FI L ED U.S. COURT OF A P P E A LS E LE V EN T H C IR C U IT J UNE 5, 2007 THOMAS K. KAH

N CL ERK

Honora ble Arthur L . Alarc on, United States Circuit J udg e for the Ninth Circuit, sitt ing * by desig nation. [DO NOT PUBLISH]

IN THE UN ITED STATES COURT OF APPEALS FO R T HE EL EV EN TH CIRC UI T

____ ____ ____ ____ ____ ____ N o. 06- 1518 0

____ ____ ____ ____ ____ ____ D. C. Docket N o. 05-03052 -CV -T W T- 1 CLAUDE J. STILTZ, Pl ai nt iff -Ap pe ll an t, ve rs us METROPOLITAN LIFE INSURANCE COMP ANY, Defen da nt -Ap pe ll ee.

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

of G eo rg ia

____ ____ ____ ____ ____ ____ _ (J un e 5, 200 7) Be fo re P RY O R, KRA V IT CH and A L A RC O N , Ci rc uit Jud ge s. * PE R CU RIA M:2

Claude J. S tiltz appeals the summ ary j udgm ent against his suit for long-term dis ab ili ty be ne fi ts unde r the E m

plo ym en t R et ir em en t I nc om e an d S ec ur ity A ct of 1974 (E RISA ), 29 U. S. C. §§ 10 01 et seq. Stiltz argues that the plan adm inistrator, Me tr opol itan L if

e In sur an ce Co m

pany ( Me tL if e) , a ct ed arb itr ar ily

and ca pr ic iou sly

w he n it de nie d hi s c la im

f or be ne fi ts. Me tL if

e re spon ds tha t i ts de ci sio n to te rm inate S til tz ’ s di sa bil ity be ne fi ts b as ed

on a f unc tio na l c ap ac ity e v a l u a t i o nan dr e v i e w s b y tw o i n d e p e n d e n tp h ys i c i an s w a s n o tw r o n g . We a f f i rm. I. BACKG ROUND Stiltz, a senior m anager f

or a consulting firm , r eceived disabilityinsurance through his em

ploy er, who obtained a group po licy from MetL ife. In N ovem

ber 2001 , S tiltz becam e ill and was hospitalized after a business trip to India. In De cem ber, Stiltz applied for and eventually rec eived short-term

and long -term disabili ty benefits from

MetL ife. Inthe f oll ow ing m onths, S til tz ’ s tr eatin g ph y sic ian, D r. A nth ony Ca pta in, m ad e dia gnos es that i nc lud ed f ibr om y al gia , c hr oni c fatig ue sy ndr om e, and irritable bowel sy

ndrom e. By

Oc tober 2002 , D r. Captain’ s notes rem arked that Stiltz wa s “ doin g well, ” but that sam e m onth , D r. Captain subm itted to MetLife a statem ent regarding Stiltz’ s claim , and stated that Stiltz couldonly work less than three to four hours per day . Dr . C aptain’ s office notes fr om ear ly 2003 ref lect that3

St ilt z w as r ep ortin g c om

pla int s of c hr oni c pa in and an in ab ili ty to func tio n f

or m or e than an ho ur

a t a ti m e. T hr ough200 4, S til tz c ont inu ed to se e D r. Ca

pta in an d vari ous spe ci al ist s f

or ong oin g tr eatm en t of

his vari ous co m

pla int s. In May 2003 , Me tLife ref

erre d Stiltz’ s claim

for an independent phy sician review . Dr . T race y

Schm idt reviewe d Stiltz’ s m edical re cords and conclud ed that his f ile c ont ai ne d on ly

sub j ec tiv e co m

pla int s of f at igu e an d la ck ed

“ suf fi ci en t m ed ic al [ ev ide nc e] to supp ort ob j ec tiv e ev ide nc e of

phy sic al f

unc tio na l c ap ac ity im pa irm en t t o any

oc cu pa tio n. ” D r. S ch m idt

a lso r em ar

ke d th at the li m itatio ns St ilt z re porte d to D r. Ca

pta in w er e inc onsi ste nt w ithS til tz ’ s st at em en ts o n hi s application for benefits that he regularly coached soccer , per form ed housework and y ardw ork, and helped his teenaged daugh ters w ith their stud ies. I n Septem ber 2003 , Me tL if

e as ke d D r. S ch m idt

to re vie wS til tz ’ s f

ile a ga in. D r. S ch m idt re vie w ed ne w ly sub m itt ed

m ed ic al r ec or ds and a ga in c onc lud ed that the f ile la ck ed obj ec tiv e ev ide nc e of

