ disabili ty ” under Ch oic eP oin t’ s L T D pol ic y , w hic h pr ovi de d: Fo r pe rs ons oth er

than pi lot s, c o- pil ots , an d cr ew m em be rs of ana ir cr af

t: a. if t he Co ve red Pers on is eli gi bl e fo r t h e 24 Mo nt h Own O cc upa tio n be ne fi t, “ D isa bil ity ” or “ D isa

ble d” m eans tha t duri ng the E lim ina tio n P er iod

a nd the ne xt 2 4 m onths o f D isa bil ity the Co ve re d P er son, a s ar es ult of I nj ur y or S ic kne ss , i s un ab le to pe rfo rm th e Ma te ria l an d Subs ta nt ia l Du ti es of h is Own O cc upa tio n; and b. the re af

te r, the Co ve re d P er son is unable to pe rf orm , w ith re as ona ble c ont inu ity , the Ma te ri al an d Subs ta nti al D uti es of A ny O cc upa tio n. (R. 2-12 at 6.) A ft er L ibe rty L if e de nie d he r cl ai m

f or L T D be nefi ts, D oy le vis ite d a rh eu m at olo gis t w ho dia gnos ed he r w ith fi br om y al gia
. I n li ght

of thi s ne w dia gnos is, Doy le appealed denial of her c laim
. Liberty Lif e re viewed her

addit i o n al m edical records and received further pee r re view f rom a specialist in internal m edicine. L ibe rty L if e the n uphe ld its de ci sio n de ny ing D oy le be ne fi ts, sta tin g th at she sti ll did
no t m eet th e “ own oc cupa ti on ” st an da rdof “ di sa bi li ty” un de r Ch oi cePo in t’s LTD p o l i c y.Cases in our cir cuit equate the ar bitrary and capricious st andar d with the abuse of discretion 1 standard. See Jett v. Blue Cross & Blue Shield of Ala., Inc. , 890 F.2d 1137, 1139 ( 11th Cir. 1989). 4 Invokin g ERI SA j urisdictio n, 29 U. S. C. § 1132 (a)( 1)(B) , ( e)(1) , D oy le filed thi s a ct iona ga ins t L ibe rty L if e se ek ing r ev ie w of

it s de ci sio n. L ibe rty

L if e fi le d a
m ot io n fo r su m

m ary jud gm en t, wh ic h t he di st ric t co ur t g ran te d. Do y le ap pe al s. III. ERISA F RA MEWORK A ND THE D ISTR ICT C OUR T P ROC EED ING ER ISAdoes not p rom

ulgate standards un der w hich dist rict courts m ust review
an ad m in is tra to r’s de ci si on de nyin g b en efi ts
. Firestone Tire & Rubber Co. v. Bruch , 489 U.S . 101, 109, 109 S. Ct. 948, 953 (198 9). To fill this void , the S uprem e Court he ld i n Bruch that district courts shou ld review de novo benefit decisions m ade by an
a d mi n i s t r a t o r

w h o i s w i t h o u td i s c r e t i o n t o d e t e rmi n e e l i g i b i l i t y o r c o n s t r u e t h e t e rms of an ERISA-g ov ern edpl an . Id

. at 115 , 109 S
. Ct
. a t 95 6. O n th e oth er ha nd, the Co ur t said that where the adm inistrator exercises discretion, def erential (i. e. , arbitrary
an d c ap ri ci ous ) re vie w is ap pr opri at e accor din g to tr ust pr inc ipl es , w hic h gu ide 1
rev ie w o f de ci si on s af

fect in g ERI SA-g ov ern edpl an s. Id

. a t 11 1, 109 S
. Ct
. a t 95 4. Finally , the Court observed that when an adm inistrator w ith discre tion o perates under
a co nf lic t of int er es t, tha t “ co nf lic t m ust be w ei ghe d as a ‘ fa ct or in de term ini ng whether there is an abuse of discretion.’ ” Id

. a t 11 5, 109 S
. Ct
. a t 95 7 ( quot ing Restatem ent (Sec ond) of Trusts § 187 cmt. d (1959)).5

Fo llo w ing Bruch , w e unde rt ook the “ ta sk [of ] de ve lop [i ng] a coh er en t m ethod fo r integ rat ing f

ac tor s su cha s se lf

-i nte re st i nto the le ga l st an da rd f or r ev ie w ing benefits determ ination s.” Brown v. Blue Cross & Blue Shi eld of Ala., Inc. , 898 F
. 2d 1556 , 1561 (1 1th Ci r. 199 0)
. I n Brown , a plan interpretation case, we rea soned th at tru s tp r i n c i p l e s m a n d a t e dt h a ts o m e d e f e r e n t i a l l e v e l o f

r e v i e w ap p l i e s t o b e n e f

i ts de ci sions , id. at 156 8, but r ef use d to appl y

“ hig hly de fe re nti al ” re vie w w he n th e ad m in is tra to r op erat edun de r a co nf li ctof i nt eres t, id. a t 15 62. T hus, w e se ttl ed on
w hat cam e to b e know n a s th e “ he igh te ne d a rb itr ar y a nd c ap ri ci ous standard ” (h er ei na ft er

the “ he igh te ne d st an da rd ”) , the ha llm ar k of w hic h is it s bu rd en -s hif

tin g
re qui re m en t. U nde r thi s sta ndard , “ the bur de n shif ts to the f idu ci ar y to pr ove tha t i ts interpretation of plan provis ions comm itted to its di scretion was not tainted byselfinterest.” Id

