## United States Court of App eals

F O R T H E E I G H T H C I R C U I T

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No. 1 1- 32 95

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Sh aro n Wade

, *

* App el la nt

, *

* App eal fro m

th e Uni te d S ta te s

v. * Dis tri ct Co ur t fo r th e

* East ern Dis tri ct of M is so ur i.
Aetn a Life Ins ur an ce Co m pa ny, *

* App el le e. *

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Su bm it te d: Apr il 18 , 20 12
Fi le d: Ju ly 24, 2 01 2

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Befo re RI LEY, Chi ef J ud ge , MURPHY an d M ELLOY, Cir cu it Ju dg es

.

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RILEY, Chi ef J ud ge

.

Aetn a Life Ins ur an ce Co m pa ny, as th e pl an ad m in is tra to r, de te rm in ed Sh aro n

W ad e was no lo ng er d is ab le d and st op pe d paying lo ng -te rm di sa bi li ty ben efi ts fro m

W ad e’s fo rm er em

pl oyer’s welf

are be ne fit pl an

. W ad e so ug ht jud ic ia l rev ie w of

Aetn a’s de ci si on by fil in g a ci vi l a c t i o n un de r th e Em pl oyee Ret ire m en t In co m e

Secu rit y A c t o f 1 9 7 4 (ERISA) , 2 9 U.S.C. § 10 01 et se q. The di st ric t co ur t gr an te d 1

The Hon or ab le Ch arl es A. Sh aw, Uni te d St at es Dis tri ct Ju dg e fo r th e East ern 1

Dis tri ct of M is so ur i.su m

m ary jud gm e n t i n fav or of Aetn a, co nc lu di ng Aetn a di d no t ab us e it s di sc ret io n

in te rm in at in g W ad e’s be ne fit s be cau se su bs ta nt ia l ev id en ce su pp or te d th e de ci si on

.

On ap pe al

, W ad e req ue st s th at we “ or de r th e di st ric t co ur t to rei ns ta te [Wade’s]

be ne fit s” an d award at to rn ey fees pu rs ua nt to 29 U.S.C. § 11 32 (g ). W ad e arg ue s th is

is ne ces sa ry be cau se th e di st ric t co ur t (1 ) ap pl ie d th e wro ng st an da rd of rev ie w; (2 ) fai le d to gi ve ap pr op ria te weig ht to th e So ci al Secu rit y Adm in is tra ti on ’s (SSA)

gr an t of lo ng -te rm di sa bi li ty be ne fit s to W ad e; an d (3 ) ab us ed it s di sc ret io n by

de te rm in in g su bs ta nt ia l ev id en ce su pp or te d Aetn a’s te rm in at io n of be ne fit s. Afte r de

no vo rev ie w, se e Mi dg et t v. W as h. Grp

. In t’l. Lon g Term Dis ab il it y Pl an , 56 1 F.3 d

88 7, 89 3 (8 th Ci r. 20 09 ), we co nc lu de W ad e’s arg um en ts are w i th ou t m eri t, an d we

affi rm th e jud gm en t o f th e d is tri ct co ur t.

The di st r i c t co ur t rev ie wed Aetn a’s te rm in at io n of W ad e’s be ne fit s un de r an
ab us e of di sc ret io n st an da rd be cau se th e di st ric t co ur t co rrec tl y de ci de d th e op erat iv e pl an gr an te d Aetn a di sc ret io na ry au th or it y to de te rm in e whe th er W ad e w a s e n ti tl ed

to be ne fit s. See id

. (s ta ti ng an ab us e of di sc ret io n st an da rd ap pl ie s “ whe n an ERISA
pl an gr an ts th e ad m in is tra to r di sc ret io n to co ns tru e th e pl an an d to de te rm in e be ne fit s
el ig ib il it y ” ( qu ot in g Je ss up v. Alco a, In c., 48 1 F.3 d 10 04

, 10 06 (8 th Ci r. 20 07 ))
(in te rn al m ark s o m it te d) ).

Wa d e co nt en ds a de no vo st an da rd of rev ie w sh ou ld ap pl y be cau se “ Aetn a

co m m it te d se rio us pr oc ed ur al irr eg ul ari ti es ,” su ch as (1 ) fai li ng to pr ov id e W ad e’s

at to rn ey th e op erat iv e pl an do cu m en ts fo r ov er two y ears , an d (2 ) la te r in tro du ci ng th e

co rrec t do cu m en ts to th e di st ric t co ur t. See W oo v. Delu xe Co rp ., 1 4 4 F

. 3 d 11 57

, 11 60 (8 th Cir . 19 98 ) (ex pl ai ni ng a le ss de fere nt ia l st an da rd of rev ie w i s ap pr op ria te

whe re th ere is “ m at eri al

, pr o b a t i v e ev id en ce de m on st rat in g th at (1 )

. . . a se rio us

p r o c e du ral irr eg ul ari ty ex is te d, whi ch (2 ) cau se d a se rio us br each of th e pl a n
ad m in is tra to r’s fid uc ia ry du ty”), a br og at ed in pa rt by Me tro . L i f e I n s. Co . v . Gl en n,

55 4 U.S. 1 05 (20 08 ). W e d is ag ree.