S til tz ’ s ph y sic al im

pa irm en t. On O ctober 6, 2003, D r. Captain wr ote to Dr. Schm idt and ob j ected to her co nc lus ion s. H e as se rt ed that S til tz ’ s te nde r poi nt j oin t t en de rn es s w as obj ec tiv e ev ide nc e of

his dia gnos is o f fi br om

y al gia and s tate d th at

S til tz c oul d no t su sta in ac tiv ity f or m or e than an ho ur

a t a ti m e. D r. S ch m idt

und er too k athi rd

r ev ie wof Stiltz’ s file for M etLif

e and concluded that her opin ion had n ot changed. D r.4

Sc hm idt spo ke w ithD r. Ca

pta in o n N ove m

be r 3 and e nc our ag ed

D r. Ca pta in t o subs tanti at e St ilt z’ s su

bj ec tiv e co m

pla int s of ina bil ity to w ork and c onc en tr at e by subm itt ing the r es ult s of

am en ta l st at

us e xam inatio n and a

f unc tio na l c ap ac ity ev al ua tio n. On Fe brua ry

4, 2 00 4, St il tz un de rwen t a f un ct io na l capa ci ty eval ua ti on . T he r ep ort c onc lud ed , ba se d onase ri es of te sts e va luatin g S til tz ’ s a ct ua l a bil ity to sit, stand, w alk, c lim

b stairs, stoop, rea ch, squat, kneel, and lift, that Stiltz wa s ca pable of pe rf orm ing ali ght -d

uty oc cu pa tio n, a s de fi ne d inthe D ep ar tm en t of L ab or ’ s D ic tio nary

of O cc upatio na l T itl es , f

or an e igh t- hour

w orkday . T he ev al ua tio n r ef

le ct ed that, in ane igh t- hour

day , S til tz c oul d si t, w al k, stand, and cl im b “ freq ue nt ly,” tha t i s, o ne -th irdto two -th ird s o f th e ti m e. O n M ar ch15, D r. S ch m idt r ev ie w ed S til tz ’ s f ile f or af ourth t im e. S he noted th at a j ob descriptio n subm itted by Stiltz’ s em

ploy er included sittin g three hour s, standi ng thr ee hours , w al kin g thre e hour s, and o cc as ion al ly li ft ing and carr y ing up t o 20 pounds. D r. S ch m idt c onc lud ed

that this w as a“ lig ht” occupation and , based on the functional capacity evaluation, the file lac ked o b j e c t i v e e v i d e n c e o f

ap h ys i c a l f

u n c t i o n a l c ap a c i ty i mp a i rme n tt o af u l l - t i me l i g h t -du ty o cc up at i o n . On Ap ri l 2 7 , 2 0 0 4 , M et Li fe co m p l et edi t s re v i ew o f S t i l t z’s cl ai m and t er m inate d be ne fi ts. S til tz appe al ed .5

D ur ing the appe al pr oc es s, Me tL if e submitt ed

S til tz ’ s f ile to a se co nd i n d ep en d en tp h ysi ci an fo r r ev i ew . On J an u ary 4 , 2 0 0 5 , a ft erre v i ew i n g St i l t z’s file, Dr . D ennis Gordan concluded th at Stiltz w as capable of light-duty work. D r. G or dan c ri tic iz ed