. at 1566. W e said t h at an adm inistrator’ s plan interpretation th at

“ advan ce s t h e con flicting interest of the fiduciary at the expense of the af fecte d be ne fi ci ar

y ” w as a rb itr ar

y a nd c apri ci ou s, unl es s th e adm ini str at or “ j ust if ie s th e int er pr et at ionon the gr oun d of i ts b en ef it to the c la ss o f al l part ic ipants a nd beneficiarie s.” Id

. at 1 56 7. Our m ore re cent cases c ondens e the holdin gs of Bruch a nd Brown into a 6-step
an al y sis to gui de dis tr ic t c ourts i n r ev ie w ing a n a dm ini str at or ’s d ecisionto de ny be ne fi ts:6

(1 ) A ppl y

the de nov o st an da rd

to de te rm ine w he the r the c la im adm inistrator’ s benefits-denial decision is “ wro n g ” (i.e ., the court dis ag re es w it h th e adm ini str at or ’ s de ci sio n) ; i f it is n ot, the n e nd the in qu iry and affi rm

th e d eci si on . (2) If the adm inistrator’ s decision in fac t is “ de n o vo wrong,” then de te rm ine w he the r he w as ve ste d w ithdis cr et ionin rev ie wing c la im s; if not , e nd j udi ci al inquir

y a nd r ev er se the de ci sio n. (3) If the adm inistrator’ s decision is “ de novo wr ong” and he wa s vested with discretion in review ing cla im s, then deter m ine whether
“ re as ona ble ” gr ound s su

ppor te d it ( he nc e, r ev ie w his de ci sio n un de r the m ore defe rential arbitrary and capricious standard). (4 ) If no r ea sona

ble gr ound s e xis t, the n e nd the inquir y a nd r ev er se the adm ini str at or ' s de ci sio n; i f re as ona ble gr ound s do ex ist , the n de te rm ine if he ope ra te d un de r a co nf lic t of int er es t. (5 ) If the re is no c onf

lic t, the n e nd the inquir

y a nd a ff irm the de ci sio n. (6 ) If the re is a co nf

lic t of int er es t, the n a

ppl y he igh te ne d a rb itr ar

y a nd ca pr ic iou s r ev ie w to the de ci sio n to a ff irm or de ny it
. W illiams v. B ellSout h Telecom ms. , I nc. , 373 F
. 3d 1 132 , 1 13 8 (11th C ir
. 200 4) (s um m ar iz ing a na ly sis se t f

orth i n H CA H ea lth Se rv

s. of G a. , I

nc . v . E m ploye rs H ea lth I ns. Co

. , 24 0 F .3d 98 2, 9 93 -9 5 (1 1t h C ir. 2 00 1) ) (fo ot no te s o m it te d)
. Th e d i s tri ct co u rt b eg an i t s d i s cu s s i o n i n t h i s ca s e b y n o t i n g t h at Ch o i ce Po i n t ’s plan ve ste d L ibe rty

L if e w ithdis cretion i n m ak ing c la im s de ci sio ns ( ste p 2)
. T he
co urt ne xt f

ound that ge nui ne iss ue s of

m at er ia l f

ac t pr ec lud ed a de te rm ina tio n of whether Liberty

Lif e’ s decision was right or wr o n g ; s o , f or purposes of summ ary j udgm en t, the c ourt a ssu m ed tha t L ibe rty

L if e’ s de ci sio n w as w ro ng ( ste p 1)
. N ex t, the co urt r ec ite d th e m ea sur es ta ke n by L ibe rty L if e in r ev ie w ing D oy le ’ s c la im f or7

benefits and conclud ed that Liberty Lif e’ s denial of her claim

was reason able (step 3)
. Fi na lly , the co urt foun d that L ibe rty L if e ope ra te d unde r a c onf

lic t of int er es t sin ce it w as r es pons ibl e fo r both de te rm ini ng e lig ibi lity an d pay ing be ne fi ts unde r the plan (st ep 4)
. B ut, ins te ad of appl y ing the he igh te ne d a rb itr ar y a nd c ap ri ci ous standard ( ste p 6) , it

appl ied a“ m odi fi ed ” he igh te ne d a rb itr ar y a nd c ap ri ci ous standard
. T he c ourt a

ppare ntl y “ m odi fi ed ” the he igh te ne d st an da rd in the f oll ow ing
way : instead of requiring Liberty Lif e t o p ro ve that its decision wa s not in fluenced by the conflict—as the heightened st andard requires—the court re viewed the r ecord and concluded th at “ there does not appear to be any evidence that Liberty in any way
m an ipu la te d or

im pr ope rl y inf lue nc ed D oy le ’ s LTD be ne fi ts p ro ce ss i n or de r to
ac hie ve a fi na nc ia lly be ne fi ci al re sul t. ” T he co urt sa id tha t “ giv en the lac k o f an y ind ic at ionto the c ontrary , . . . L ibe rty w oul d have r ea ch ed

the sa m e co nc lus ionin thi s
case e ven if it had not been op erating under a conflict of intere st.” T he c ourt off

er ed tw o ju sti fi ca tio ns for not appl y ing the he igh te ne d st an da rd
. First, the court thou ght that the questio n of whether the heightened st andard applied to an a dm ini str at or ’ s fac tua l de te rm ina tio ns “ re m ai ns ope n in thi s c ir cu it, ” al tho ugh it ac know le dge d th at

