NOT RECOMMENDED F OR PUBL I CATI ON File Na me: 12a0932n.06 No. 11-3887 UNI TED STATES COURT OF A PPEAL S FOR THE SIXTH CI RCUI T

J EFF REY J

. CHRI STOFF , adoptive fathe r, guardia n, and next friend of K .C., a minor; K.C., individually ,

Plaintiffs-Appellants,

v. O H I O N O R T H E R N U N I V E R S I T Y EMPL OYEE B ENEF I T PLAN,

Def endant- Appellee

. ) ) ) ) ) ) ) ) ) ) ) ) ) ON APPEALFROM THE U NI TED STATES DI STRI CT COURT FOR THE NORTHE RN DI STRI CT OF OH I O

OPI NI ON

Before: BOGG S, GILMAN, and DONALD, Circ uit Jud ges. RONALD L EE GILMA N, Circuit Judge. J eff rey J

. Christoff appeal s fr o m a judgment in favor of his employer’ s healthca re plan, the Ohio Norther

n University Employ ee Be nefit Plan, that denied cover ag e for his son K.C.’s cognitive-retr aining thera py and neuropsycholog ical testing for Attention-Def

icit Hy pera ctivity Disorder and Cognitive Di s o r d e r N o t O th e r w is e Sp e c if

ie d. The Plan is subject t o the provisi ons of t he Empl oyee Retirement and Income Sec urity Act (ERI SA), under which Christoff c halleng es the proc edure s that contributed to the Plan’s denia l of cove rag e. Specifica lly , Christoff argues that he was denied a “full and fair revie w,” as mandated by 29 U.S.C. § 1133, due to five alleg ed proce dural err ors in the proce ssing of his claim: (1) the Plan Administrator was aff

ecte d b y a co n fl ict of interest beca use he also serve d as an employee of the University , the larg est contributor to the Plan itself; (2) the decisions o f t h e fi le revie wer s wer eChrist off v. Ohio N. Univ. Employe e Be nefit Plan, et al.

No. 11-3887 prejudice d by the fac t that the Plan Administrator forwa rded to eac h subsequent revie wer the repor ts of eac h of the prior

revie wer s, all of whom found a g ainst Christoff; (3) the opinions of Dr. Steven Br ezny and a second revie wer from the Medica l Review Institut e of Americ a are unreliable beca use these two revie wer s either wer e not qualified or lacke d the authorization to issue opinions on K.C.’s claim; (4) the Plan Administrator arbitra rily ignor ed the evidenc e from K.C.’s treating phy sician and improperly acc epted repor ts from file revie wer s who failed to comply with the Plan Administrator’s instruction to speak with K.C.’s phy sician prior to prepa ring their repo rt s; and (5) the Plan Administrator improperly relied on f

ile revie ws instead of phy sical examinations. The district court conclude d that eac h of these ch al l en ges l acke d merit and that the Plan Administrator’s dec ision to deny benef its was not arbitra

ry or capricious. See DeLisle v. Sun Life Assurance Co. of Can. , 558 F.3d 440, 444 (6th Cir. 2009) (explaining that the defe rential arbitra ry and-c apric ious standard of revie w applies when the Plan Administrator is vested with the discretion to interpre t the pl an’s terms, as he is here ). We ful l y agr ee with the t horough and comprehensive analy sis of the district court and thus will limitour discussion to avoid unnece ssary duplication. Wit h respe ct to his first challeng e, Christoff a rgues that a c onflict of intere st ex isted in the administrative proce ss beca use the Plan Administrator is the Vice President of Financ ial Affa irs for the University and thus has a financ ial incentive to deny claims. But even if we wer e to assume that the Vice President ’s l i n k t o the University would be sufficie nt to cre ate a potential conflict of interest, Christoff was unable to meet the key require ment that he provide “significant evidenc e that the conflict actua lly aff

ecte d or motivated the decision at issue.” Cooper v. Life Ins. Co. ofN. Am. , 486 F.3d 157, 165 (6th Cir. 2007) (interna l quotation marks omitted). The evidence to which he -2-Christ off v. Ohio N. Univ. Employe e Be nefit Plan, et al.