D r. Ca pta in f or “ giv ing und

ue w ei ght to sym pto m s, ” an d concluded th at “ [Stiltz] has overreported sym ptom s and [Dr . C aptain] has ove rr at ed sy m pto m s. ” D r. G or dan st at ed that the f unc tio na l c ap ac ity

e va luatio n, wit h i ts “ em

pi ric ba si s,” g av e a b et te r es ti m at e o f St il tz ’s actua l capabi li ti es . On January 5, Me tL if

e uphe ld i ts d ec isi on t o de ny be ne fi ts. Me tL if

e ag re ed to co nduc t o ne fur th er re vi ew. O n S ep te m

be r 12, 200 5, Me tL if

e ag ai n c onc lud ed

that S til tz w as not en tit le d to be ne fi ts. Me tL if e re lie d onthe de fi nit ionin the D ic tio nary of O cc upatio na l T itl es to co nc lud e that, de spi te S til tz ’ s in sis te nc e that hi s a ct ua l j ob re qui re m en ts w er e m or e than li ght , his “ own oc cu pa tio n” r equir ed

onl y li ght ex er tio na l c ap ac ity . T he f

unc tio na l c ap ac ity

e va luatio n su

ppor te d th e co nc lus ion that S til tz c oul d pe rf

orm a“ lig ht” oc cu

pa tio n, and n o ob

j ec tiv e fi ndi ngs in the m ed ic al f ile pr ec lud ed

thi s f ind ing . St ilt z sue d M et L if

e in G eo rg iastate c ourt. A ft er r em ovi ng this a ct ionto federa l court, Me tLife m oved for summ ary j udgm ent. T he district court granted that m oti on and d en ie d S til tz ’ s c ro ss- m oti on f or sum m ar y j udgm en t.6 II. ST AN DA RD OF RE VIEW W e re vie wasum

m ar y j udgm en t de nov o, a

ppl y ing the sam e le ga l st an dard s as the dis tr ic t c ourt. W ill iam s v. Be lls outh T el ec om m s. , I nc . , 373 F . 3d 1 132, 113 4 (1 1thCi r. 200 4) . T he r ev ie wof ade nia l of

be ne fi ts i n an E RI SAc as e fo llo w s a series of steps. “ At e ach step, the c ourt m akes a deter m ination that results in either the progression to the next step or the end of the inq uiry .” T ippit t v. Re liance Standard L ife Ins. Co., 457 F.3d 1227 , 1232 (11th Cir. 2006). T he six steps are as fo llo w s: (1 ) Appl y the de nov o st an dard

to de te rm ine w he the r the c la im adm inistrator’ s benefits-denial decision is “ wr ong” ( i.e. , the c ourt dis ag re es w iththe a dm ini str at or ’ s de ci sio n) ; i f it is n ot, the n e nd the inquir y and a ff irm the de ci sio n. (2) If the adm inistrator’ s decision in fac t is “ de novo wr ong,” then de te rm ine w he the r he w as ve ste d w ithdis cr et ionin re vie w ing c la im s; if not , e nd j udi ci al inquir

y and r ev er se the de ci sio n. (3) If the adm inistrator’ s decision is “ de novo wr ong” and he was vested with discretion in reviewing claim s, then determ ine whether “ reasonable” grounds supported it (hence, r eview his decision und er 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 and r ev er se the adm inistrator’ s decision; if re asonable groun ds do exis t, then de te rm ine if

he ope rate 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 and a ff irm the de ci sio n.7

(6) If there is a c onflict of interest, then apply heightened arbitrary an d c ap ri ci ous re vie wto the de ci sio n to a ff irm or de ny it . W il li am s, 3 73 F.3dat 1 13 8 (f oo tn ot es om it te d) . III. D ISCU SSION St il tz m ak es two ba si c arg um en ts ab ou t M et Life ’s dec is io n t o d en y be ne fit s. Fi rs t, h e arg ue s t ha t M et Life erre d wh en itin te rp ret edth e p la n t o d efi ne hi s “ own occupation” as a light-du ty occupation. Sec ond, he argues that MetL ife er red w he n it de te rm ine d th at

he w as not

dis ab le d by

r equir ing him

to pr es en t ob

j ec tiv e m ed ic al e vid en ce and i m pr ope rl y w ei ghi ng the e vid en ce in his f ile . B oth ar gum en ts f

ai l; w e dis cu ss e ac h intur n. A. The Conclusion of

Me tLife That Stiltz’s “Own O ccupation ” W as Light-Duty W as N ot D e No vo W

rong . St ilt z ar gue s th at

Me tL if e er re d whe n it

int er pr et ed plan langua ge r eg ar din g his oc cu pa tio n. T he plan de fi ne s di sa bil ity a s “una ble to pe rf