the he igh te ne d st an da rd

appl ie s in pla n in te rp re ta tion c as es .8

Se co nd, the co urt re as one d that a m odi fi ed standard w as m or e in l ine w ith Bruch a nd pr in ci pl es of t ru st law t ha n was ou r he ig ht en edst an da rd
. IV. ISSU ES ON AP PE AL AN D S TAN DA RD OF RE VIEW Doy le raises two argum ents on appeal. First, she argues that the district court
erre d in findin g that Liberty Lif e’ s decision w as reasonable. Second, she argues that the d i s tr i c t c o u rt e rr e d i n ap p l y i n g a m o d i f i e d , r a t h e r t h a n h e i g h t e n e d , s t a n da rdof
re vie w . T his e rr or , she co nte nds, is m an if es te d in the c ourt’ s c onc lus iontha t L ibe rty L if e’ s de ci sio n w as not inf

lue nc ed by a co nf

lic t of int er es t, a co nc lus ion th at she arg ue s i s n ot su pp or te d b y th e rec or d. Liberty Lif e re spon ds that the court did not err in finding that its decision was reasonable, even if, as the court assum ed, it w as wr ong. Ne xt, L ibe rty Lif e ar gues that the district court did not err in apply ing a m odified stand ard because o u r ca ses have not conclus ively

determ ined whether the heightened standard applies in factual determ ination cases. But, even if it does apply , Liberty Lif e argues, the heightened
s t a n d a r da s c r i b e s mo r e i mp o r t a n c e t o t h e p r e s e n c e o f ac o n f l i c tt h a n t h e S up r e me C o u rt r e q uir edin Br u ch
. F ina lly , L ibe rty L if e ar gue s th at

the r ec or d c ont ai ns n o
ev ide nc e tha t i ts d ec isi on w as inf lue nc ed by ac onf lic t of int er es t.9

W e re vie w the dis tr ic t co urt’ s gr an t of sum m ar y j udgm en t de nov o a nd a

ppl y th e sa m e le ga l s ta nd ard s t ha t g ov ern edth e d is tri ctco ur t’s d eci si on . Wil li ams , 373 F. 3d a t 11 34. V. DISC US SION A. Re asonableness Fin ding Doy le argues that the district c ourt e rred in findin g that Liberty Lif e’ s denial of he r cl ai m

f or dis ab ili ty

be ne fits was r ea sona

ble
. S pe ci fi ca lly , she a rg ue s th at it
w as unr ea sona

ble f or L ibe rty L if e not to co nsi de r he r subj ec tiv e cl ai m s of pa in and suffering, w hich she argu es are subst antiated by her fibrom

y lagia diagnos is. A fter review ing the record, we agree with the district court that Liberty Lif e’ s decision was
reas on ab le . W e ex pr es s n o o pi ni on on whet he r it was ri gh t o r wro ng . L ibe rty L if e co nsi de re d Doy le ’ s m ed ic al re co rd s and em plo y ed the se rv ic es of tw o in de pend en t ph y sic ia ns t o r ev ie w tho se r ec or ds. I t c onc lud ed tha t sh e did

not
m ee t the plan’ s de fi nit ion of “ dis ab ili ty
. ” W e co nc lud e tha t i t w as not unr ea sona

ble fo r L ibe rty

L if e to d isr eg ar d D oy le ’ s c om pla int s of int an gib le pa in an d suff er ing
. U nde r Ch oic eP oin t’ s po lic y , aplan be ne fic iary m ust pr ovi de pr oof

tha t sh e is dis ab le d inor de r to o bta in L T D be ne fi ts. The pol ic y de fi ne s “pr oof

” as inc lud ing

“ chart notes, lab f

indin gs, test results, x-r ay s and/or other form s of obj ec tiv e m edic al evidence i n supp ort of a cla im for benef

its.” ( R.2- 12 at 9) (em

phasis add ed).10

Ther efore, it wa s reasonable for L iberty Lif e t o re ly only on objective m edical
ev ide nc e supp ortin g D oy le ’ s c la im , e vid en ce w hic h L ibe rty L if e’ s r ev ie w ing ph y si ci an s fo un d l a c k i ng . Se e, e . g. , R .1 -1 2 at 2 7 8 (s t at emen t o f L i b er t y Li fe ’s revi ew ing phy sic ia n, D r. S ilv er , tha t D oy le ’ s c om pla int s “ ar e not

sub stanti at ed

by obj ec ti v e c l i n i c a l f

i n d i n g s ” ) ; R
. 2
- 1 2 a t1 0 4 ( s t a t e m e n to f L i b e rt y L i f e ’ s r e v i e w i ng phy sic ia n, D r. T ru ch el ut, tha t D oy le ’ s “ subj ec tiv e re ports are dis pr opor tio na te to the phy sic al , r ad iol ogi ca l, la

bor at or y , a nd neu ro dia gnos tic ” re co rd s)
. W e fi nd n o e rr or in th e d is tri ctco ur t’s d et erm in at io n t ha t Li be rty Life’s d eci si on was re as on ab le
.

B. ERIS A’ s Heighten ed S tandard of R eview D oy le ’ s se co nd and p ri m ar y ar gum en t is that the dis tr ic t cour t e rr ed in ap ply ing
a m odi fi ed , r athe r than he igh te ne d, st an da rd of r ev ie w . W e ag re e. O ur

c as es hol d tha t the he ig ht en ed

standard appl ie s to a n a dm ini str at or ’ s be ne fi ts- de nia l de ci sio n ba se d onf

ac tua l de te rm ina tio ns, a s w el l a s de ci sio ns b as ed on pla n in te rp re ta tio ns. In To rres v . P itt

sto n C o. , 346 F
. 3d 1 32 4 (1 1th Ci r. 200 3) , af ac tua l de te rm ina tio n
ca se , w e sta te d un equiv oc al ly : [W ] e ar e boun d by

pr ec ed en t t o a

ppl y the he igh te ne d a rb itr ar

y -andca pr ic iou s st an da rd

both to fa ct

ua l de te rm ina tio ns an d in te rp re ta tio ns o f the plan docum ent by an ER ISA fiduciary operating with discretionary au th or it y bu t o pe rat in g u nd er a co nf li ctof i nt eres t.

