grants its administrators discretion.

Before delving into the details of the benefits plans, the Court will tum to the legal
requirements for remanding the case. This Court has authority to remand the benefits claim to
plan administrators under some circumstances. See Quinn v. Blue Cross & Blue Shield Ass’n,
161 F.3d 476, 477 (7th Cir. 1998). In order to remand the case to the plan administrators in this
case, this Court would have to make a determination that the decision to deny benefits was based
on “[in]adequate findings or [a] fail[ure] to provide an adequate reasoning.” Quinn, 161 F.3d at
477.

Both of Plaintiffs requests, to remand the benefits claim or to expand the record with
additional discovery, would require this Court to make significant factual findings. This Court is
reluctant to make those findings at this stage of the proceedings. This litigation has not yet
proceeded to the dispositive motion stage. Moreover, it is not entirely clear what factual issues
the Plaintiff wishes to explore. The Court is unaware of a case where a district court remanded a
benefits claim to the plan administrator before dispositive motions were submitted. Good
teasons exist to support this absence of precedent. Determinations about the details of the plans
and the reasoning supporting the denial of benefits should not be entered into lightly. The factual
issues underlying Plaintiff's Motion to Expand or Remand are much more appropriate to resolve
after submission of Motions for Summary Judgment pursuant to Rule 56 of the Federal Rules of
Civil Procedure. Consequently, this Court Denies Plaintiff's Motion to Expand or Remand with
the understanding that this issue may (or may not) be revisited after briefing on dispositive

motions.



2002, Defendants removed the case to federal court pursuant to 28 U.S.C. § 1441.

At this point, Plaintiff seeks either to conduct additional discovery or to remand the case
to the plan administrators for further factual development. Plaintiff contends that the record
contains inconsistent information regarding his work history with Custom Labels, Inc. Both
Defendants, Standard and Prudential, oppose the Motion to Expand or Remand.

ANALYSIS

Plaintiff seeks either to expand the record with additional discovery or to remand the
claim for benefits to the plan administrators. Each request raises distinct legal questions for this
Court, so each will be considered separately. First, the Court tums to the request to expand the
record with additional discovery. It is clear that this Court has authority to conduct additional
discovery in cases that arise under ERISA to the plan administrators under some circumstances.
See Casey v. Uddeholm Corp., 32 F.3d 1094, 1098-99 (7th Cir. 1994). The Seventh Circuit has
held, though, that “when review under ERISA is deferential, courts are limited to the information
submitted to the plan’s administrator.” Perlman v. Swiss Bank Corp. Comprehensive Disability
Protection Plan, 195 F.3d 975, 982 (7th Cir. 1999). This brings us to the preliminary question of
whether this Court is required to undertake deferential or de novo review of Standard and
Prudential’s benefits determinations.

The Supreme Court has held that decisions of ERISA plan administrators presumptively
receive de novo review. Firestone Tire & Rubber Co,, v. Bruch, 489 U.S. 101, 115 (1989). Ifthe
benefits plan affords the administrators discretionary authority to construe its terms, however,
federal court review will be deferential. Id. at 115. In order to answer the question about the

standard of review, then, the Court must first determine whether the benefits plan at issue here


CONCLUSION

For the reasons stated in this opinion, the Court denies Plaintiff's Motion to Expand or

Remand.

Enter:

i David H. Coar
United States District Judge

Dated: September 26, 2002



Minute Order Form (06/97)

United States District Court, Northern District of Illinois

wsgameanae| pen. Coan | Striiaroie

CASE NUMBER 02 C 766 DATE 9/26/2002
CASE John E, Edmondson vs. Prudential Insurance Co., et al.
TITLE

[In the following box (a) indicate the party filing the motion, ¢.g., plaintiff, defendant, 3rd party plaintiff, and (b) state briefly the nature

MOTION: of the motion being presented.]