orm the m at er ia l and subs tanti al dut ie s of

y our O w n O cc upatio n, ” an d de fi ne s “ own oc cu pa tio n” a s the activity

that y ou regularly

perform and that serves as y our source of inc om e. I t i s no t l im ite d to the spe ci fi c posi tio n y ou h el d w ith Your E m ploy er. It m ay

be a sim ilar ac tivitythat could be perform ed with y our Em

ploy er or any

other em ploy er. MetL ife applied this langu age and relied on the Dic tionary of O ccupational T itl es to co nc lud e that S til tz ’ s own oc cu pa tio n invol ve d li ght -d

uty w ork. S til tz8

co nte nds that hi s oc cu

pa tio n inf

ac t r equir ed

him to do m or e than li ght -d

uty w ork, includi ng lifting 75 pou nds, carr y ing 25 poun ds, traveling to W ashingt on, D .C. we ek l y, tr av el i n g o v er s ea s o cc as i o n al l y, an dwo rk i n g 6 0 t o 7 0 h o u rs a w ee k . We agree with MetL ife that the ac tual requirem ents of Stiltz’ s m ost recent positio n are not c ontro lli ng. U nli ke the plans r ev ie w ed in the de ci sio n up on whic h S til tz r el ie s, the MetL ife plan defines the term “ occupation.” Cf. Shahpazian v. R eliance Standard Lif e Ins. Co., 388 F. Supp. 2d 1368, 1377 (N. D. Ga . 2005). The c lear plan langua ge a llo w ed

Me tL if e to l ook be y ond the r equir em en ts o f “ the spe ci fi c posi tio n” S til tz he ld. Me tL if e w as e nti tle d to r el y

on the D ic tio nary

of O cc upatio na l T itl es , w hic h de fi ne s th e oc cu pa tio ns o f “ m an ag er ” an d “ co nsul tant” as sedentary , and consi der the j ob descriptio n provid ed by Stiltz’ s em

ploy er, w hic h de sc ri be d S til tz ’ s j ob a s r equir ing thr ee hours e ac h of sittin g, standi ng, and w al kin g e ac h day . Whe n aj ob i nvol ve s e xe rt ing ne gli gib le f or ce but r equir es a signi ficant am ountof w alking o r standing, the “ light ” classification, rather than

“ se de nt ary, ” is ap pr op ria te . Dict io na ry of Oc cupa ti on al Tit le s ap p. C, § IV. T h e f u n c t i o n a l c ap a c i ty e v a l u a t i o nr e f l e c t e dth a tS t i l t z c o u l dp e r f o rm a light -duty occupation as defined bythe Dic tionary of O ccupational Titles, and that d ef i n i t i o nwa s co n s i s t en twi th th e g en er al jo b d es cr i p t i o np ro v i d edb y St i l t z’s9

em ploy er. T he functional capacity evaluation conclud ed that Stiltz could work an eight-hou r day

and that he could si t, w alk, and stand“ frequently ,” that is, onethi rd to tw o- thi rd s of

the ti m e. T he c onc lus ionof Me tL if e, ba se d onit s int er pr et at ionof

the plan and the f

unc tio na l c ap ac ity

e va luatio n, that S til tz c oul d pe rf orm his li ght -d

uty oc cu pa tio n w as not

de nov o wro ng. B . T he Co nc lus ion of M

et Li fe T hat Sti ltz W as N ot D isa ble d W as N ot D e No vo W

rong . St ilt z cr iti ci ze s th e fa ct

ua l de te rm inatio n by

Me tL if e on tw o gr ound s. F ir st, he argues that MetL ife im properly required him

to subm it objective m edical evidence. Second, S tiltz argues that MetLif e im properly considered the evidence in S til tz ’ s f

ile , giv ing too m

uc h w ei ght

to the r es ult s of

the f unc tio na l c ap ac ity ev al ua tio n and n ot e noug h w ei ght to St ilt z’ s r ep orte d li m itatio ns and the paym en t of be ne fi ts b y