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-In reject in g W ad e’s arg um en t, th e di st ric t co ur t, wi th ou t ex cu si ng Aetn a’s

m is ta ke s, reco gn iz ed th at th e pr oc ed ur al irr eg ul ari ti es at is su e “ oc cu rred lo ng aft er th e
cl ai m s de ci si on to te rm in at e [Wad e ’s lo ng -te rm di sa bi li ty] be ne fit s was m ad e, an d

a f t e r t h e ap pe al of th at de ci si on was co nc lu de d.” The di st ric t co ur t reas on ed Wa d e

ha d “ no t sh own an y fact s to in di cat e th at Aetn a’s su bs eq ue nt pr oc ed ur al erro rs co ul d

ha ve ha d an y effe ct on ei th er th e cl ai m s de ci si on or th e ap pe al pr oc es s.” The di st ric t

co ur t was co rrec t. Ass um in g W oo st il l ap pl ie s, th e de no vo st an da rd W ad e su gg es ts 2

is no t warra nt ed in si tu at io ns su ch as th is

, whe re the pr oc ed ur al irr eg ul ari ti es ha d no

“ co nn ect io n to th e su bs ta nt iv e de ci si on reac he d.” Men z v. Pro ct or & Gam bl e Heal th

Care Pl an , 52 0 F.3 d 86 5, 86 9 (8 th Ci r. 20 08 ) (q uo ti ng Bu tt ram v. Cen t. St at es , Se. &

Sw. Areas Heal th & W el fare Fu nd

, 76 F.3 d 89 6, 90 1 (8 th C i r

. 19 96 )) (in te rn al

qu ot at io n m ark s o m it te d)

.

W e al so di sa gr ee wit h W ad e’s co nt en ti on “ Aetn a ab us ed it s di sc ret io n by
ig no rin g an d fai li ng to pl ace an y weig ht on ” th e SSA’s award of lo ng -te rm di sa bi li ty

be ne fit s to W ad e. “ [A]n ERISA pl an ad m in is tra to r or fid uc ia ry ge ne ral ly is no t bo un d
by an SSA de te rm in at io n th at a p la n pa rti ci pa nt is di sa bl ed .” Farf al la v. Mu t. of

Om ah a I n s

. C o

. , 32 4 F.3 d 97 1, 97 5 (8 th Ci r. 20 03 ) (q uo ti ng Ja ck so n v. Met ro

. Life

I n s

. C o

. , 30 3 F.3 d 88 4, 88 9 (8 th Ci r. 20 02 )) (in te rn al m ark s om it te d)

. Aetn a

te rm in at ed W ad e’s be ne f i ts ne arl y fiv e y ears aft er th e SSA ev al ua te d an d ap pr ov ed

W ad e’s be ne fit s. Aetn a’s de ci si on was ba se d on ne w i nf or m at io n th e SSA ha d no

op po rtu ni ty to co ns id er, in cl ud in g an in de pe nd en t m ed ic al ex am in at io n, rev ie ws fro m
fiv e in de pe nd en t bo ard -cer ti fie d co ns ul ta nt s, vi de o su rv ei ll an ce of W ad e, an d two

la bo r m ark et an al y se s. “ It is no t cert ai n th at th e SSA st il l wou ld ha ve co nc lu de d th at [Wade] was en ti tl ed t o d i s a b i l it y be ne fit s ha d it rev ie wed th e sa m e reco rd th at was

See W ren n v

. P r in ci pa l Life In s. Co

., 63 6 F.3 d 92 1, 92 4 n.6 (8 th Ci r. 20 11 ) 2 (rec og ni zi ng “ [a]fter th e Su pr em e Co ur t’s deci si on in Glen n, th e W oo sl id in g- sc al e
ap pr oa ch is no lo ng er tri gg ered by a co nf li ct of in te res t,” bu t “ [t] h e p r oc ed ur al

ir re gu la ri ty co m

po ne nt of th e W oo sl id in g sc al e ap pr oa ch m ay

. . . st il l ap pl y in ou r ci rcu it po st -Gle nn ”).

-3

-be fo re” Aet na in 20 08 whe n Aetn a te rm in at ed W ad e’s be ne fit s. Ja ck so n, 30 3 F .3d 3

at 88 9.

Afte r care fu l rev ie w of th e reco rd

, we ag ree wi t h t h e d i st ric t co ur t “ th at

su bs ta nt ia l ev id en ce su pp or ts Aetn a’s de ci si o n to te rm in at e [Wade’s] lo ng -te rm
di sa bi li ty be ne fit s.” W e th eref or e affi r m t h e ju dg m en t of th e di st ric t co ur t fo r th e

reas on s s ta te d i n i ts th or ou gh an d wel l-r eas on ed op in io n. Se e 8 th Cir . R. 47 B.

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W ad e arg ue s fo r th e f

i r s t ti m e on ap pe al th at “ Aetn a ha s act ed in ba d fai th ” 3

be cau se Aetn a “ en co ur ag ed an d a ss is te d” he r in ob ta in in g S oc ia l Se cu rit y be ne fit s,

“ rece iv [ed ] th e bu lk of th e be ne fit s” of W ad e’s SSA cl ai m , an d th en la te r te rm in at ed
he r lo ng -te rm di sa bi li ty be ne fit s un de r Aetn a’s pl an

. W ad e cl ai m s th is “ in di cat es
pr oc ed ur al un reas on ab le ne ss .” W e do no t co ns id er th is arg um en t be cau se , “ ‘[a] bs en t

ex cep ti on al ci rcu m st an ces ,’ no t pr es en t he re, ‘w e can no t co ns i d er is su es no t rai se d
in th e di st ric t co ur t.’” Mo rri so n Ent ers ., LLC v. Drav o Co rp ., 63 8 F.3 d 59 4, 60 8 n.5 (8 th Ci r. 20 11 ) (q uo ti ng Sh an kl in v. Fi tz ge ral d, 39 7 F.3 d 59 6, 60 1 (8t h Cir. 20 05 )).

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