. . . .

. . . [W]e conclud e th at the heighte ne d a rb i trary a nd capricious stand ard of re view for de cisions by a c o nflict ed ERISASh aw v . Co nn . G e n. LifeIn s. Co. , 35 3 F .3 d 12 76 (11 th Ci r. 2 00 3) ; Levinson v. Re liance

2 Standard Li

fe Ins. Co. , 245 F.3d 1321 ( 11th Cir. 2001). 11 fiduc iary applies eq ua lly to dete rm inations of fact as to dete rm inations of plan int erpr etation. Id

. at 1 329-32 (em

phasis added). W e declined to differe ntiate betwee n denials based on p la n in te rp re ta tio ns and d en ia ls b as ed on fa ct ua l de te rm ina tio ns, say ing tha t “ the need to protect against the fiduciary ’ s self-interest applies w ith equal force to plan de te rm ina tio ns and fi ndi ngs of fa ct m ad e by a con fl ic te d fidu ci ar y in the c our se of

it s benefits decision.” Id

. a t1 3 32; see als o Yo chum v. Barnett B anks, Inc. Severance P ayP lan , 234 F.3 d 541, 544 ( 11th C ir
. 200 0) ( ap ply ing he igh te ne d st an da rd to
co nf lic te d a dm ini str at or ’ s f actu al de te rm ina tio ns r eg ar din g “ co m pa rable
em pl oym en t” un de r se ve ran ce p ay pl an ). Ne vertheless, the district court considered the burden-shifting question open in l igh t of

the f oll ow ing statem en t i n W il li ams : “ Inboth Shaw an d Le vi nson , two factual-d et er m ination cases, we did no t say whether Brown ’ s ‘ heightened arbitrary
an dcap ri ci o u s ,’ burd

en -s hif tin g ap proa ch shou ld b e ap pli ed to fa ct ua l de te rm ina tio n
ca se s li ke thi s. ” 373 F. 3d a t 1138 -3 9 (e m pha sis ad de d)
. D es pit e thi s st at em en t, the 2 W il li ams court said that the district court “ shou ld have applied th e heightened, rather than the ‘ regular’ arb i t ra ry and capricious standard,” id. at 1137, even after ack no wled gi ng th atth e cas e in vo lv ed“ a p la n a dm in is tr at or ’ s f ac tua l de te rminat io ns ,”12

id. at 1134 n.3. T he W

il li ams c ourt r ec ogni ze d th at , a s in Shawa nd Le vi nson , it did not have to dec ide whether the burden-shiftin g approach under th e h ei g h t ened standard appl ie d be ca

use it c onc lud ed

tha t the adm ini str at or ’ s dec isi on wa s de nov o ri ght
. Id. at

113 9 ( “ Be ca

us e no gr ounds e xis t t o di stu rb [ the a dm ini str at or ’ s] de te rm in at io n un de r the de nov o r ev ie w standard , w e ne ed not r ev ie w it und er the
m ore defe renti al (‘m ere’ or ‘ heightened’ arbitrary and capricious) standard . .
. .” ). Thus, the W

il li ams court’ s com

m ent about the burden-shiftin g approach b ei n g an ope n qu es tio n w as dic tum
. F ina lly , in re ca pit ula tin g th e 6- ste p a na ly sis fo r re vie w ing
an adm ini str at or ’ s be ne fi ts d ec isi on o ri gin al ly de ve lop ed

in HCA , the W

ill iam s court
ex pli ci tly sa id tha t the a na ly sis appl ie d to “ all E RI SA -p la n be ne fi t de nia ls, ” i nc lud ing de ni al s b as edon fact ua l d et erm in at io ns . Id

. at 1 13 7 & n.6
. W e conclude that the district c ourt erre d in no t review ing Liberty Lif e’ s factual de te rm ina tio ns unde r the he igh te ne d ar bitrary an d cap ri ci ous standard de ve lop ed

in Brown a nd a

ppl ie d in Torres
. T he pr ac tic al e ff ec t of thi s erro r w as to re lie ve L ibe rty L if e of it s bu rd enof

pr ovi ng tha t i ts d ec isi on t o de ny D oy le LTD bene fi ts w as not ta int ed by ac onf lic t of int er es t. I nst ea d, the dis tr ic t c ourt, upo n cons ide ra tio n of the
e v i d e n c e , c o n c l u d e d t h a t L i b e rt y L i f e w a s du e s u m

m a ry j u d g m e n t b e c au s e its de ci si on was n ot affe ct edby the co nf li ct
.13