Me tL if e fo r ne ar ly

tw o y ears . B otharg um en ts f ai l. St ilt z as se rt s th at

the plan do es not

r equir e a cl ai m an t t o pr ovi de obj ec tiv e m edical evidence in suppo rt of his claim . W e agre e, but the record does not reveal that M et L if

e de nie d be ne fi ts b as ed

on a f ai lur e to p ro vid e obj ec tiv e ev ide nc e of St i l t z’s ai l m en t s . To b o rr o w t h e w o rd s o f o u r s i s t erci rc u i t , “ M et Li fe ’s co m m uni catio ns w ith[ St ilt z] sup port i ts c ont en tio n th at it w as r eque sti ng o nly subs tanti at ionof

the e xte nt o f [S til tz ] ’ s di sa bil ity and n ot an im

poss ibl e le ve l of10

objec tive proof that [he] suffere d from fibrom y algia.” Pra lutsk y

v. Me tro. L ife Ins. Co. , 435 F. 3d 83 3, 839 (8th Cir. 2006). MetL ife’ s final decision cons idered both th e subj ec tiv e an d th e obj ec tiv e ev ide nc e in S til tz ’ s f ile , and M et L if

e fo und that the objective evidence in the functional capacity evaluation was the m ore re lia ble e vid en ce of

S til tz ’ s a bil ity to w ork. St ilt z ar gue s th at

Me tL if e’ s de te rm inatio n pl ac ed

too m uc h w ei ght

on the results of the functional capacity evaluation, but we disagree . MetL ife never dis cr ed ite d S til tz ’ s su

bj ec tiv e co m

pla int s of pa in and f

at igu e. C f. H awkin s v. F ir st Uni on Co rp . Lon g- Term

Dis ab il it y

Pla n, 3 26 F.3d91 4, 9 19 (7t h C ir. 2 00 3) . MetL ife properly

concerned itself w ith whether Stiltz c ouldperform the m aterial an d su bst an tia l dutie s of

his oc cu pa tio n. T he f

unc tio na l c ap ac ity

e va luatio n re fl ec te d th at

S til tz c oul d pe rf

orm li ght -d uty w ork f or an e igh t- hour

day , and i t wa s not th e only

evidence that Stiltz w as not dis abled. S tiltz’ s reported non-work ac tiv iti es , w hic h in cl ude d c oa ch ing ay outh so cc er te am , part ic ipatin g ona w al kin g te am , and p er fo rm ing hou se w ork and y ar dw ork, w er e al so i nc onsi ste nt w ithhis r ep orte d w ork li m itatio ns. S til tz did not bol ste r his f

ile w iththe r es ult s of a second functional capacity evaluation un dertaken on a “bad day ” or any other evidence that the evaluation was not an accurate m easurem ent of his abiliti es. Cf. D onov an v. E at on C or

p. , L ong T er

m D isa bil ity P lan, 462 F . 3d 3 21, 327 -2 8 ( 4th11

Ci r. 200 6) ; se e H ortonv. Re lianc e St an dard L if e In s. Co . , 141 F . 3d 1 038, 104 0 (11th Cir. 1998) (E RISAclaim ant has burden of establish ing di sability ). St ilt z al so arg ue s th at

Me tL if e’ s paym en t of

dis ab ili ty

be ne fi ts f

or ne ar ly tw o y ears sho uld

w ei gh a ga ins t i ts d ec isi on t o di sc ont inu e be ne fi ts. W e have never held that such a fact is a relevant consideration when we reviewthe denial of be ne fi ts unde r E RI SA . E ve n if w e w er e to c onsi de r the pr ev iou s paym en t of benefits by

MetL ife, it would not chang e our conclusion . The r ecord re flects that m any of S til tz ’ s w ide -r an gin g c om pla int s, suc h a s ir

ri ta ble bow el sy

m pto m s and a sl eep di so rd er, were su cces sf ul ly treat edaft er h e fi rs t fi le d fo r di sabi li ty ben efi ts . T ha t M et L if

e al low ed S til tz so m

uc h ti m e to p ro duc e ev ide nc e of his ina bil ity to work and that he still failed to do so s uppo rts the determ ination by MetL ife. IV. C ONC LUS ION T he sum m ar y j udgm en t f

or Me tL if e an d a ga ins t S til tz ’ s c om pla int is AFFIRMED.