DOCKET ENTRY:

(69) im] Filed motion of [ use listing in “Motion” box above.}

Q) im Brief in support of motion due

@) Q Answer brief to motion due__. Reply to answer brief due

(4) Oo Ruling/Hearing on setfor____at

6 O Status hearing[held/continued to] [set for/re-set for]on___set for___at

©) Oo Pretrial conference[held/continued to] [set for/re-set for}on__—setfor__——sat_—

(o) im Trial[set for/re-set for] on____ at

(8) Oo [Bench/Jury trial] [Hearing] held/continued toa

(9) a This case is dismissed [with/without] prejudice and without costs[by/agreement/pursuant to]

OFRCP4(m) (Local Rule 41.1 O FRCP41(a)(1) OO FRCP41(aX{2).

ao «=o [Other docket entry] For the reasons stated in the attached memorandum, Plaintiff’s Motion to
Rehear Plaintiff's Prior Motion to Expand the Record, or, in the Alternative, to Remand this Action to
Prudential Life Insurance Co. and to Standard Insurance Co. [Doc. 25] is denied. Dispositive motions
are now due October 17, 2002; responsive pleadings are due by November 7, 2002; reply briefs are due
by November 21, 2002. The final pre-trial order deadline is reset for March 7, 2003. The final pre-trial
conference is reset for March 14, 2008 at 11:00 a.m. Trial is reset for :

ql) [For further detail see order attached to the original minute order.]
No notices required, advised in open court.

No notices required.

Notices mailed by judge's staff.

Notified counsel by telephone.

o | Docketing to mail notices.
Mail AO 450 form.

1ynod Lawisia’s'n

Copy to judge/magistrate judge.
courtroom 26 S
jar/ie deputy’s
initials
Dateftime received in: -. 2:
central Clerk's Office



IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION
JOHN E. EDMONDSON, )
) No. 02 C 766
Plaintiff, )
) HONORABLE DAVID H. COAR
v. )
)
PRUDENTIAL INSURANCE CO., et al. )
)
) D0CKErEn
Defendant/Cross- ) SEp °
claimant/Cross-defendant. 274 002
MEMO OP’ AND ORDER

Before this Court is Plaintiff John Edmondson’s Motion to Rehear Plaintiff's Prior
Motion to Expand the Record, or, in the Alternative, to Remand this Action to Prudential Life
Insurance Company and to Standard Insurance Company (“Motion to Expand or Remand”). For
the foregoing reasons, Plaintiff’s motion is denied.

STATEMENT OF JURISDICTION

Plaintiff’s claim that his benefits were wrongfully denied arises under the Employment
Retirement Income Security Act (ERISA), 29 U.S.C. § 1132(a)(1)(B). This Court has
jurisdiction to hear the claim pursuant to 29 U.S.C. §1132(e).

FACTUAL & PROCEDURAL BACKGROUND

Plaintiff was an employee of Custom Labels, Inc. Although Custom Labels, Inc., is
located in Bossier City, Louisiana, Plaintiff lived in Illinois at all times pertinent to this dispute.
He was employed as a regional “on the road salesman” for Custom Labs.

On November 3, 2000, Plaintiff experienced headaches and confusion, so he sought



medical attention. The preliminary diagnosis was that Plaintiff suffered from a brain tumor. On
November 10, 2000, Plaintiff underwent an open skull surgical biopsy on the tumor, which
confirmed the preliminary diagnosis. Thereafter, he received radiation therapy to abate the
tumor’s growth throughout December 2000. When the radiation therapy was unsuccessful, he
had surgery to excise the tumor from his brain on January 9, 2001. After the surgery, he
experienced significant side effects. He was hospitalized again with pneumonia and a collapsed
lung in February 2001.

While Plaintiff was a regular employee of Custom Labels, Inc., he was also covered by
their insurance policies, which at all times included disability coverage. When Plaintiffs brain
tumor was diagnosed and until November 30, 2000, Standard Insurance Co. (“Standard”) was the
insurance carrier for Custom Labels, Inc. On December 1, 2000, Prudential Insurance Co.
(“Prudential”) became the insurance carrier for Custom Labels, Inc. Prudential was the insurance
catrier for Custom Labels, Inc. at all times relevant to this case after December 1, 2000. In the
context of the facts of this case, if Plaintiff became disabled before December 2000, Standard is
liable on the claim. If he first became disabled on or after December 1, 2000, Prudential would
be responsible.

Plaintiff filed claims for disability insurance coverage with both Standard and Prudential.
Both companies denied his disability claims. Standard adjudged that his disability did not begin
until after November 30, 2000, when the company was no longer the insurance provider for
employees of Custom Labels, Inc. Prudential determined that his disability began before they
became the insurance provider for Custom Labels, Inc., on December 1, 2000. Plaintiff filed a

complaint in Illinois state court alleging that he was wrongfully denied benefits. On January 30,