O f co ur se , the dis tr ic t co urt’ s er ro r in a ppl y ing the inc or

re ct standard w ar rants
re ve rs al onl y

if the r ec or d do es not

sup port s um m ary jud gm en t i n f av or of L ibe rty Life , in whi ch cas e th e erro r wou ld be ha rm le ss . Lucas v. W .W . G raing er, I

nc. , 257 F. 3d 1 249, 125 6 ( 11th Ci r. 2001 ) (n oti ng tha t “ w e m ay a ff irm [ the ] j udgm en t ‘ on any gr ound tha t f ind s su ppor t i n th e re co rd ’ ” (quot ing Ja ffk e v. D unha m , 352 U
. S. 280 , 281, 77 S. C t. 307, 308 (1957))). W e conclude, however, that summ ary j udgm ent was im pr op er. Inor de r to s uc ce ed

on i ts s um

m ar y j udgm en t m oti on, L ibe rty L if e, a s th e
m ovi ng p ar

ty , bor e the bur de n of es ta bli shi ng tha t the re e xis te d no ge nui ne iss ue of
m at eri al fact an d th at it was en ti tl ed to jud gm en t as a m at te r of law. Li ve rnoi

s v . M ed

. Disposab les, I

nc. , 837 F
. 2d 1 018, 102 2 (11th Cir
. 1988 ). O n the iss ue of w he the r its de ci sio n w as ta int ed

by ac onf lic t of int er es t—the piv ota l is su e up on wh ic h th e di st ric t co ur t b as edit s g ran t o f su m m ary jud gm en t— Lib ert y

Life a dv an ced on ly two argum ents in its summ ary j udgm ent brief. First, Liberty Lif e ar gued that its approval of ST D benef

its “ dem onstra t es t h at Liberty Lif e’ s decision m aking processes were not bia se d.” ( R. 1- 11 a t 16 n. 1. ) S ec ond, L ibe rty L if e ar gue d th at

it s de ci sio n to
em ploy a n independ ent phy sician to review D oy le’ s benefits-denial appeal

“ de m onstra te [s ] tha t its dec isi on- m ak ing pr oc es s w as f re e fr om bia s. ” ( R. 1- 11 a t 19 n.2.)14

I n he r o pp os i t i ont o L i be rt y

L i f e ’ s m ot i onf

or s um m a ry j ud gm e nt , h ow ever, Doy le offer ed alternative explanations for Liberty Lif e’ s actions. Doy le argued th at Liberty Lif e’ s approval of 90 day s of ST D benef its—which it characte rized as

“ ch ar ita ble ”— co uld

be vie w ed

a s an a rb itr ar

y de ci sio n to te rm ina te be ne fi ts o n th e 91st da y “ w ith out an y ex plana tio n as to how Ms
. D oy le ’ s co ndi tio n ha d c ha nge d on the 90th day . ” ( R. 2- 14 a t 9. ) Furthe r, D oy le ex pla ine d tha t L ibe rty L if e’ s r et en tio n of a n in de pe nde nt p hy sic ia n to re vie w he r be ne fi ts- de nia l a ppe al did not de m onstra te its la ck of bia s be ca use L ibe rty

L if e w as r equir ed

by f ed er al r eg ula tio ns t o “ obt ai n a report fr om an unrelated phy sician consul tant as part of [her ] appeal under 29 C.F .R. § 256 0.503-1(h)(3)(iii) & (v) and 29 C. F. R. § 256 0.503-1(h)(4). ” (R .2-14 at 9. ) I t w a s o n t h i s e v i d e n c e t h a t t h e d i s t r i c t c o u rt c o n c l u d e d t h a t “ t h e r e d oe s no t ap pe ar to be a ny

e vid en ce tha t L ibe rty

in an y w ay m an ipu la te d or

im pr ope rl y influenced Doy le’ s LT D benefits process in order to achieve a financially beneficial
re sul t. ” ( R. 2- 18 a t 13
. ) W e co nclud e tha t the c ourt e rr ed in so f ind ing
. U nde r our burden-shiftin g standard, L iberty Lif e bore t h e burden of provin g that und isput ed fa ct s su ppor te d ade ci sio n th at

it w as not inf lue nc ed by ac onf lict , a bur de n th at

it fa il e dt o c a rry

o n t h e f a c t s i ta d v a n c e d
. T h e r e f

o r e , w e r e v e r s e t h e g r a n to f L i b e rty Life ’s m ot io n fo r su m

m ary jud gm en t.15

Whil e w e re ac h th e re sul t w e unde rs ta nd o ur pr ec ed en t to r equir e, w e thi nk i t appropriate to note that we agree with the district c ourt’ s observation s in this case that
our he igh te ne d st an da rd

is “ fl aw ed , ” an d that “ ap ply ing a bur de n sh if tin g a na ly sis to
a cl ai m s a dm ini str at or ’ s f ac tua l de te rm ina tio ns p ose s un iqu e dif fi cu lti es . ” ( R. 2- 18 at12 .) W e th in k o urhe ig ht en edst an da rdis fla wedin at l eas t t hr ee ways. Fi rs t , o u r h ei g h t en ed s t an d ar di s i n co n s i s t en twi t h t h e S u p re m e C o u rt ’s
an noun ce m en t i n Bruch of tw o standard s unde r w hic h an adm ini str at or ’s dec is ion shou ld b e re vie w ed , de nov o a nd a buse of dis cr et ion
. T he a gr ee m en t a m ong the ci rc uit s th at

the de ci sio n of

ac onf lic te d E RI SAa dm ini strato r ex er ci sin g di sc re tio n shou ld be review ed under a less defer ential standard than the decisio n of an ad m ini str at or

not ope ra tin g un de r a co nf

lic t i s pr em ise d onthe Co urt’ s di ct um in Bruch tha t “ if a ben ef

it plan give s disc re tio n to an adm ini str at or or f idu ci ar y w ho i s ope rating un de r a conf

lic t of int er es t, tha t c onf

lic t m ust be w ei ghe d a s a‘ fa ct or

in determ ining whether

there is an abuse of discre tion.’ ” 489 U .S
. at 115, 109 S. Ct. at 957 (quot ing Re sta te m en t ( Se co nd) of T ru sts § 187 c m t. d ( 1959 ))
. A s th is s ta te m en t cl earl y say s, the e xis te nc e of

ac onf lic t sh oul d be tr ea te d on ly a s “ a fa ct or ” in determ i n i n g whether

the adm inistrator abused its discretion; the existen ce of a
co nf lic t do es not

r equir e an al tog ethe r ne w standard
. O ur use of athi rd standard —the heig htene d st an da rd