No. 11-3887 does point—that the revie wer s rec eived alleg edly prejudicia l documents as part of the file—is weak support for a conflict, particula rly in ligh t o f o t h er evidenc e that the Plan Administrator used independe nt revie wer s and considere d additional information that Christoff submitt ed on rema nd. We theref ore de cline to find a c onflict of intere st in the present c ase. Christoff next asser

ts that the file revie wer s’ repor ts wer e not truly independe nt beca use the subsequent revie wer s wer e p rejudice d by having seen the repor ts of prior revie wer s. But at oral argument and also befor e the district court, Christoff conce ded that the prac tice of prese nting prior revie wer s’ repor

ts to later revie wer s was routine. This prac tice thus does not prese nt g rounds for a findingof ar

bitrary or ca pricious conduc t. Third, Christoff challeng es the Plan Administrator’s relianc e on repor ts from Dr. Br ezny and the second revie wer from the Medica l Review Institut e of Americ a, claiming that these phy sicians either lacke d the qualifications or the authorization to evaluate K.C.’s condition proper ly

. The Plan Administrator’s relianc e on these repor ts, even if problematic, did not rende r the decision arbitra ry

or capricious beca

use the Plan Administrator had at his disposal four other repor ts on which to rely

. See, e. g . , Douglas v. Gen. Dynamics Long Term Disabilit y Plan , 43 F. App’x 864, 869 (6th Cir. 2002) (conc luding that the Plan Administrator’s decision was not arbitra ry or capricious beca

use it relied on opinions from two independe n t m ed i ca l evalua tors, both of whom conclude d that the claimant was not disabled). This fac tor there fore does not support a finding that the Plan Administrator’s dec ision was arbitra ry or ca pricious. Christoff next chal leng es the file revie wer s’ alleg ed failure to consider the evidenc e from K.C.’s treating phy sician or to contac t the phy sician to discuss K.C.’s condition. This case , howeve r, -3-Christ off v. Ohio N. Univ. Employe e Be nefit Plan, et al.

No. 11-3887 p re s en ts a unique situation in which the revie wer s wer e not attempting to asce rtain the level o f K.C.’s impairment, but wer e instead evaluat i n g wh et her the treatment in question fell within the languag e of the Plan. K.C.’s treating phy sician did not offe r a contra dictory opinion on this point, and the excerpts from the revie wer s’ repor ts a dequate ly explain why the Plan Administrator chose to follow their opinions. There is no evidenc e to sug g est that K.C.’s treating phy sician could have provided information that would have altere d the revie wer s’ decisions on this ultimate issue. Under the highly defe rential standard applicable to ERI SA claims, we conclude that the Plan Administrator has provided a

sufficie nt expl anation for his decision to withstand this particular cha lleng e. Finally , Christoff challeng es the revie we r s ’ failure to conduct a phy sical examination of K.C. and instead proce ed with a paper revie w only

. Such a challeng e may be more rele vant where t h e revie wer s draw adver se cre dibilit y deter minations or fail to addre ss the evidenc e provided by the claimant. But the rec ord in the prese nt case indicates that the revie wer s did not make any cre dibilit y deter minations at all. The question posed to them asked only whether the trea tment and the testing

wer e cove red by

the Plan, an objec tive inquiry that did not rely

on K.C.’s subjective r eports about his condition. And, t o t h e extent nece ssary , the repor ts do addre ss and ref

ute Christoff’s counter vailing evidenc e. The revie wer s’ failure to conduct a phy sical examination of K.C. there fore does not rende r arbitra

ry or capricious the Plan Administrator’s relianc e on the repor t s o f the revie wer s in denying Christoff ’s claim for

benef its. For all of the re asons set for

th above, we AF F IRMthe judg ment of the district cour t.

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