—i s no t r equir ed

by , a nd m or e im

porta ntl y is co ntr ar

y to, the16

Su pr em e Co urt’ s tr ea tm en t of a co nf lic t of inte re st i n Bruch
. Se e Ch am be rs v . F am ily H ea lth P lan Co rp. , 100 F. 3d 818, 826 (1 0th Ci r. 199 6) ( re j ec tin g Brown ’ s heightened standard “ as inc onsi ste nt w ith
. . . the S upr em e Co urt’ s di ct um in [ Bruch ]. ”). The sec ond flaw in our heightened stand ard is its bur de n- sh i f ting feature, under which the a d

m i n is trat or be ars the bur de n of pr ovi ng tha t i ts d ec isi on w as not influenced by

a conflict. A s the Second Circuit noted, our burden-shifting s tandard is “ contrary to the traditional burden of p roof i n a civil case. ” W hit ne y v. E m pir e B lue Cr oss & B lue Shi el

d , 106 F
. 3d 475, 477 ( 2d C ir
. 199 7) ( quot ing Sulli van v. L TV A er ospa ce & D ef

. Co

. , 82 F
. 3d 1 251, 125 9 ( 2d C ir
. 199 6) ) (i nte rn al quo ta tio n m ar ks
om itt ed ). T he tr ad iti ona l burd enof pr oof req ui res the pla int if f to p ro ve tha t the de ci sio n w as ta int ed by

se lf -i nte re st, w he re as our

standard r equir es the de fe ndant t o pr ove tha t i ts d ec isi on w as not ta int ed
. W e stand a lon e in our ap pli ca tio n of a stan da rd tha t sh if ts t o th e adm ini str at or the bu r de n of pr ov i ng t ha t i t s de c i si on w a s no t i nf l ue nc e d by a c on f

l i c t. O ther ci rc uit s a ppl y one of tw o di ff er en t a ppr oa ch es , ne ith er

of w hic h sh if

ts the bur de n of proof to the adm inistrator. The First and Second Circuits, for ex am ple, have a dopt ed a “ r e du c e d de f

e r e nc e ” app r oa c h, u nd e r w hi c h ac ou rtw i l l r e du c e t he d e f e rence
a f f or de d un de r a r

bi t r a ry a nd c apr i c i ou s r e vi e w after the claim ant show s th at theW

right v

. R.R. Donnelley & Sons Co. G roup Benefits Plan , 402 F.3d 67, 74 & n.4 (1st Cir. 3 2005) (burde n on claimant to show conf lict exi sts and once that showing is made “the c ourt ‘may cede a diminished deg ree of def ere nce–or no d efe renc e at a ll–to the administ rator’ s determinations’” (q u o t i n g Leahy v. R aytheon Co. , 315 F.3d 11, 16 (1st Ci r. 2002)) ); W hitney , 106 F.3d at 477 (Second Circuit holding that claimant must prove that the “conf lict of interest aff

ecte d t h e adminis trator’ s decision” a

nd upon such proof

, “the de f e r e n ce othe rwise a ccor ded the a dminist rator’ s decision drops aw ay an d t h e c o u rt i n t er

p re t s t h e p l an d e n o v o ” ( q u o t i n g Sullivan , 82 F.3d at 1256, 1259) (interna l quotation marks omitted)). Se e als o Pinto v. Reliance Standard Li

fe Ins. Co. , 2 1 4 F
. 3 d

3 7 7 , 3 9 2 ( 3 d

Ci r . 2 0 0 0 ) ( “ We 4 a do pt the a

pp ro a c h of the sli din g sc a le c a se s. ” ); Stup v. UNUM Life Ins. Co. of Am. , 390 F.3d 301, 307 (4th Cir. 2004) (“ Under this sli ding- scale standard of revie w, ‘[t] he more incentive f or the administrator or f

iduciary t o b en ef

i t itself by

a ce rtain interpr etation of be nefit elig ibilit y or other plan t erms, the more objectively rea sonable the administrator or fiduciary ’s dec ision must be and the m o re s u b s t an t i al t h e e v i d en ce m u s tb e t o s u p p o rt i t
. ’” (q u o t i n g Ellis v. Metro. Life Ins. Co. , 126 F.3d 22 8, 23 3 (4t

h Ci r. 19 97 )) ); Vega v . Nat’l Li fe Ins. Serv

s., Inc. , 188 F.3d 287, 297 ( 5th Cir. 1999) (en ba nc ) ( “ Ha vin g po lle d th e oth e r C ir c uit s, we re a ff ir m to da y that our a pp ro a c h to thi s k ind

of c a se is the s liding scale st andar d articula ted in W ildbur
. . . . The g reater the e vidence of conf lict on the part of the a dmi nis tr a tor , th e le ss d e fe re nti a l ou r a bu se of dis c re tio n s tand ard

wi ll b e .” ); Smith v. Cont’l Cas. Co. , 450 F.3d 253, 260 ( 6th Cir. 2006) (“[T] he possi ble conflict should be taken into ac count when de ciding whether

the plan adminis trator’ s decision i s arbitra ry and ca pricious. Howe ver, the sta nd ard of re vie w o f n ot al te re d to a le ss d e fe re nti a l st and ard wh e n th e be ne fi ts a dmi nis tr a tor is operating unde r a c onflict of int ere st. ‘Instead, . . . the standa rd re mains unchang ed and a conflict of i ntere st is to be conside red in applying th at s t an d i n g. ’” (c i t i n g an d qu o t i n g Calvert v. Firstar Fin., Inc. , 4 09 F .3 d 28 6, 29 2- 93 (6 th Cir
. 20 05 )) (i nte rn a l c itatio ns omi tte d) ); W oo v. De luxe Corp. , 144 F.3d 1157, 1161-62 (8th Cir. 1998) (“B ased on our revie w of [ Bruch ], we adopt the ‘sliding scale ’ approa ch. . . . [A]ppl ying the ‘sliding s ca l e’ approac h, the evidenc e supportingthe plan 17 adm ini str at or ’ s de ci sio n w as ta int ed by a co nf lic t of int er es t. C onve rs el y , the T hir d,

3 Fo urth, F if

th, S ixth, S ev en th, E igh th, N inth, an d Ten th Ci rc uit s a ppl y a“ sli din g scale” a pproach, under w hich the d i s t rict court “ decrea se[s] the level of defe rence giv en to the co nf

lic te d adm ini str at or ’ s dec isi on in prop ortio n to the se ri ousn es s of the conflict,” Ch am be rs , 100 F
. 3d a t 82 5, a nd the n on ly a ft er th e cl aim an t sh ow s th e
ex ist en ce of

ac onf lic t, Rud v. Li be rtyL ife A ssu ranc e Co

. of B oston , 438 F
. 3d 7 72, 777 (7th Cir. 2006 ). 4administrator’s de cision must incr ease in pr oportion to the seriousness of the conflict or pr ocedur al

ir re g ula ri ty .” ); Abatie v. Alta Health & Life Ins. Co. , 458 F.3d 955, 968 ( 9th Cir. 2006) (en ba nc) ( “A district court, whe n fac ed with all the fac ts a nd circ umstances, must de cide in e ach c ase howmuch or how little to cre dit the pl an adminis trator’ s rea son for denying insurance cover ag e. An e g reg ious conflict may

weig h more he avily

(that is, may

cause the cour t t o fi n dan abuse of discre tion more rea dily) than a

minor, technica l conflict mi g ht. But in any g iven ca se, all the fa cts and c ircumstance s mus t be c on side red and nothi ng‘s lid e s, ’ s o w e fi nd the me ta ph or unne c e ssa

ry and po te nti a lly c o n f u s i n g .” ); F

o u gh t v. UNUM Life Ins. Co. of Am. , 3 7 9 F
. 3 d 9 9 7 , 1 0 0 4 ( 1 0 thC i r . 2 0 0 4 ) ( “ In Cha mb e rs , we i d en t i fi ed t wo b as i c ap p ro ac h es th at h ad em er ged i ni n t er p re t i n g [ Bruch ]: the ‘sliding scale ’ appr oach a

nd the ‘pre sumptively

void’ approa ch. W e ex plicitly adopted the f ormer. ‘ Under [t he sliding sc ale] ap p ro ach, the revie wing court will alwa y s apply an ar bitrary and ca pricious s t an d ar d , b u tt h e c o u rt m u s t d ec re as e t h e l ev el o f d ef er en ce gi v en t o th e c o n fl i ct edad m i n i s tra t o r's d e c i s i o ni np ro p o rt i o nt o t h e s er i o u s n es s o f t h e c o n fl i ct
. ’” (q u o t i n g Cha mb e rs , 100 F.3d at 825) (interna l citations omit ted)). 18 Fi na lly , the thi rd

f la w in our

he igh te ne d st an da rd

is the r em arkabl y

dif fi cu lt burden it im

poses upon the adm inistrator in proving that its decision was not tainted by ac onf lic t. Per ha ps re co gni zi ng tha t prov ing the posi tiv e is e as ie r than pr ovi ng the
ne ga tiv e, thi s c ourt sa id i n Brown , a plan interpretation case, that an adm inistrator can
carr y thi s bur de n by show ing tha t its de ci sio n be ne fi tte d th e “ cl as s of a ll pa rt ic ipants
an d be ne fi ci ar ie s. ” 898 F. 2d a t 15 67. B ut, in a fa ct ua l de te rm ina tio n c as e, it is virtua lly im poss ibl e fo r ana dm ini str at or to pr ove tha t its fa ct

ua l f ind ing s so m eh ow be ne fi t the “ cl as s of

a ll pa rt ic ipants an d be ne fi ci ar ie s. ” E ac h c la im is uni que a nd
re qui re s in div idu al a sse ssm en t of the f ac ts s uppo rt ing the cl aim , so tha t a be ne fi ts de ci sio n w ithr es pe ct to one be ne fi ci ar y carr ie s no pr ec ed en tia l va lue w ithr es pe ct to oth er be ne fi ci ar ie s. S o, una

ble to pr ove tha t i ts d ec isi on b en ef its oth er be ne fi ci ar ie s, the adm ini str at or is re le ga te d to the une nvi ab le ta sk of pr ovi ng the ne ga ti ve , a ta sk19

w hic h is c om

pli ca te d by

the f ac t tha t the de ci sio n- m ak er m ust pr ove tha t i t w as not
ev en un co ns ci ou sl y in flu en ced by the co nf li ct
. Se e, e . g. , id. at 1565 (“ A c onflicted fi duc ia ry m ay f av or , c onsc iou sly

or unc onsc iou sly , it s in te re sts ove r the int er es ts o f th e p la n b en efi ci ari es .”). Thi s i s an un wor ka bl e st an da rd
. T h e d i s t r i c t c o u rt r e c o g n i z e d t h i s f l a w w h e n i t s a i d t h a t u n d e r o u r s t a n d a r d“a fi duc ia ry ope ra tin g un de r a co nf

lic t of int er es t is ac tua lly subj ec t to gr ea te r sc ru tin y than un de r de no vo re vie w . . . . ” ( R. 2- 18 a t 11
. ) O ur standard is ta ntam ount

to inv oki ng a

pr es um pti on tha t the a dm ini str at or ha s a ct ed w ro ngl y in its se lf -i nte re st. T his is why cou rt s and c om m en ta tor s have la

be le d ou r he igh te ne d st an da rd the

“ pr es um pt iv el y vo id ” st an da rd
. See Vega v. Nat’l Life Ins. Servs., Inc. , 188 F. 3d 2 87, 297 (5 th Ci r. 1999 ) (en ba nc ) (citin g Brown a s an e xa m ple of the “ pr es um

pti ve ly voi d” appr oa ch ); W

oo v . D el ux e Co rp. , 144 F
. 3d 1 157, 116 1 ( 8thCi r. 198 8) (d isc uss ing Brown ’ s “ presum ptivelyvoid” stand ard); C h am be rs , 100 F
. 3d a t 82 6 (Ten th C ir cu it re

j ec tin g Brown ’ s “ p r e s u m p t i v e l y v o i d ” s t a n d a r d ) ; K a t h ryn J. Ken ne dy, Judicial Standa rd of Re view in E RI SA Be nefit C

laim Cases , 5 0 Am . U. L. Re v. 108 3 , 1 1 5 8
- 6 0 ( 2 0 0 1 ) ( d i s c u s s i ng Brown ’ s a dopt ionof the “ pr es um

pti ve ly voi d” st an da rd ). T he be ne fi ts dec isi on of an adm ini str at or ope ra tin g un de r a co nf

lic t of int er es t shou ld be subjected to m ore exacting reviewin both fac tual determ ination and planWe wri te on ly on the c a se be fo re us , a fa c tua l de te rm inatio n c a se , a nd , w ith out th e be ne fi t 5 of brief in g an d o ral a

rgument, express no opinion on the propriety of applying our

heig htened standard in plan inter

pretation cases. 20 interpretation cases. A s we have previouslynoted, in both cases “ the sam e selfint er es t op er at es suc h th at a‘ co nf lic te d f id uc ia ry m ay f av or , c onsc iou sly

or
uncons ciously , its interests over the interests of t he plan beneficiarie s.’ ” Torres , 346 F. 3d a t 13 30 ( quot ing Brown , 898 F. 2d at 156 5). But, o ur heightened stand ard effe ctively

m akes the adm inistrator’ s conflict of interest the dispo sitive factor, rather than m er el y

“ a fa ct or , ” in d et er

m ini ng w he the r its de ci sio n w as arbitr ar y a nd capricious. W e should adopt the approach used b y the Bruch Co urt and , w ith out shi ft ing the bur de n of

pr oof , ins tr uc t the dis tr ic t c ourts t o take int o a cco un t the
ex i s t en ce o f a co n fl i ct o f i n t e r es twh en d et er m i n i n g wh et h eran ad m i n i s t ra t o r’s de ci si on to de ny ben efi ts was a rb it rary andcap ric io us . W e ur ge our

c ourt t o r ev ie w en ba nc thi s tr oubl es om e he igh te ne d st an da rd a nd
co nsi de r ad opt ing a m or e w orkable standard to ap ply in fa ct ua l de te rm ina tio n c as es . 5 This case illust rates the f laws in our standard. The district court f ound no evidence of any influence of conflict, but Doy le argues—corr ectly we think —that the court has
re lie ve d L ibe rty

L if e of the bur de n it

be ar s unde r our he igh te ne d standard
. W e ha ve tr oubl e im ag ini ng w ha t e vid en ce L ibe rty L if e co uld of fe r to s at isf

y tha t st an da rd
.L iberty L ife’s motion for summar y judgme nt, and Doyle’s re sponse, pre sented no proc edura l 6 iss ue s. An d, the c a se fo r b oth pa rt ie s w a s b ott ome d o n th e a dmi nis tr a tiv e re c or d. I t se e ms p re fe ra ble in a c a se lik e thi s f

or the dis tr ic t c ourt

to d e te rm ine by

c on fe re nc e or

sti pu latio n w he the r e ith e r p art y desires to pre sent evidenc e beyond the administrative re cord, a nd if not, take t h e case under submissi on and ente r finding s of fa ct and c onclusions of l aw. Rule 56 prac tice see ms to be an extra and unnec essar

y step—and one that can r esult in two appea ls rather than one. 21 VI. CO NC LUS ION Be ca use the dis tr ic t c ourt e rr ed in gr an tin g su m

m ar y j udgm en t i n f

av or of L ibe rty L if e, w e re ve rs e the gr an t of sum m ar y j udge m en t and r em an d th e ca se to the dis tr ic t c ourt f

or f urthe r pr oc ee din gs c onsi ste nt w iththi s op ini on. 6 REVERSED AND REMANDED.